AN 



ENCYCLOPEDIA 



OF THE 



PRACTICE OF MEDICINE, 



BASED OX 



BflCTEKIOLOQT, 



J. BUCHANAN, ^I. D. .^ ',^,^' 



FIRST EDITION. 



NEW YORK : 

Published by R. R. Russell. 

1890. 






COPYRIGHTED 

By J. Rttchanax, M. D., 

XKW YORK. 



Press of Avil Printing Co., 

rHILADKLPHl^. 



PUBLISHER'S PREFACE. 



From various considerations it is evident that Good Health in 
a great measure rests upon abundance of pure air and light, good 
food and drink, proper clothing and housing, the daily removing 
by bathing and otherwise the waste matter of our bodies, which 
to each of us is a poison. 

Successive epidemics of preventable and unpreventable disease 
have taught us that if we wish to maintain the highest possible 
standard of health as a nation, wdth a people vigorous and sound, 
we must secure to them the necessaries of life in due proportion 
and of proper purity ; that if we are to prevent disease and degra- 
dation of elementary living matter, there must be no overwork, 
)L0 exhaustion, no mental strain, and all insanitary states, together 
with ^nimal and vegetable waste, must be got rid of as speedily 
and c Tectually as possible. 

The statistics of our country show that the greatest mortality, 
immense waste of human life, is due to the presence of microbial 
diseases. 

The aim and scope ot the present work is to aid in the 
elucidation of the Germ Theory of Disease ; to the introduction of 
Bacte.'icides in treatment, so as to give all scientific physicians 
the means of grappling with maladies which baffled his pre- 
decessors. 

It 13 therefore a Practice of Medicine based upon Bacteriology, 
bringing the science and art of medicine forward as a great na- 
tional prophylactic, not only to prevent the evolution of disease 
germs, but the best means of preventing their dissemination and 
securing their destruction and extinction. 

It is intended as an introduction to the science of Bacteriology, 
and has been written more especially for those who have neither 
the time nor opportunity to pursue a thorough investigation ot 



12 PUBLISHER'S I'KKKACE. 

the subject, our sole aim being to render the work as practical as 
possible. 

Theoretical discussions have been avoided, and as far as possi- 
ble accepted opinions and definite facts have been given. 

The introduction of a New Materia Medica, consisting of Bac- 
tericides or Microbicides, for sterilizing and destroying disease 
germs in and on the body, is an important feature of the work. 

The stamping out of disease germs, the creation of a higher 
type of manhood, the mitigation of human suffering and prolong- 
ing life, are themes which pervade the entire volume. 

The preventing of the dissemination of microbes, and their 
complete extinction, are briefly hinted at by opening up a new 
field of therapeutic success. 

The illustrations of the various Disease Germs are a marvel of 
art, being all microscopic, then photographed, and subsequently 
reduced to ordinary cuts. 

These are the work of two of the most celebrated artists in 
New York city, namely, Adolph Kleminger and Rudy Ortmayer. 
They have faithfully portrayed from pathological specimens, by 
original microscopic views, every microbe found in morbid states 
of the human body. The profession at large can attest their ac- 
curacy. 

The various specimens of morbid anatomy are also the pro- 
duction of those eminent artists. 

The photographing of the entire Eight Hundred Illustrations 
is the work of the Franklin Photo- Electro-Type Company, No. 
305 Pearl street, New York city, the superior excellency of 
whose work is readily demonstrated by any one. 

We owe a deep debt of gratitude to the entire Medical Profes- 
sion of Great Britain and America for specimens of microbes, 
with the results of their culture and sterilization. 

The press-work and binding are the product of the famous 
AviE Printing Company, Nos. 3941-43-45 Market street, Phila- 
delphia, Pa., who are celebrated throughout the world for medical 
work. To Mr. John Avil we are specially indebted for his un- 
swerving, persevering solicitude in passing the work through the 
press. 



INDEX TO ILLUSTRATIONS. 



Abdomen, showing the viscera, 17. 
Acarus foUlculorum, highly magnified, 21. 
Actinomyces, a fungus, micro-parasite, 
23,401. 

A group from human liver, 24. 

The fungus, 24. 

Human liver, 24. 

From the tongue of an ox, 25. 
Alcoholic vapor bath, 588. 
Adipose tissue, highly magnified, 30. 
Amceba of nasal catarrh 168, 389. 

Actively at work, 169. 
Animalcules in drinking water, 237. 
Anthrax in the blood and also in pustule, 

59>39- 
-Vnus imperforate, four varieties, 493. 
Aorta, 733. 

Apoplexy cerebral, clot in base of brain, 
65. 
Spinal clot in cord, 67. 
Aquatic saprophytus, 947. 
Asperillus albus, 934. 
Asperillus niger, three stages of growth. 

755- 
Aural fungus, in three stages of growth, 

755- 
Aural polypus, difterent varieties, 811. 

Bacteria, 390. 

Bacteria pneumonia, 391. 

Gastric fever, 321. 

Rhinoscleroma, 421, 917. 

Pemphigus, 793. 

Magnified, 947. 

Dental caries, 1015. 
Bacillus anthrax in human blood, 59. 

In pustule, 59. 

Alvei in honey, three diagrams, 258, 

943 
Alvei in intestines, 258. 
Amylobacta, 391, 573, 906. 
Comma cholera infanturn, 181, 257. 
Epidemic cholera, 403. 
Cancer, 394. 

Figurans in garden earth, 257, 949. 
Foot sweat, 1013. 
Leprosy, 676, 
Loevis, 935. 



Bacillus Mallei, (glanders) 396,425. 
Megatherium sauer krautj 257. 
Boilied cabbage. 258, 94S, 949. 
Malaria, 323, 405. 
Attacking red discs, 324. 
In pink marrow, 325. 
In oysters, sewage flats, 942. 
Putrid fish, 258. 
Saprogenes, (caries and necro.sisi 

152, 397. 
Scarlatina, 359, 408. 

Large colony, 362. 
Stagnant water, 944. 
Subtilis, (microbe of hay fever) 351 

399- 935- 

Syphilis, 400, 1184. 

Tuberculosis in blood, 397. 

Eye, 571, 1043, 1044, 1046. 

In rectum, 1049. 

On skin, 1053. 1054, 1069. 
Barber's itch, 792. 
Bladder diagram, 871, 977. 
Bladder and Seminal Vesicles, 978. 
Blood corpuscles, 45. 
Brain, 546. 
Breast, (female) 561. 

Calculi gall, vertical section, 108. 
Calculi renal, 112. 
Cartilages in gout, 429. 
Cancer on abdominal wall, 120. 

Of the lip in a woman, 122. 

Breast before removal, 124. 

After removal, 124. 

Scalps, 125. 

Brow, 126. 

Tongue, 126. 

Temporal region, 127. 

Antrum, 127. 

Outer canthus of eye, 128. 

Arm, 129. 

Lung, 130. 

Head of penis, 137. 

Tongue, l^o, 141, 142, 143. 

Neck of uterus, 146. 

Microbe entering os uteri, 147. , .. 

Infiltrating neck of uterus, 147, 14S, 
149- 



14 



INDEX TO ILLUSTRA'lIONS. 



Cancer tilling up its cavity, 150, 

Extehial labia, 151. 
Cholera Bacilli, 403. 

Cocci found in the mouth in Quinsy, 645. 
Comma-bacillus in stools, 257. 

At work in bowels, 184. 

In sewers, 937, 946. 
Concretion, section intestinal, 235. 
Conferva in bronchitis, 99, 406. 
Crenothriiis kuhniana, 946. 
Crystals of cholesterin from gallstone, 

108. 
Cysts in the kidney, 24(). 

Liver, 246. 

Lung, 247. 

Mesentery, 247. 
Cysticercus in the eye, 464. 

Fat of the hog, 778. 

Diphtheric Membrane, 271. 
Diphtheria Pasture Field evolution of 
Germ, 272. 

Embryo Trichinia, 782. 
Human, 832, 833. 
Emphysema of the Lungs, 299. 
Enteritis, Different stages, 557. 
l-'rysipelas, Microbe in skin, 308. 

Fatly Globules in cardiac degeneration, 

I'atty Liver. 312. 
Filaria Sanguinis Hominis, 368. 
Fissure of the Rectum, 370. 371. 
Fistula Rectal, 372. 

Gail-Bladder, filled with calculi, 102. 
Gastritis, Section of stomach walls, 636. 

Chronic, 637. 
Glucose fungus in diabetes, 250. 
Gonococcus in the eye, 571. 

Hair-lip, five different forms, 531. 
Hemorrhage in the kidney, 441. 
Hemorrhoids, internal and external, 

447, 448, 453- 
Hydatids, 462, 463. 

In walls of uterus, 463. 
Voung brw^ds in eye, 464. ^ 

In lung, 466. 
Hydrocele, 467. 
Hydrocei)halus, 469. 
Hymen imperforate, 7 different varieties, 

494. 
Hypersemia of the liver, 595, 597. 
Hypertrophy of the prostate gland, 478; 

2 cuts, 479; 2 cuts, 480; 2 cuts, 481 ; 

2 cuts, 482 ; 2 cuts, 483 ; 1 cut, 484. 
Human ova, 6 and 8 weeks, 832. 



Imperforate Anus, four different forms 

493- 
Imperforate Hymen, seven different forms, 

494. 
Inflammation of the bowels, enteritis, (3^ 

557- 
Influenza, Infusorial Catarrh, 652. 
Itch-mite, 785. 

Kidney, vertical section of a human kid- 
ney, 26. 

Cysts, 246. 

Contracted, 582. 

Three different forms of degenera- 
tion, 583. 

Labor, 841, 842, 843, 844,848, 849. 
Labor Complex, 856, 857, 858, 859, 

860. 
Laryngitis, vertical section membrane, 

592. 
Liver, Congestion, 595. 

Fatty, 1 197. 
Lupus on the cheek, 682. 
Nose, 683. 

Mesentery, engorged with Typhoid Germ, 

.334. 335- 
Microbe of l)oils, 404. 
Actinomyces, 401. 
Cancer, 114. 
Catarrh Uterine, 176. 
Caries, 397. 
Cutaneous, 423. 
Cholera, 185. 
Diabetes, 250. 
Diarrhea, adults, 255,401. 
" infants, 252, 402. 
Diphtheria, 268, 274, 276, 278. 
Dysentery, 280, 281, 282, 403. 
Dengue, 342, 416. 
Dental caries. 397. 
Ecchymosis, 239. 
Glanders, 396. 
Gonorrhea, 407, (3) 1175. 
Hooping-cough. 410, 459. 
Hay Fever, 351, 399. 
Indican, 395. 
Influenza, 404. 
Leprosy, 241, 676. 
Lupus, 681. 
Malaria, 326, 325, 678. 
Measles, 356. 408. 
Molluscum, 693. 
Neurasthenia, 704. 
Puerperal, 348. 
Pneumonia, 391. 402, 403. 
Pemphigus, 790. 
Small-pox. 363, 409. 



|rV|)t;X. TO ILLUSTRATI01\S. 



Microbe of Sj'philis, 1 187. 

Tetanus, 396, 1008. 

Tetragonas, 409. 

Typhus Fever, 401. 

Typhoid Fever, 332, 333, 334. 

Venereal, 1187. 
Micrococci Urea, 39, 157. 

In chains, 348. 
Microsporon Missitissimum, 310. 
Moulds, 948. 
Mouth, 611. 

Nest of Lupus Germs. 681. 

Trichina in muscle, 781. 
Nipple, (oidium albicans) 562, 

Oidium albicans, (aphth;?e) 64, 270, 411, 

562, 612. 
Omentum filled with cholera germs, 691. 
Ophidium Sanguinis in stagnant water, 

946. 
Organisms in the mouth, 1013, 1022. 
Othoematoma in primary stage, 753. 

More aggravated, 753. 
Ova filiaria sanguinis hominis, 368. 
Oxaluria, 267. 

Pericarditis and iis microbe, 616. 

Penis, illustrating three discharges from 

urethra, 979. 
Pigment liver, 592. 
Piles, 447, 448, 453. 
Phlebitis, 651. 

Phosphates and chlorides in urine, 265. 
Placenta prgevia, 850. 
Pleurisy and its microbe, 622. 
Pneumococcus, (pathogenic microbe) 391. 
Pneumonia, 601. 

Prune juice sputum, 602, 604, 605, 
606. 
Pneumothorax, 806. 
Polypoid growths, 808, 809, 823. 
Polypus of the ear, 81 1. 

Rectum, 818, 819. 

Umbilical, 820. 

Uterus, 822. 
Pelvis, (female). 828. 
Presentations in labor, nine diagrams, 852. 
Prolapse of the rectum, 864. 

Utei-us, 867. 
Puerperal fever germ, 348. 

Rectal fissure, 370. 
With piles, 370. 
From syjihilis, 371. 
Rectal fistula varieties, 372. 
Renal hemorrhage infarction of kidney, 

441, 578. 
Rupia, 795. 



SarcincV: ventriculi, i6i, 166, 418. 

Aurantiaca, 934. 
Saccharine fungus of diabetes, 417. 
Scabies, 785. 

Sclerosis in paralysis, 770. 
Section of the molluscum, 693. 

Kidney in meat poisoning, 945. 

Rectal polypus, 818, 819. 

Skin with the trichoplyton, 789. 
Sewer gas and its microbes, 936. 
Side view of female genital organs, 828. 
Spermatozoa dwarfed, 171, 960, 972, 

Healthy, 686, 977. 
Spermatic crystals, 486, 499. 
Spinal cord, 639, 640. 

Inflammation, 640, 
Spirillum plicatile, 411. 

Volitans, 257, 946. 

Marsh, 935, 946. 
Streptococcus of diphtheria, 268. 

Er\sipelas, 308, 414. 

Cerebro-spinal meningitis, 354, 413 

Foot disease, 414. 

Pyogenes, 415, 884, 885. 

Puerperal, 415. 
Stricture of Oesophagus, 994. 

Rectum, 996. 

Urethra, 999. 
Suppuration of liver, 598. 



Taenia Solium, head, neck and 

779- 
Crown of hooks, 780. 
Tinea capitis, 787. 

Tonsurans, 786, 798. 
Favosa, 791. 
N'ersicolor, 790. 
Sycosis, 792. 
I Tongue, 101 1. 

Trichina Spiralis, 781. 
I Tubercle Bacilli, 1022, 1023, 1025, 
I 1032. 

Tumors, Adenoma, 1 1 15. 
! Section of, on breast, 1 1 16. 

i Adeno-fibroma, (3) 1118. 

Adeno-fibroma, sarcoma, 1118. 
i Angioma, (2) nil. 

Cystic of breast, 1098. 
Cystic on neck, 1098. 
Embryonic type, 1095. 
Epithelioma on lip, 1120. 
' Fibroid, 1096. 

In female breast, 1096. 
Fibroma of the cerebellum, icgf) 
Hyahne myxoma, 1098. 
Lymphomata, 1105. 
Myoma, (2) 1 108. 
Neuroma in skin, mo. 
Ovarian dermoid, (3) I no. 



)oinl 



ip t. 



INDEX TO ILLUSTRATIONS. 



Tumors, Ovarian, with lock of hair, iioi. 

Papilloma dermoid, 1113, (3) 1 1 14. 

Pedunculated dermoid, iioo. 

Sarcoma, 1105. 

Sections of, (3) 1106. 

In bladder and in liver, 1107 
ricers, Bacteria in, 1123, 1137. 

Cervix uteri, 1145. 

Discharge from, 1141. 

Duplicate, 1 128. 

Ducts and acini, II32. 

Germs in, Irritable, 1123. 

Hypertropliy with ulceration, 1145. 

Indolent, Bacteria in, 1124. 

Induration of neck of uterus, 1144. 

Internal walls, 1147. 

Intra-uterine catarrh with ulcer,! 146. 

Larynx, 1135. 

Perforating of stomach, 1130. 

Phagedenic, 1126. 

Pus from syphilitic, 1 128, 1141. 

Rectal, 1 141. 

Spores of anthrax in, 1 1 29. 

Tubercular, 1124, 

Tubercular bacilli in, 1124. 
Urine, Uric acid, common form in, 1152. 

Blood m, 1 163. 

Epithelial casts, 1162. 

Fatty casts, 1162. 

Fat globules from chylous urine, 
1 156. 

Glucose fungus, 1154. 

Granular casts, 11 60. 

Hyaline casts, 1 163. 

Leucin, 1156. 

I'hosphate of lime, 1 159. 

Pus corpuscles of, 1158. 

Spermatozoa. 1164. 

Triple phosphates, 1 1 60. 

Tyrosin, 1156. 

Urate of ammonia, ii'Sy. 

Urate of soda, 1157. 
L ric acid crystals, 263. 
Uterus, normal, 646, 829. 

Metritis, 647. 

Internal view, two diagrams, 829. 

Gravid, uterus, two diagrams, 840. 



Varicocele, External appearance, 11 71. 
Result of masturbation, 1172. 
Testicle, natural, 1171. 

Healthy section of, 1171. 
Venereal chancre on lip, 1185. 

Bacillus in lung structure, 1200. 
Of skin, 1207, (41 1 211.. 
I'ubercle, 1207. 
The bone, 1210. 
Microbe in breast, 1185. 
Syphihs, 1187. 

In liver, 1197, 1198. 
Cerebral softening, 1191. 
Dr>- gangrene, 1216. 
Fatty liver, 1197. 
Ichthyosis, 1215. 
Lichen, 1213. 
Microbes, 121 7. 
Micrococcus furfur, (2) 1207. 
Papula, 1 21 2 
Psoriasis, 121 2. 
Rupia, 1 21 2, 121 5. 
Sclerosis of brain, 1191. 
Syphilitic germ in kidney, 1195. 

Bronchitis, 1201. 
Softening of cerebral pulp, 1191. 
Sputum, 1 199. 
Syphilitic microbe — Lepra, 1210. 

of bone, 1210. 
Tenia tonsurans syphilitic, 1207. 
Vegetating condylomata of vulva, 
1203. 
Vesicular emphysema, 299. 

Warts, Vertical section of, 1226. 
Wasting paralysis, appearance of gray 
matter, 771. 

Xeroderma pigmentosa, 1227, 122S. 

Yeast plant in gastric, intestinal catarrh. 
'161. 
Uterine cavity, 175. 

Associated with other germs, 175. 
In intra-uterine catairh, 285. 
In sewer air, two varieties, 935. 



BACTERICIDES CONTAIN TWO HUNDRED ILLUSTRATIONS. 



AN ENCYCLOPEDIA 



OF THE 



Practice of Medicine 



Abdomen. 



The trunk of the human body is divided by 
the diaphragm into two cavities ; the upper beino- 
the thorax or chest, and the under the abdomen 
or belly. Both the cavity and the viscera it contains are in- 
cluded in the term abdomen. It contains the liver, pancreas, 
spleen and kidneys, as well as the stomach, small intestine, colon 
and rectum. The bladder, lower bowel and internal organs of 
generation lie in the lowest part of the cavity, which is called 
the pelvis. The entire abdomen, 
with all its viscera, is lined with a 
serous membrane, the peritoneum, 
which is folded or reflected over 
every organ, keeping them in their 
proper relation to each other. The 
external division of the abdomen is 
into three parts, namely, the upper 
or epigastric region ; the middle 
or umbilical, and the lower or 
hypogastric. These are again sub- 
divided by two vertical lines, the 
side divisions being called the 
hypochondriac, lumbar, and iliac 
regions respectively. 

Diseases of the abdominal vis- 
cera are frequent, and consist 
chiefly of acute and chronic disor- 
ders of the digestive organs or of derangements of the nerve- 
plexus and ganglia there situated. These disorders, ov/ing to 
the presence of innumerable ganglia, and intimate anastomosing 
with the great sympathetic system, give rise reflexly to innumer- 
able cerebral affections. 

Besides, its importance is greatly enhanced as being the seat of 

2 (17) 




Gall-bladder. 3. ir'ylor 
Right Lobe of Live 



Diaphragm, 
end of Stomach. 

5. Duodenum. 6. Great end of Stomach. 
7. Spleen. 8. Piece of Caul, or Omentum. 
9. Pancreas (Sweetbread). 10. Small In- 
testine (Jejunum). 11. Great Intestine 
(Colon). 12. Small Intestine (Ilium). 



1 8 DISEASE GERMS. 

the sympathetic nervous system, the seat or abode of organic 
and emotional life, the abdominal brain, the great sympathetic in 
which our emotions, desires, affections, passions, preside. 



The expulsion of the foi^tus before the seventh 

Abortion, month of uterogestation, or before it is viable, is 
termed abortion ; between the seventh and ninth 
month, a miscarriage. When it once occurs it is apt to recur 
about the same time in subsequent pregnancies. 

Causes. — These are numerous and variable, and are referable 
to the mother or to the foetus and its appendages. The causes 
in the mother may be extreme nervous susceptibility, great debil- 
ity, disease, plethora, faulty mechanism, violent mental emotion, 
fright, passion, violent exercise ; disease germs lurking in her 
blood as tuberculae, syphilis, cancer and those which are the 
factors of fevers ; sexual excesses, racing, jumping, blows ; the use 
of certain drugs as iodide and bromide of potass, sabina, aloes, 
cinchona, cotton root, borax ; thickening of the neck of the 
uterus is a common cause of habitual abortion at four and a half 
months. The causes seated in the foetus are its death, disease 
or rupture of its membranes. 

The ordinary symptoms of abortion are one or more rigors of 
variable degrees of intensity, a disappearance of the morning 
sickness, flaccidity of the breasts, uterine hemorrhage, tenesmus 
or bearing down, flakes of decidua with intermitting pain, and 
other symptoms incidental to parturition. 

Treatment. — This is variable, according to the constitution of 
the patient, but in all cases an effort should be made to prevent 
such a catastrophe if possible, for which purpose the patient 
must maintain the horizontal position in bed, rigidly enforcing 
rest and quietness, with a perfect freedom from care, worry or 
excitement, at the same time uterine tonics should be adminis- 
tered to brace up that organ. The best of these is the distillation 
or wine of the aleteris farinosa, one of the most powerful vitaliz- 
ing uterine tonics in the Materia Medica. This is a remedy of 
unexcelled therapeutic power in toning and bracing up the uterus ; 
it is of the greatest efficacy to all ladies who have that organ in 
any way damaged or suffering inertia, or who happen to be the 
victims of habitual abortion or miscarriage. Its use during preg- 
nancy, especially prior to parturition, renders labor easy and 
speedy, and its peculiar action on the uterine fibres renders 
it a prophylactic against all ulterior results, such as after-pains, 
metria, etc. 

Opium in some form is the remedy to arrest uterine contrac- 



BACTERICIDES. ig 

tions, thus : Opii pulv. grs. x ; Dover's powder and pulverized 
asclepias, of each grains xxx. Mix. Make 1 5 powders, one every 
three hours. No plug or tampon, or any other body should be 
introduced into the vagina unless there is excessive hemorrhage, 
as its presence excites uterine contractions and expulsion of its 
contents. If these means fail, the case should be treated same as 
an ordinary labor. 

This is not a threatened abortion, nor 
Missed Abortion, an imperfect abortion. Threatened abor- 
tion is very common at four and a half 
months, especially if there is the slightest thickening of the neck, 
for when it begins to stretch and emerge into the body, if there is 
resistance, there will be irritation communicated to the fundus 
and contractions. When a woman has threatened abortion, she 
suffers pain, has a bloody discharge, and mouth of the womb is 
opened. An abortion may be threatened and averted, and preg- 
nancy go on in a healthy way. There might be an abortion in 
the case of twins, one aborted and the other remain and go 
on to development. The abortion of one of the twms may be a 
missed abortion, or the miscarriage of one may be a missed mis- 
carriage. 

If the foetus alone, or the entire ovum alone, comes away, the 
woman has miscarried, or aborted ; it may not be complete, but 
imperfect. The ovum may come away alone, without the mem- 
branes, or the after-birth ; or only a portion come away. This is 
always dangerous, as it is liable to give rise to hemorrhage or 
else lead to putrid absorption. This is especially liable to be the 
case if the abortion has been caused by instruments or drugs, for 
then there is always less or more endometritis. Imperfect mis- 
carriage invariably induces endometritis in subsequent life. 

When a woman has a missed miscarriage, or abortion from a 
fright or blows, the natural course of events is as follows : The 
foetus dies, the symptoms of pregnancy are arrested, milk may 
appear in the breasts, there may be a bloody oozing from the 
uterus, or otherwise; if the waters are not dried up, they are ab- 
sorbed, and the contents of the uterus shrivel up and become 
mummified. If the membranes remain entire, absorption is the 
rule, with mummification. The uterus steadily diminishes in 
size, but its contents remain and continue up to the full time, 
when they are expelled. The expulsion is frequently unex- 
pected ; happens while standing or defecating, and the mass, 
shrivelled up in a bundle, or rolled up in a parcel, is expelled. 
The mass is usually fresh, of a brown color, and contains the 
foetus in the centre. 



20 DISEASE GERMS. 

When such a case as the above is clearly made out, the intro- 
duction of a catheter, or catgut bougie, into the uterus for several 
hours, so as to excite contractions, together with quinine and 
caulophyllum to stimulate uterine energy, is indicated. 



A collection of pus in any part of the body 

Abscess, (streptococais pyogenes). The process by which an 
abscess is formed is as follows : A damage of suffi- 
cient violence has been inflicted — capillary vessels relaxed. With 
this partial death exudation of blood products, lymph, and lymph 
degraded into bacteria, pass or flow through. This lymph, if the 
state of partial death is great, or vital force low, may break down as 
it is effused, becoming pus or .purulent matter, or if not so greatly 
depressed, the exuded lymph may remain and form a thickening 
or induration which may remain in the minute interstitial struc- 
ture of a part. 

Effused lymph may remain in a part indefinitely or may be ab- 
sorbed, or may suffer some accidental shock, when it may sud- 
denly break down. The lymph dissolving into pus, making for 
itself a cavity, makes its way to the surface or to some natural 
outlet of the body. 

The breaking down of lymph into pus is invariably ushered in 
by a rigor or chill, and if there be pain, heat, redness, swelling, 
they each change in their character ; pain becomes throbbing, 
heat diminishes, redness changes into a livid color ; swelling be- 
comes soft, flaccid. 

Pus, or the streptococcus pyogenes, may make its appearance in 
a different part of the body from whence it was formed, as in the 
case of psoas abscess in disease of the spine. The pus may find 
an outlet either artificially or naturally, or it may be absorbed, and 
cause blood poisoning. 

In order to prevent suppuration or the formation of pus in a 
cavity, the stimulation over the affected part must be in propor- 
tion to the amount of depression which caused the original lesion 
— or as powerful as the structure of the part will bear without 
causing its destruction ; local stimulation should not only be pow- 
erful, but, as far as the nature of things can, germicidal. Who 
has not witnessed the splendid remedial action, the ozone gener- 
ating power, of turpentine in peritonitis, and pleuritis — the persist- 
ent action of a saturated tincture or oil of lobelia in periostitis of 
the phalanges of the fingers ? 

When the rigor comes, the precursor of abscess, heat and mois- 
ture unremittingly applied are the proper remedies, with free open- 
ings and counter openings to afford a free egress to all purulent 
productions. 



BACTERICIDES. 



21 



The pus of all abscesses is simply the lymph from the biood 
— altered, changed — degenerated into the bacillus pyocyaneus — 
the microbe of pus. 




Acarus foUicu- 
lorum, mag- 
nified. 



This wood cut affords a beautiful illustration 
Acarus of a microscopic parasite residing in the seba- 
FoUiculorum. ceous sacs, and hair follicles of the 
human skin. They are met with in 
almost every person, but most numerous in those 
whose skin and liver is torpid, or in those who 
suffer sexual perversion. They vary in length from 
one-fortieth to one-hundredth part of an inch. The 
head is always directed downwards and when a large 
number is present, they collect into a conical bundle, 
the larger end of the cone being formed by their 
heads. Their number varies from two to three in a 
follicle and in some cases as many as fifteen. The 
parasite posseses eight thoracic appendages of the 
most simple and rudimentary kind ; the mouth is suc- 
torial ; sexes are distinct. 

In order to eradicate this parasite, the liver, bowels, 
skin should be well stimulated, brought into an active 
condition, sexual perversion overcome. On the nose, 
cheeks or other parts where sebaceous glands are 
numerous, after first bathing with warm water and 
drying off, a ten-per-cent. solution of peroxide of hydrogen 
should be applied. 

A perfect arrest of the function of the liver, so 

Acholia. that the various materials from which the bile is 
formed accumulate in the blood, and cause blood 
and brain poisoning. 

It is a state or condition which is extremely liable to occur 
during the progress of almost any acute or chronic disease of the 
liver, but an almost invariable attendant on acute atrophy and 
fatty degeneration, such as is present in yellow fever, in which 
there is a destruction of the hepatic cells, with rapid wasting of 
the gland. 

Acute atrophy of the liver is the direct result of the presence 
of a fungus or microbe in the blood impairing the nutrition of the 
gland, much aggravated by venereal excesses, mercury, alcohol, 
and by mental and physical prostration. 

It is impossible to explain how those microbes, or their spores 
or ptomaines, can cause such rapid metamorphosis in a gland so 
rich in blood vessels, as to cause one-half or more of it to disap- 



22 DISEASE GERMS. 

pear in a few days, without the blood vessels themselves being 
affected. No other disease has the least analogy to it. 

It is most present in chronic alcoholism, where all cases show a 
fatty Hver. Indeed the general pathological condition found among 
all drinkers is interstitial deposits of fat, and an infrequence of 
fibroid tissue. 

Next in order to alcohol comes the germ syphilitica, which acts 
directly as an eating fungus upon the hepatic cells.; the cancer 
microbe eats up the glandular epithelium and thus leads to an 
arrest of function. More rarely is acholia due to chronic inflam- 
mation with either amyloid or fatty degeneration. 

Whether then the cause be microbes or poisons, or plastic 
lymph effused in an inflammatory process, an impermeable state 
of the ductus communis choledochus and an arrest of the capil- 
lary circulation take place. 

An effort at treatment should in all cases be tried. Locally over 
the liver, con. ozone, followed by hot poultices ; internally some 
of the following remedies should be tried: Chionanthus Virg., 
euonymus, with an eight vol, solution of peroxide of hydrogen. 



Inflammation of the sebaceous glands and hair fol- 

Acne. licles, with retention of the gland secretion, which is 
degraded into bacteria. 

The treatment embraces both local and constitutional measures. 

The diet should be very nutritious, but plain, embracing abun- 
dance of vegetables and fruit ; all stimulants avoided, such as 
wine, malt liquors, tea, coffee. Glycerite of sulphur, administered 
in the evenings in sufiflcient doses to move the bowels. 

Boroglyceride paste applied to the patches, over night, is a par- 
ticularly serviceable and efiflcacious remedy. Distillation of jequi- 
rity is also of great value. 

That which is common in young men and women at and sub- 
sequent to puberty is best relieved by dusting on the microbe 
powder during the day, and applying an ointment made thus : 
Iodide of sulphur, grains 25 to one ounce of ozone ointment, or re- 
sorcin jelly. Baths of alkalies, iodine, are invariably of service. The 
liver in all cases should be well stimulated by chionanthus, perox- 
ide of hydrogen. 

The affection is presumably one which is 

Actinomycosis, dependent on the presence and activity of a 

micro-organism. The micro-parasite is a 

member of the fungoid class and consists chiefly of a mycelium 

which divides in a dichotomous fashion, and gives rise by its 



BACTERICIDES. 



23 



spread from a centre to a radiated appearance, whence its name— ^ 
actinomyces — is derived. The circumferential ends of the myce- 
lial sprouts have a flask-shaped swelling. The little masses of 
felted mycelium may be recognized by the naked eye as sul- 
phur-yellow bodies of about the size of a hemp-seed. The disease 
which this parasite is supposed to cause may develop in many 
parts of the body. The most common site appears to be the jaw 
and parts bounding the mouth. The affection in animals has long 
been known in this situation under various names, and has been re- 
garded as a form of scrofula and as a new growth. It is believed that 
the parasite gains an entrance through the medium of a carious 
tooth or some wound of the gum leading to the jaw-bone. There 
is but little to be said of the morbid anatomy of the disease. A 
swelling forms in the jaw, and 
gradually increases in size. This 
tumor in its earhest stages may 
be punctured without any matter 
being let out, although it gene- 
rally has an elastic and semi-fluc- 
tuating consistence. A section 
made into a tumor in the early 
stap"e of its existence shows a 
reddish-white area sprinkled in 
places with gold-colored granu- 
les. Later on abscesses and fistu- 
Ise form, in the discharge form 
which the sulphur-colored bo- 
dies maybe seen. Broadly speak- 
ing, the tissueof the morbid new 
growth, which must be regarded as inflammatory rather than sarco- 
matous, has very much the characters of ordinary granulation tis- 
sue. Actinomycosis may occur primarily in the respiratory tract 
proper. It is localized to the bronchial mucous membrane, giving 
rise to the signs and symptoms of chronic bronchitis, with fetid ex- 
pectoration, in which the actinomyces are often readily discovered. 
Primary localization of the disease is in the parenchyma of the lung, 
from whence it is propagated to the pleura and to the pravertebral 
tissues. Some of the cases have many of the clinical characters of 
empyema with discharging sinuses, and in such cases a complex 
system of fistulse not infrequently undermine^ the morbid tissues. 
The structures in the posterior mediastinum and prevertebral re- 
gions are often affected, and the bodies of the vertebra may become 
carious. In another class of cases the disease begins primarily 
in the intestinal canal. In some of the cases the foci of the dis- 
ease are widely disseminated. The liver, spleen, miuscles of the 




Actinomycosis. 
A nodule is shown composed of round cells, in 
the centre is the clump of actinomyces sur- 
rounded by large transparent cells. Magnify- 
ing power 350. 



24 



DISEASE GERMS. 



back, and muscular substance of the heart, have been shown on 
post-mortem examination to have numerous centres of actinomy- 
cosis. Large abscess cavities may form behind the peritoneum 
as well as behind the pleura, and these may communicate by many 
perforations of the diaphragm. The symptoms necessarily depend 
chiefly on the localization of the disease as well as on its rate of 
progress, and present therefore extremely varied clinical pictures. 




A group X A Zeiss {z=: 3-5 inch; 
shows probably the earhest stage of 
growth : each separate coUeciion of 
lungus consisting of fine filaments 
radiating from a common centre. 




The portion of fungus as seen in 
this cut is older, more matured. Under 
this power some of the filaments are 
apparently thicker than the majority, 
and are club-shaped. 



No doubt the fungus effects an entrance by the mouth, taken 
in with the food, through the medium of a crack, fissure on 
the gum or a carious tooth, and at first appears as a whitish 
nodule looking like tubercle. This nodule becomes the neoplasm, 
the swelling or abscess, a purulent cavity. 

No doubt the disease is transmitted in man very readily by the 

use of imperfectly cleansed 
dental instruments, by the 
cups of public fountains or 
the like. 

There is no structure or 
tissue in the body exempt 
from the entrance of this 
germ ; besides the mouth, the 
crypts of the tonsil, larynx, 
bronchial membrane, lungs, 
intestines, testes, ovaries, 
bones. 

By certain experiments we 
are led to regard the actino- 
myces as the result of a 
highly degenerative change 
in the life history of man. 
The diagnosis rests upon 
the discovery of the small yellow granules in which the fungus 




Acitnomycosis from human liver. 



BACTERICIDES. 



25 



may be detected. The disease must not be confounded with 
extra-peritoneal abscess about the soft tissues of the jaw due to 
carious teeth. 

The fungus bears cultiva- 
tion well in almost any nu- 
trient menstruum — it pro- 
duces the same micro-or- 
ganism by inoculation. 
The form we meet with in 
cattle is the same as what 




Actinomycosis from tongue of ox, for comparison. 



occurs m man. 

The treatment which is 
of utility is a general alter- 
ative and tonic course of re- 
medies, in which germici- 
dal medicaments should 
play an important part. If 
the germ is in the mouth 
peroxide of hydrogen and 
solutions of boroglyceride 
are invaluable ; if in the intestines, resorcin ; if in the bronchi or 
lung, glycerite of ozone ; if in the bones, saxifraga. 

Acti7iomycosis finds a favorable location for breeding in the liver, 
which is often mistaken for cancer or syphilis, but a microscopi- 
cal examination of the faeces indicates its true character. It seems 
quite possible that the weakening of the system by the microbe 
of syphilis, cancer, or by the excessive use of mercury, is a cause 
why it is found in the liver. One thing is certain, the microbe is 
communicated from cattle to man, and passes from man to man 
by contact. 

It behooves us to take all possible means to make a careful diag- 
nosis, and if the disease is recognized in animals it should be at 
once stamped out and not allowed to spread from one to another 
and endanger human beings. 



It has been recently demonstrated 
Addison's Disease, that disease of the suprarenal capsules, 
or what some term Addison's Disease, 
is due almost entirely to an infiltration of those glands with the 
tubercular bacilli. This disease germ, once deposited in the 
suprarenal capsules, grows, and goes through its different stages 
of growth and degeneration, causing chronic interstitial inflam- 
mation and fibro-caseous and calcareous metamorphosis. In the 
early stage of the disease the capsules become enlarged from 



26 



DISEASE GERMS. 



the presence or aggregation of the bacilli. These germs gene- 
rally localize in the centre of the gland, grow and breed outwards, 
usurping its entire structure; as it reaches the vortex, cheesy 
and calcareous defeneration 



change is uniform. In rare 



commences in the centre. This 
cases the bacilli are deposited in 



points or nodules in the glands, which gives it a lobulated appear- 
ance ; whichever it may be, their proper structure is entirely oblit- 
erated, no sign of gland structure is left; on a cut section it 
appears yellow. The structure and functions of the suprarenal 
capsules are the same as the lymphatics, pink marrow and 
mesenteric glands. 

The lesions of the nerve centres of the suprarenal capsules and 
great sympathetic account for the phenomenal pigmentation and 
discoloration of the skin. The spleen is enlarged and softened ; 

the liver, kidneys, lungs, stomach, 
intestines, spinal cord and brain are 
dotted over with tubercle ; even the 
testes and prostate are implicated. 

The blood is anaemic, fibrin dimin- 
ished, red discs altered in size and. 
form, and does not run together as 
normal corpuscles, o w i n g to the 
lymph spaces being crowded with 
tubercle ; the white globules are in- 
creased in number. Lurking deep in 
the vital stamina there is great pov- 
ert}' of nerve force, a paralytic state 
of the vaso-motor fibres of the great 
sympathetic, and, as a consequence,, 
the blood is imperfectly and unequally 
distributed. 

In addition to the discoloration or 
bronzing of the skin, we have the 
characteristic features — anaemia, gene- 
ral languor or debility, with extreme 
prostration, expressed by a loss of muscular power, weakness of 
pulse, remarkable feebleness of the heart's action, breathless- 
ness upon the slightest exertion, dimness of vision, functional 
weakness and irritability of the stomach. The progress of the 
disease is very slow ; melancholia is not uncommon, drowsy,, 
dreamy languor, dizziness, and syncope not infrequent. Heart 
failure predominates all through ; anaemic murmurs are heard 
as the disease advances, the skin becomes a lustrous bronze,, 
and the mucous membrane of the lips and gums are strongly 
pigmented. Sight and memory fail ; convulsions and choreic 




A vertical section of the human kid- 
ney ; a, exhibits the suprarenal 
capsules, which are infiltrated with 
tubercle in Addison's disease. 



BACTERICIDES. 



27 



symptoms, followed by delirium or comatose state. The urine 
is normal in quantity, albuminous ; uric acid, coloring matter 
are in excess with the microbe indicum. 

In eighty per cent, of all cases tuberculosis of the most intense 
character is present. It is regarded as an infectious blood dis- 
ease, more especially common among males in the adult period 
of life, and is found associated with cancer, apoplexy, and waxy 
and fatty degeneration of glands. Numerous cases have recently 
been discovered in which there was no tubercular infiltration of 
the suprarenal capsules at all. 

As the tubercular diathesis is so intense, the germs blocking 
up all the important blood-raising glands, it has generally been 
regarded as incurable. 

All remedial measures, up to the present time, have been in- 
operative. Accepting the theory — a disease of nervous bank- 
ruptcy, with intense tubercular growth — positive benefit, at least 
a great prolongation of life, results from the use of germicidal 
remedies, and a tonic treatment, nutritious diet, the avoidance of 
everything that would debilitate, -with rest in the recumbent pos- 
ture, and the avoidance of all insanitary states. Glycerite of 
ozone, in twenty-drop doses, has been found a most efficacious 
remedy ; alternating with either the glycerite of kephaline or 
tincture of oats, to which quinine and tincture of ignatia have 
been added. The stimulation of the cervical sympathetic with 
concentrated ozone, with general faradization of that nerve, are 
important factors in the treatment. 



Pseudo-leucocythaemia is a peculiar disease 
Adenoma, of the blood, like leucocythaemia dependent upon 
an enlargement or hypertrophy of lymphatic 
glands; glands of neck, axilla, groin symmetrically enlarged, not 
inflamed or fused together ; thoracic and abdominal glands also 
affected. Patient becomes weak, loses flesh, soon out of breath 
on exertion, symptoms of pressure at base of chest or abdomen, 
gradually increasing debility. It is also called Hodgkin's disease, 
or malignant lymphomata. The lesion of this disease does not 
differ from lymphomata. They are divided into hard and soft 
tumors. The soft lymphomata are of an encephaloid consistency. 
Their color is of a reddish gray, studded with spots of extravasa- 
tion. As the glands enlarge, they become confluent, forming a 
large, soft, fluctuating, lobulated tumor. Hard tumors have a 
fibrous feel. 

It is well known that the lymphatics preside over or are car- 
riers of nutrition or lymph, but how they influence the blood in 



28 DISEASE GERMS. 

the production of white cells is unknown. The spleen, lymphat- 
ics, mesentery, suprarenal capsules, and the pink marrow of the 
bones constitute the great lymph channels ; in each or all of 
them when obstructed, damaged or diseased, there is the prevail- 
ing characteristic cropping out — excess of white corpuscles. 

The diagnosis of the disease is not difficult, the swelling of the 
glands in the neck, armpit, or groin are significant; but when 
the deeper glands are affected it is more difficult. In all forms, 
however, emaciation and anaemia are marked and progressive. 
Usually enlarged spleen, palpitation, slight fever, muscular 
weakness. 

A general alterative and tonic course should be tried, and a 
highly nutritious diet will- be found to be the most available 
means in the line of treatment. Change of air, and sea bathing 
when the strength permits, are of advantage. 



The entire lymphatic system, including the 
Adenitis, lymph canals, the pink marrow of bones, spleen, 
suprarenal capsules, mesentery and other glands 
are in health actively at work raising the blood from elementary 
molecules, to leucocytes, thence to red discs. Leucocytes are 
protoplasmic units partly differentiated so as to assume a function 
higher than a mere amoeba, that is, they unite in forming struc- 
tures that have the property of vital endowment in a particular 
direction. All the structures of organic things are made or built 
of cells, and these cells are differentiated leucocytes. The white 
cells have amoeboid movements, and thus change place and form. 
Tissues become active as these movements are differentiated and 
then there are classifications of types of tissues. The respiratory, 
circulator^' and digestive tissues are primordial, and in the first 
of the series of life ; generation is carried out only on the primi- 
tive plan of motion by mere division, as fission, budding, etc. 
In the organic structural animal wherein tissues are so far differ- 
entiated as to be set apart for the performance of certain specific 
functions for the good of the organism at large, the leucocytes 
that form the secretory cells are only slightly differentiated from 
the primitive leucocyte, and their functions are substantially the 
same as the primitive ones, but they have the additional property 
of converting the pabulum of their nutritive material into a func- 
tionating product in a special way. A gland cell is the singular 
thing that is creating out of its own protoplasm a new material, 
using its nutritive substance to elaborate the constituents of its 
secretion. A muscle cell uses its pabulum to differentiate move- 
ment ; a nerve centre cell to differentiate impulses that originate 
reflex movements. 



BACTERICIDES. " 29 

In the treatment of disease we have to do with these differen- 
tiated leucocytes, or modified amoebas. Sometimes the power 
to take oxygen is degraded, or the power to expel detritus from 
the innermost parts is impaired, or the power to rejuvenate itself 
is injured in some way by some adverse state, into other living 
matter. We are ever dealing with primitive elements when we 
approach a living thing, no matter how complex it may be in 
arrangement of its cells and tissues. 

A partial death of a portion of the lymphatic system strikes at 
the root of organic life. An inflammatory condition may arise 
from various causes. 

1. Simple Adenitis. — May be the direct result of a blow, 
walking, absorption of some irritating poison through an abrasion. 
Such an inflammation or irritation is very common at the elbow, 
axillae, knee, groin. The chain of femoral glands may enlarge 
as the result of a wound on leg, foot, ingrowing toe-nail; while 
irritation of the penis affects the inguinal chain (bubo). The 
glands at the back of the neck frequently enlarge when there is 
irritation of the scalp, and the cervical glands become enlarged in 
diphtheria, malignant stomatitis, scarlatina, etc. 

2. Tubercular Adenitis. — In individuals whose vital forces are 
greatly below par, where the tubercular bacilli are present in the 
blood, either as the result of an infection, or a special degradation 
of normal bioplasm into the bacilli, or from both, especially in 
children, the glands of the neck from some irritation will become 
inflamed, irritated, enlarge slowly, suppurate, the tubercular 
bacilli will undergo its usual changes, become caseous then calca- 
reous. If there happens to be irritation of the bowels, the mes- 
entery will take on an analogous condition, become engorged with 
the products of inflammation, and the microbe of tubercle, masses 
or chunks of the bacilli can be felt through the abdominal walls. 

3. The Microbe of Syphilis. — The adenitis which almost in- 
variably accompanies a soft chancre, or a gonorrhea, is very apt, 
if the treatment be not correct, to be accompanied with a viru- 
lent bubo, which comes on about a week after infection ; inflam- 
matory symptoms run high, acute pain, rigors, fever, great 
swelling and sometimes suppuration. The true syphilitic germ, 
in the inoculation, the hard chancre, often migrates to the lym- 
phatics of the groin giving rise to multiple bubo ; as a rule the 
migration of the germ is painless, no suppuration. The indura- 
tion proceeds slowly from gland to gland, in the inguinal chain 
till all are affected. They are never very large, are always hard, 
and can be moved about under the finger. Various other glands 
throughout the body become germ-laden and enlarged, as in 
induratedc hancre of the lip, the submaxillary become indurated ; 



30 DISEASE GERMS. 

in chancre of the fingers in washerwomen the glands of the 
axillae are enlarged. 

4. Cancerous Adenitis. — In whatever part of the body a can- 
cerous infiltration takes place the lymph glands m close prox- 
imity to the aggregation of germs become engorged, partly with 
products of inflammations, and partly with cancer germs. In 
grave cases they become a valuable element of diagnosis and prog- 
nosis. The most common examples are the enlarged sub- 
maxillary in cancer of the lip and tongue, the axillae in cancer of 
the breast. 

5. Adenia, or Hodgkins Disease. — This affection is character- 
ized by an enlargement of all the lymphatic glands of the entire 
body. They often attain great size, but do not suppurate, but 
there is invariably associated with it marked anaemia, vastly 
diminished red corpuscles in the blood, but no increase in the 
white, spleen and suprarenal capsules generally enlarged. 

6. — In the plague, or relapsing fever, anthrax, glanders, 
or farcy, malignant erysipelas, dissection wounds, phlebitis from 
any cause, malaria, bite of an enraged man, etc., there is apt to 
arise a general enlargement of the lymphatic glands throughout 
the body, along with hypertrophy of the spleen, and an increase 
of the white corpuscles of the blood. 

Treatment of all forms of adenitis require great energy and 
sound judgment. Within these few years past, it has been 
clearly demonstrated that the filling up of the lymphatics, as we 
have in adenitis, is chiefly due to the germs of disease, a concrete 
essence, an absolute and visible germ in all cases, whatever the 
form may be. The gland is but a bacteriological colony when 
irritated. So in all cases a rigid germicidal treatment should be 
inculcated, both internally and locally. 

In all cases, comp. saxifraga, phytolacca, iodol, and special 
remedies to sterilize the microbe ; locally plantain leaves, iodo- 
form, sozoiodol, resorcin and ozone ointment ; peroxide of 
hydrogen. 

An animal membrane 
Adipose Tissue, or tissue, consisting of an 
aggregation of minute 
spherical pouches or vesicles, filled with fat or oil. 
The tissue itself is organic and vital, the vesicles 
secreting the fatty matter from the capillary 
blood-vessels with which they are surrounded ; 
the secreted matter or fat is inorganic and ^^'^l^^I^!"^' 
devoid of vitality. The adipose tissue differs 
from cellular or filamento as tissue in having the vessels closed, 




BACTERICIDES. -, I 

•SO that the fat does not ooze through even when fluid. A con- 
• siderable layer of fatty tissue under the skin, over kidneys and 
in or on the mesentery, around large ve7sels and nerves, around 
joints, is not incompatible with a high standard of health. 

Fucus vesiculosus with dioxide of hydrogen strips the muscular 
tissue of a redundancy of fat. 



By this term we mean the presence in the 
Albuminuria, urine of an albuminous body, v/hich is coagu- 
lated by heat or precipitated by neutraliza- 
tion. It was once regarded as a diagnostic symptom of Bright's 
disease, but recent researches have caused it to lose this its primi- 
tive meaning. 

The variety of the pathological conditions under which albu- 
men may appear in the urine is very great, as congestions, 
inflammation, .mechanical obstruction to the circulation of the 
kidney ; whenever disease germs are present in blood as the 
malarial microbe, the bacillus of tubercle, cancer syphihs ; the 
germs of diphtheria, scarlatina, variola, erysipelas, etc. ; in blood 
diseases proper, as anaemia purpura, and also in diseases of the 
heart, lungs, liver, in peritonitis, pregnancy, diseases of the brain 
and spinal cord, in epilepsy and various skin diseases, even after 
bathing. 

For convenience, all conditions in which albumen may be 
found in the urine may be arranged under the following groups : 

1. Congestion of the Kidneys. — Congestion of the kidneys 
may result from a chill to the skin, as in bathing, exposure to 
cold ; from the elimination of some irritating poison, such as 
alcohol, uric acid, phosphorus, lead, cantharides ; from the 
direct action of a microbe blocking up the kidneys, as we have in 
scarlet fever, diphtheria, typhoid, variola, erysipelas, or from vaso- 
motor paralysis, the result of a concussion of the spinal cord. 

Passive congestion may result from cardiac, pulmonary, 
hepatic disease; or from peritonitis, pregnancy, or from heart 
failure in anaemia. 

2. Acute or chronic inflammation, as w^e have when the grlands 
are literally blocked up with disease germs. 

3. Degeneration, fatty, amyloid, cystic, forming deposits, 
usurpation of normal structure, with softening or thinning of the 
renal arterioles. 

These are some of the causes, and it would be interesting to 
discuss the mechanism by which albumen passes into the uri- 
nary secretion, and what causes the transudation. Is there a 
physical change in the lining membrane, or is there some altera- 



32 



)ISEASE GERMS. 



tion in the blood pressure, or the rapidity of the blood current? 
Ill all the states mentioned, from simple congestion up to con- 
tracting kidney, the walls of the glomeruli are actually perme- 
able, permitting the passage not only of thin fluids and colloids, 
but even of semi-solids, and this too in parts of the kidney pre- 
senting no recognizable structural alterations. Even a slight 
relaxation temporarily induced will give rise to albuminuria, and 
it may occur in dyspeptic people, in weak, overgrown persons, 
without being an indication of actual or potential renal disease. 
To arrest the escape of albumen, in addition to general tonics 
and nutritious diet, try first nitro-glycerine, then either erigeron 
or gallic acid and port wine ; or convallaria maidis ; or ergot, or 
corn smut ; or aromatic sulphuric acid and quinine. 



This is met with either acute or chronic. 

Alcoholism. In acute alcoholism, the mucous membrane of 

the stomach and duodenum is greatly congested. 
Patches of aphthcTe ioidmnialbicans) are formed upon it, and the 
mucous membrane of the stomach is covered all over with a thick 
ropy mucus, heavily loaded with the sarcinae ventriculi, slightly 
tinged with blood. The gastric juice is altered in quantity as well 
as quality. The brain, lungs, kidneys are congested and the 
pericardium and pleura are filled with bloody serum. In cJironic 
alcoholism, tliere are always and invariably present chronic gas- 
tritis, congestion or cirrhosis of the liver, emphysema, or tuber- 
culosis of the right lung, fatty degeneration and dilatation of the 
heart, atheroma of the blood vessels and interstitial nephritis. As 
the whiskey in the blood circulates as a free agent, it irritates and 
degenerates every organ, gland and tissue of the body, retards 
their working capacity, and arrests the normal metamorphosis. 
The poison has a special action on the brain, inducing in all cases 
chronic inflammation, with effusion of lymph, which causes thick- 
ening of its entire substance ; besides the brain is literally steeped 
in the poison, which withers, whittles down the organ to a mis- 
erable state of atrophy, an anaemia. In long standing cases, cer- 
ebral softening occurs, and in such the viscera are fatty, the sub- 
cutaneous tissue and omentum being loaded with that non-vital 
element, if they are beer, ale or wine drinkers ; while those who 
drink spirits are thin, spare, prematurely old, on account of the 
increase of the connective tissue. 

Perpetual drinking gradually induces a tubercular diathesis, 
with the tubercular bacilli in blood. The blood in chronic alco- 
holism besides contains more fat than normal ; one of the first 
effects of the alcohol is a true chemical combination with nerve 



BACTERICIDES. 



33 



tissue, and as the ingestion of spirits is constant, both the gray 
and white progressively atrophy and harden. This is hastened 
by a state of poor blood. 

Differential Diagnosis. — The greatest care must be exercised in 
making a diagnosis. The coma of alcoholism must never be con- 
founded with that due to nrcemia, or apoplexy, or opinm, or any 
other form of cerebral irritation. 

In inflammation of the brain, we have the firm, hard pulse^ 
pyrexia, retracted abdomen, and that agonizing headache aggra- 
vated by noise, light, heat, motion, photophobia, all of which are 
absent in alcoholism. 

Alcoholic tremor has often been confounded with shaking 
palsy, locomotor ataxia, and softening of the brain. 

Prognosis. — If the patient is manageable, usually good. Death 
may occur in the acute form from active gastritis, or lobular 
pneumonia. Danger of passing off in a comatose state or from 
apoplexy. In chronic alcoholism there is always danger from 
chronic gastritis, ulcer of the stomach, degenerative changes in 
the brain, blood vessels and nerves, fatty liver and kidneys — 
w^hich predispose to a long list of diseases that tend to shorten 
life. Insanity, impotence, epilepsy, organic brain disease are its 
frequent sequelae. 

Treatment. — In acute maniac delirium, wash out the stomach 
by a copious emetic of infusion of lobelia leaves and bicarbonate 
of soda, in repeated doses until free emesis is effected, hot infu- 
sion of capsicum between each dose, getting full free emesis, if 
possible ; follow this with a saHne purge, and warm bath, followed 
by friction and massage to the entire body. Subsequently in- 
duce sleep by repeated doses of sulphonal in 30 grain doses — 
dose to be repeated every half hour. 

If sulphonal does not succeed, then try 1 5 grains of chloral 
hydrate with 15 grains of bromide of potassa in syrup of orange 
peel, which can be repeated. If this is not successful, then a 
hypodermic injection of ^ of a grain of sulphate of morphia. 
There must be a remedy selected and administered to procure 10 
or 12 hours of profound sleep. 

On arousing from this sleep, the patient should be placed upon 
large doses of capsicum in alternation with tincture of green root 
of gelsemium or digitalis. At the same time abundance of fluid 
nourishment should be given, as essence of beef. The patient 
should be kept quiet, and diffusible stimulants like capsicum, 
prickly ash, ammonia, administered till he is tided over the crisis, 
when coca et celerina should be administered in teaspoonful 
doses every three hours, to appease or satiate the appetite for 
stimulants. Such is the most efficient treatment. 



24 DISEASE GERMS. 

The effects of the prolonged use and abuse of alcohol are most 
disastrous in the production of a deteriorated race; in the 
creation of a type of nervous diseases of the insane group. 



A partial or complete deficiency of hair usually 

Alopecia, results from the presence of disease germs in the 
blood, or from indirect starvation of the follicular 
or peri-foUicular tissues inducing a state of atrophy. 

The epidermis suffers from defective nutrition, the derma con- 
tracts, hair follicles shrink, become patulous ; efforts may be 
made by the nuclei, and abortive results at hair formation may 
be recognized at the base of the hair sacs. 

The correct treatment of alopecia consists in imparting to the 
blood the elements of which the hair is made, such as avena and 
glycerite of sulphur, then stimulation to excite a state of hyper- 
aemia in which growth results ; this involves bathing, friction, rub- 
bing, shampooing, etc., simply damping the scalp with the ozone 
hair restorer. 

A scanty crop of soft, short, downy hair is peculiar to the mi- 
crobes of syphilis and tuberculae, and requires germicidal treat- 
ment and the local application to the hair and scalp daily of the 
following : 

Ty Ozone ointment, . . . . . i ounce. 

Oil of boroglyceride, .... 3 drachms. 

Resorcin, ...... i drachm. 

Chrysophanic acid, . . . .10 grains. 

Mix. 

In the treatment of those cases no remedy has a higher and 
more established value than the Ozone Hair Restorer. 



Partial, or complete amaurosis, or loss of 

Amaurosis, or vision from some disease of the retina, optic 

Blindness. nerve, or brain, the optical instrument, the 

eye, being in a normal or healthy condition. 

The causes that are likely to affect the brain, optic nerve, or retina, 

are embraced under five distinct heads, viz., anaemia, hyperaemia, 

reflex irritation, poisons, organic changes. 

Ge7teral Symptoms. — Partial or complete loss of vision, without 
effusion in the cornea or on lens, or any form of opacity. This 
impairment of vision naturally gives the gait and countenance a 
peculiar expression. He walks with an air of uncertainty ; his 
eyes, instead of being directed to surrounding objects, have an 



BACTERICIDES. ^^ 

unmeaning look, appear to be staring at nothing, or are in constant 
rapid motion. In partial amaurosis, movements of the iris slug- 
gish, and pupil dilated ; in total blindness, pupil greatly dilated, 
and iris immovable. When both eyes are affected, they are often 
unnaturally prominent, and of an unhealthy color, the sclerotic 
being often yellow and covered with varicose veins. 

An examination of the eye with the ophthalmoscope usually 
reveals inflammation of the optic nerve, changes in the retina or 
brain. Those changes are variable, consisting chiefly of relaxa- 
tion, effusion, thickening deposits and extravasation. Another 
class seems to depend on atrophy, or wasting of the retina, optic 
nerve, or brain. This atrophy may follow neuritis, or exist with- 
out. When due to tobacco, this shrivelling up or whittling down 
of retina and optic nerve proceeds to utter blindness without in- 
flammation being present. 

1. Blindness due to anceniia will exhibit an impairment of 
vision, with all the symptoms of a diminution of red corpuscles in 
the blood, as vertigo, ringing in the ears, specks or spots before 
the eyes, pale face, lip, tongue, murmurs in the left carotid, and 
general debility. The causes that lead to this may be meagre, 
poor, or bad food, absence of sunlight, over-work, drugs, disease, 
fevers, long or excessive nursing, want of exercise, sexual excess. 

Best cured by a removal of cause, building up of blood with 
abundance of best of food, fresh air, exercise, and by using com- 
pound tincture cinchona and mineral acids, or pill quinine, iron, 
hydrastin, nux, sulphate quinine and aromatic sulphuric acid. 

2. Blindness due to congestion or plethora^ or over-feeding and 
stimulation, with all the symptoms of that condition. 

Best treated with removal of cause or causes, free purgation, 
heat to feet, blisters to nape of neck, followed by irritating 
plaster; alteratives, as iodide of potass in syrup of stillingia or 
Phytolacca ; and even here, cinchona or its alkaloids, because we 
have no drug equal to it in restoring the integrity of the optic 
nerve. 

3. Blindness may be due to reflex irritation, as the irritation of 
teething, worms, ovary, uterus, pregnancy, but more especially 
self-pollution, or masturbation — this latter form usualh- common, 
as all the inmates of our prisons, refuges, asylums, boarding- 
schools, retreats, are addicted to this loathsome and degrading 
practice. Nearly all the young and middle-aged men and women 
to be seen on our streets with defective vision and glasses, have 
been inmates of some charitable college or institute, and exhausted, 
drained off, their nervo-vital fluid, and obliterated the finer cere- 
bral convolutions of their brain, and are partialh- blind. The 
origin of the optic nerve being in the spinal cord, medulla, and 



36 



DISEASE GERMS. 



brain, the reflex centre, or bulb, suffers intensely, and the whole 
process of growth is arrested, and the perpetrator becomes a 
miserable victim of self-conceit, egotism and puniness. 

Cured upon general principles, by removing cause, and treating 
for masturbation and for the e)'e ; stinmlants to nape of neck, 
quinine, glycerite of ozone, kephaline and other tonics. 

4. Blindness may be due to poisons, as tobacco, chloral h)'drate, 
opium, whiskey, belladonna, conium, syphilis, mercury, and the 
use of hair dyes and cosmetics, as the nitrate of silver, lead, 
bismuth, which act very disastrously upon base of brain along 
the ophthalmic tract. Much of the defective vision to be seen is 
due to the use of those agents. 

A discontinuance of the use of the poison, with ^ general 
alterative and tonic course, is usually sufficient for a cure, if seen 
early and persevered in. 

5. Blindness may be due to organic changes in the retina, 
optic nerve, or brain. — These changes may be inflammatory, and 
proceed on to softening of the nerve or its branches, or due to 
atrophy from ansemia or want of nutrition. This is the most 
hopeless form, as white softening, or ramoUissement, is an irre- 
parable affection. 

General Treatment. — In all cases, if it is possible or practicable, 
the following plan of procedure should be carried out : 

The bowels regulated ; skin stimulated with daily baths ; two 
open sores at nape of neck, one inch square, on each side of the 
spinal column ; flannel clothing ; appetite to be stimulated and a 
diet consisting of animal food, eggs, white-fish boiled, oatmeal 
porridge and cream — a brain diet, an important factor in a case. 
As the optic nerve not only originates in the spinal cord, but is 
freely blended with the medulla, the seat of reflex action, morn- 
ing and night all the peripheral extremities of the nerves of the 
entire superficial portion of the body should be stimulated from 
half an hour to two hours with friction, shampooing, palpation 
and electricity. This faithfully performed, raises the standard ot 
vitality of cord and bulb, and the patient sees better at once or 
after a few applications. The medical treatment is the same as 
for chronic inflammation and softening of brain — alteratives and 
tonics, iodide of potass, cinchona, and especially the ozonized pre- 
parations, as they tend to cleanse brain and optic nerve of all 
extraneous substances ; glycerite of ozone, ozone water, kepha- 
line. Treatment to be persev^ered with for six or twelve months ; 
change of air and scene often of utility ; other cases benefited by 
rest and quietness, especially those caused by exhaustion and 
nervous debility. 

If a real organic change has taken place in the optic nerve, all 



BACTERICIDES. 



37 



remedies are useless. In all cases there should be an avoidance 
of all malt or alcoholic liquors ; all acro-narcotic drugs, especially 
tobacco, and hair dyes or tonics ; and sexual congress only per- 
mitted at rare intervals. Probably of all causes that give rise to 
the great frequency of organic amaurosis, tobacco, sexual excesses 
and syphilis are the most common and detrimental, and most 
likely to produce degeneration of the optic nerve. 



An absence of the menstrual flow. It is 

Amenorrhcea. met with under two forms : 

I. Retention of Menses, — This may de- 
pend on a variety of congenital conditions, as arrested develop- 
ment, organic affections, malformations, such as absence or 
atrophy of ovaries, uterus. Those organs may be present, but 
vagina may be absent, or suffer occlusion, so that if the menses 
are secreted, they cannot find their way out. It may depend 
on some disease of brain, spinal cord, or blood. A large per- 
centage of such cases can be rectified either with medical treat- 
ment or some surgical proceeding. 

2. Suppression of Menses. — This is the most common form of 
amenorrhcea. The flow having appeared, been properly estab- 
lished for a while, has, from some cause, become suddenly arrested. 

The front part of the uterus being very profusely supplied 
with branches of the sympathetic nerve in highly-civilized females, 
the menses, while on, are liable to cease or stop from violent 
emotion, grief, anxiety, or from cold, damp, exposure. 

Instead of ceasing suddenly, as in those cases, it may disappear 
gradually, returning at the proper time, but becoming less and 
less, and then entirely stopping. It is liable to cease in acute 
and chronic disease, as in fevers, blood-disease, especially anaemia, 
cancer, tuberculosis, albuminuria. In all cases the greatest care 
should be observed, so as not to overlook pregnancy. The sup- 
pression is always attended with some constitutional disturbance ; 
great, if sudden ; not so well marked, if slow and gradual. 

Treatment. — If the case is seen at once during an attack of acute 
suppression, there should be an effort made to re-establish the 
flow, by alcoholic vapor-bath, with hot mustard foot-bath ; put to 
bed between blankets, with hot bricks to feet, and dry heat to 
vulva or over bladder, consisting of baked bran, or hops, or 
chamomile flowers, in bags. Aconite, with compound tincture of 
serpentaria, administered internally, with infusion of pennyroyal ; 
no cold drinks nor ice. If several days have elapsed, it is useless 
to try the above, or any other means, but begin at once and pre- 
pare patient for next period. Bowels should be regulated, cloth- 
ing warm, flannel round waist and hips, warm foot and hip-baths, 



38 



DISEASE GERMS. 



nourishing food. If there is any special disease it should be at- 
tended to, especially anaemia, with acetate of iron three times 
daily, with cinchona and mineral acids ; and about a week before 
the expected period, begin with the compound betin pill, one or 
two three times a day ; and if the case is stubborn, put mustard 
plasters on the nipples, for a short time before bedtime, for one 
or two nights. The compound betin pills excel all drugs in 
their mildness, efficacy, and certainty ; they arouse the inert, 
sluggish uterus into active life, restore its natural movements, 
and impart tone and vigor ; they are our best emmenagogues, 
and excel all other drugs in their prompt action. They super- 
sede entirely those old and deleterious drugs, such as cotton- 
root, savin, aloes, ergot. As soon as the flow is established they 
are to be stopped, and resumed the following month about seven 
days before the expected period. Ladies who suffer from habi- 
tual suppression, or where the flow is scanty, or who dread early 
suppression, can maintain menstrual activity for a long length of 
years, and thus keep the freshness of youth in their nervous sys- 
tem and skin indefinitely. Of the long list of remedies noticed, 
there remain caulophyllin and pulsatilla, and of these much can 
be said of a favorable nature. Caulophyllin, the resinoid pre- 
pared from 'caulophyllum thalictroides, known under the various 
names of squaw root, pappoose root, blue berry, has been recog- 
nized as a valuable therapeutic agent from very early times, and 
has been highly spoken of by many physicians of note. Its 
name, " pappoose root/' suggests the uses it was put to by the 
natives long before the cultured minds of our present physicians 
investigated its properties and catalogued its claims. There 
seems to be a a;eneral agfreement among^st those who have studied 
its action that its effect is chiefly felt by those motor nerves 
which are connected sympathetically with the menstrual organs, 
and that this action is of a sedative character, allaying that irrit- 
able condition of the generative system which so often lies at the 
root of functional irregularities. As a remedy in these derange- 
ments, in " irritable neurotics, '^ especially when they are marked 
by disturbances in the sacral plexus, it has undoubtedly acquired 
a sounder reputation than most of its competitors, and deserves a 
permanent place in the select circle of approved remedies. But 
its action, although often favorable when administered alone, is 
much more reliable when given in combination with pulsatilla 
(anemone pidsatilla, Pasque flower), which has long been known 
as a popular and effective remedy in uterine functional derange- 
ments. As Pulsatilla increases the beneficial action of caulo- 
phyllin, so the latter increases the action of the former, and it is, 
therefore, when they are both combined that we get the most 



BACTERICIDES. 



39 



perfect emmenagogue that our present state of knowledge has 
yet suggested. Indeed, it is not too much to say that this com- 
pound emmenagogue redeems from the charge of imposture the 
reputation of its dilapidated class. 

Vicarious Meiisiruation may occur as a form of amenorrhoea ; 
that is, the menses may be suppressed at the vaginal orifice, but 
are thrown off by the nose, mouth, eyes, ears, or blood-stains by 
the skin, by ulcers or by necrosis, if present, or by odors about 
umbilicus, or eruptions. 

The real cause of vicarious menstruation is either inertia or 
atrophy of the uterus ; so great that the uterine wave is abolished 
or abrogated. The cure consists in stimulating the uterus with 
hip-baths, horseback exercise, or moderate walking exercise, the 
betin pill, massage, iron, pulsatilla, cinchona, and most nourish- 
ine food. 



The prolonged retention of urine in the 

Ammonaemia. bladder over a definite time results in its de- 
composition, in a change of its constituent 
elements, the most prominent of which are a fungus and carbon- 
ate of ammonia, which are taken up into the circulation, produc- 
ing a special form of blood-poisoning. The retention of the urea 
and its conversion into carbonate of ammonia give rise to cystitis, 
a catarrhal and dysenteric state of the bowels, in which a greenish, 
alkahne, yellow fluid is passed from the bowels, with abundant 
spores of the fungus. 

The causes which give rise to this state of fungus growth and 
decomposition are stricture, en- 
larged prostate, paralysis or 
atony of the bladder, pyelitis, 
sacculated kidney, cystitis, etc. 

Old or young men, with en- 
larged prostates are the victims p „ "^S^f ^'^'?,\f ^ 
of this malady. '^%^^>^ / - <W.'^fi 

It is an affection which can- (^ ^ jp^ ^ ^ " 




not be mistaken, even by the ''5*^'^°*«P' .. ^«>**<ito' 



most superficial observer : the 
retention of urine, or, if a drib- 
bling^, its ammoniacal odor, ^^. .,,, , . , • ^ t, 

., ?. . . . ' Micrococci Urese (of ammoniacal unne). rresent 

alkalme reaction, COntammg in cystUis, and is found in great abundance in 

:«-.*^^.,o^ ^,^^,^4.^ ^C ^U^^ the blood and in all the vital organs of the body, 

immense amounts OI phOS- in ammonaemia. 

phates ; the breath and skin 

are also highly ammoniacal. If no relief is afforded, there are 
rigors, vomiting, fever, with strong typhoid aspect ; tongue dry, 
brown, shining ; complexion sallow, ding>' brown ; headache ; 



40 



DISEASE GERMS. 



insomnia ; and, as the blood becomes more crowded with the 
spores and carbonate of ammonia, insomnia is more persistent; 
restlessness gives rise to somnolence, lethargy, with low, mutter- 
ing delirium, with the ammoniacal odor more intense. 

The most important point in the treatment is the removal of 
the cause ; but as atony of the bladder and enlarged prostate are 
the common causes, time is needed. The patient must have im- 
mediate relief, or death will ensue. Relief is best afforded by 
the introduction of a catheter and draining off of every drop of 
the ammoniacal urine, subsequently injecting the bladder with a 
tepid germicidal solution of either boroglyceride or peroxide of 
hydrogen — if the latter, a few drops to the pint. This proceeding 
must be resorted to even when the patient seems to be sinking, 
because the moment the bladder is washed out a rapid improve- 
ment takes place. 

The bladder must thus be emptied and washed out daily, and 
the patient placed upon the proper doses of either peroxide of 
hydrogen, or ozone water, or comp. oxygen, to neutralize the 
excess of ammonia present in the blood. Virginia stone crop 
operates well in alternation with the uric acid solvent ; the pichi 
in that last compound operates in all cases most favorably ; they 
should be used persistently. The enlarged prostate must be got 
rid of, and till that is effected, the urine must be drawn regularly 
off. I have found the following formula to be unexcelled to get 
rid of an enlarged prostate ; thus, say about 7 p. m. insert one 
cocaine suppository ; allow it to remain ; before retiring wash 
out the rectum with about half-a-pint tepid solution of boro- 
glyceride, which is to be passed off; as soon as that is effected, 
inject one tablespoonful of the following : 

'^i Ozonized distillation of hamamelis, . . .^iv; 

Papoid, grs. xxxii. 

Mix. 

This is to be permitted to remain over night. This mixture of 
ozonized hamamelis and papoid acts energetically upon the 
effused lymph which, in the process of chronic inflammation, has 
been effused into the interstitial structure of the prostate. 

To be effective, it must be applied as above. The cocaine sup- 
pository produces anaesthesia of the prostate, a state most favor- 
able for the dissolution or absorption of lymph. Follow it in 
about two or three hours with the papoid mixture. Peroxide of 
hydrogen has also been most successful. 



BACTERICIDES. 



41 



Or waxy or starchy usurpation of structure, 

Amyloid De- is a peculiar affection occurring only in indi- 
generation. viduals who have suffered long from the pre- 
sence of the microbe of syphilis, the bacilli 
of tubercul?e, the micro-organisms of cancer ; prolonged osseous 
suppuration. This form of degeneration is decidedly an attend- 
ant upon old sores, wherever there is pus or muco-purulent mat- 
ter present in the body, as in empyema, chronic bronchitis and 
pemphigus, malignant variola, dysentery, ulceration of the blad- 
der, phosphorus necrosis. 

Besides, amylosis occurs sometimes in chronic gout, rheumatism, 
malarial poisoning, alcoholism. 

Although this appears to be the field of origin, still there is 
some mysterious cause, some terrible wreckage of- vital ele- 
ments, which so degrades or alters the living matter of our own 
t)odies into a disease germ, w^hich in some manner evolves starch 
granules or molecules ; these are carried by the blood through- 
out the entire body and deposited only in weakened parts and in- 
crease in bulk by aggregation of molecules. 

The microbe, which is present in all cases of amylosis, and 
Avhich is pathogenic of the disease is : 

The BacilliLS Pyocyaneus. — This microbe is present in the blood 
in all cases, but is most abundant if pus or muco-purulent matter 
be present, especially if that be of a greenish color. Taken either 
from pus or blood, it appears in the form of slender rods, linked 
in twos or threes, or collected in irregular masses, spore formation 
present and active. Easily cultivated in liquid gelatine, in twenty- 
four hours the culture has the greenish appearance of pulp. The 
pigment or coloring principles is '' pyocanin!'' 

Micrococci can be extracted with chloroform from the pus or 
washing of bandages — the microbes crystallize in the same fluid 
in the form of needles, rods, prisms. 

The injection of this microbe into animals gives rise to amyloid 
degeneration. 

The bacillus pyoganeus which gives rise to this species of degen- 
eration is not a carbo-hydrate, but a nitrogenous body. The 
heart, spleen, intestines, liver, kidneys are most frequently affected 
— each one besides may be complicated with the presence of other 
germs, or the amyloid germ may exist alone. 

The symptoms of general amyloid degeneration, present noth- 
ing very distinctive. Great and progressive debility, pale, waxy ap- 
pearance, inability to get around, urine abundant, of low specific 
gravity, small amount of albumen, paraglobunuria, hyaline casts. 

The treatment of amyloid degeneration is not by any means 
■encouraging. The removal of causes is most important as the 



42 DISEASE GERMS. 

destruction of the germs of syphilis, tubercles, cancer — any 
suppurating focus, by a general alkaline and tonic course — but 
when the proper structure of an organ is once usurped by starch 
granules it can never be restored. 

Amyloid degeneration naturally takes place on the coats of arter- 
ies, which carry the starchy, products in the blood, small arteries, 
especially the renal glomeruli, also the vessels of the spleen, liver,, 
intestines and lymph gland. 

Waxy degeneration of the intestine is usually a complication or 
waxy kidney and liver. The primary seat of amyloid deposit in 
the intestines is the arterioles. The small intestines are much 
more frequently than the large. When it takes place it entirely^ 
destroys the secreting faculty of the absorbents, causes the 
mucous membrane to become pale, shiny and slightly oedema- 
tons ; on the application of the iodine test, small maroon-colored 
spots appear in the villi, where the earliest changes occur; later 
oa the entire muscular coat becomes involved, until finally the 
•entire walls of the intestine are fused into one homogeneous mass. 
Generally infiltrated of the solitary glands ; Peyer's patches are 
less affected than the surrounding tissues. 

TJie symptoms of amyloid intestinal degeneration are usually 
masked with those of waxy liv^er and kidneys with which it is. 
invariably associated. 

A general amyloid degeneration of the intestinal tract exerts a. 
potent influence upon the general nutrition of the body — great 
exhaustion, emaciation, anaemia — a serous, persistent diarrhea 
are the best points in diagnosis. 

Amyloid Degeneration of the Spleeji. — The causes which give 
rise to waxy spleen are the same as predispose other organs to it^ 
as the germs of syphilis, tuberculae, cancer, chronic alcoholism,, 
malaria, etc. 

It is found deposited either through the entire spleen, or in 
nodules, or granules in large quantities, which causes the enlarge- 
ment. On cutting the speen, it is crispy, smooth, sh-ining and 
gives the characteristic reaction to iodine. 

Late in the disease anorexia, vomiting, hemorrhages. 

Amyloid Degeneration of the Kidneys. — Chronic intestinal 
nephritis, invariably precedes starchy deposit in the kidney — it is 
a weakening process which permits an exudation from the blood, 
and is effused into all weakened structures simultaneously. The 
primary causes we have stated. When the deposit takes place in 
the minute arteries, the secreting tubes and cells soon become 
involved, waxy products appear on isolated patches, when an 
increase of size takes place, the kidneys become hard, crispy — the 
change is most marked in the malpighian tufts. 



BACTERICIDES. 



43 



The increase of size is due entirely to the presence of starch 
bodies, which look like grains of boiled rice. All parts, the 
glomeruli, arterioles, veins and basement membrane of the tubules 
become infiltrated. In addition, fatty granular and hyaline bodies 
are found. 

However slight or indistinct, the iodine test is most reliable — 
placed upon the degenerated tufts, it always gives the character- 
istic iodine reaction. 

The usual method of the disease making its appearance is as 
follows : An individual suffering from tuberculse, syphilis, cancer, 
rheumatism or some suppurative disease, begins to realize that he 
is losing flesh, strength, becoming weaker, more feeble, loss mental 
and physical, a general goneness on very slight exertion, short- 
ness of breath, has a very pallid, waxy countenance and passes a 
very largely increased amount of urine — being compelled to rise 
several times during the night in order to pass it and in large 
quantities ; weight in the upper part of the abdomen, with a gen- 
eral fulness, with enlarged liver, spleen and kidneys ; oedema at ' 
the ankles, indigestion, occasional vomitings. Such a train of 
symptoms are significant, together with the altered, pale, waxy 
complexion. 

The usual increase in the quantity of urine is up to about lOO 
ounces, with a very low specific gravity of 1005. Very little dropsy. 

The nephritic trouble is simply an emunctory of the body 
weakened ; anatomical changes due to a usurpation of the 
structure of a gland by starch. Recovery is impossible. It may 
be arrested, retarded, but never cured. 

Our best remedies consist in a general alterative and tonic 
course, pushing special remedies, such as the iodide of potassium, 
iron and nux vomica. 

Amyloid Degeneration of the Heart. — Waxy degeneration is 
never met with except in connection with similar changes in 
other organs of the body, and is invariably due to a constitutional 
cause ; it consists in the formation of a shining homogeneous sub- 
stance in the primitive muscular fibres, which gives the reaction 
of amyloid material. It is most frequently met with in the walls 
of the right ventricle, causing its cut surface to present the char- 
acteristic appearance of waxy metamorphosis. The primar}- 
changes take place in the connective tissue surrounding the mus- 
cle-bundles. 

The presence of the syphilitic germ is the primary cause. 

The principle symptoms attending it are cardiac failure, with 
waxy degeneration of other organs, as the liver and spleen. 

Cardiac failure, with a syphilitic taint, affords good reason to 
suspect starchy degeneration. 



44 DISEASK GERMS. 

The treatment, a general alterative and tonic course, with 
strophanthus, convallaria and other remedies to strengthen the 
heart. 

Amyloid Degencrction of the Liver. — Seventy-five per cent, of 
all cases of waxy liver occur in males between 30 and 50. The 
presence of the microbe of syphilis in the interstitial structure of 
the liver is undoubtedly the chief cause. Malarial germ saturation 
of the liver is also a very prominent cause, as well as prolonged 
suppuration of bone and the micro-organism of tubercle in lung. 

The degenerative process begins in the walls of the capillaries 
and minute arteries. The microbe causing the pecular blood 
changes gives rise to the deposit of a substance resembling albu- 
men in its reaction. Its reaction is characteristic, a watery solu- 
tion of iodine changing it to a deep red-brown. The liver is always 
enlarged, hard, like a stone, non-elastic, and its substance some- 
w^hat heavier than normal. The liver cuts with a creaking sound, 
like bacon, hence the name lardaceous is applied to it. 

Its advent is never well defined — rather obscure — occurring as 
it almost invariably does with other wasting diseases of the body. 
A sense of weight, fulness and constriction in the right hypochon- 
drium, never amounting to pain, great discomfort; jaundice, ascites 
are not essential symptoms. When jaundice is present, it is due 
to an intermittent catarrh of the bile ducts. Later on in the dis- 
ease, diarrhea and vomiting on the slightest irregularity in diet. 
An?emia and progressive debility are ever present. There is a 
great increase in the white corpuscles of the blood—the patient 
has a peculiar waxy look and peculiar odor; faeces are pale, they 
do not contain any bile. The urine is highly albuminous, of a 
lower specific gravity, increased in quantity. These urinary 
symptoms increase as the disease advances. 

There is a bulging of the hepatic and splenic regions, the area 
of dulness of both being greatly increased. 

The prognosis in all cases is most unfavorable ; it has no 
exact duration, but usually merges onward to a fatal termi- 
nation. 

General principles of treatment are strict attention to warm 
clothing, general hygienic surroundings, daily baths of iodine and 
ammonia are of importance, followed by massage. A most gen- 
erous diet ; but in all cases forbid saccharine, starchy and alcoholic 
food or drink. Vegetable tonics such as hydrastis, salix niger, 
comp. tincture of marticaria, cinchonia. Preparations of iodine 
kill the microbe, and are invariably of the greatest utility. These 
should be alternated with the chloride of ammonia, which always 
produces most salutary results. 



BACTERICIDES. 



45 



Dropsy of the cellular tissue is the most striking 
Anasarca, symptom of chronic interstitial nephritis, and one 
which very naturalh' attracts the attention of the 
patient. It is common in both the large white as well as the con- 
tracting kidney. It seldom makes a decided appearance until 
the hypertrophied heart breaks down, when it appears with 
other signs of collapse of the whole body. It is first seen in a 
bagging below the eyes in the mornings, then in the legs and 
ankles, latterly higher up, indicating a failure of the heart to 
maintain the struggle any longer. 

The dropsy of the cellular tissue is due in a great measure to 
obstruction in the kidneys, although in every case there is a 
decided heart failure. 

A breaking down of the kidney, and heart failure ; in addition, 
there invariably exists a watery state of the blood, accompanied 
with increased permeability of the capillaries, caused by the pres- 
ence of urea, an acid toxic, in the blood. {See Dropsy.) 




Poverty of the Blood. — A condition in which the 

Anaemia, red corpuscles are diminished or reduced to eighty, 

sixty or even lower than forty to the one thousand 

parts, instead of one hundred and thirty, 

which is the healthy standard. The 

liquor sanguinis is also poor in albumen, 

but may contain an excess of salts. 

The common causes are poor food, 

over-work, absence of sunlight, deleterious 

trades, as operations in lead, mercury, 

phosphorus, the fumes of which are 

powerful agents in impoverishing the 

blood ; disease, hemorrhages, drugs. Red Corpuscles as seen in normal 

atrophy of gastric glands, defective assi- ^^°°^^' 

milation, lack of afresh air and muscular activity, malignant dis- 
ease, imperfect nutrition and impaired sanguinification, excessive 
loss or drain of vital secretions, excesses, passions, mental shocks, 
and it may be due to parasites, as the trichinae, taenia, and other 
micro-organisms that find their way into the alimentary canal by 
food and water. 

The Ordinary Symptoms of anaemia are great debility, pallor, 
blanched appearance of skin and mucous membrane, loss of appe- 
tite, in some cases with an intolerance of food, often nausea and 
vomiting, constipation or diarrhea. As a rule, in the earlier 
stages of the disease the breathing is quiet, only on exertion, 
which produces marked breathlessness ; but in the advanced 



46 



DISEASE GERMS. 



Stage we have great difficulty in breathing. Attacks of syncope 
or fainting fits are Hable to occur, but not so frequent as one 
would expect ; the action of the heart is generally regular and 
quick, often very feeble ; the impulse is often widely visible, 
undulating and thrilling ; the area of cardiac dulness is increas- 
ing laterally, due either to dilatation of the heart or retraction of 
the lung. Aortic and pulmonary systolic murmurs, with palpi- 
tation of the large arteries of the neck, often visibly pulsate and 
are the seat of local murmurs. The jugular hum is seldom ab- 
sent, and pulsation of the jugular vein is often observed. The 
pulse is soft and compressible, quick, jerking, empty. There 
may be enlargement of the thyroid, protuberance of eyeballs, 
with vertigo and nausea, volitantes or specks or spots before the 
eyes, albumen in urine, oedema and dropsical effusions into the 
chest, pericardium, peritoneum and cellular tissue ; amenorrhoea ; 
occasionally fatal syncope, coma. 

There is usually no enlargement of either liver, spleen or lym- 
phatics, and albuminuria is slight and transient. 

As the disease is often due to hemorrhage, epistaxis, haemop- 
tysis, menorrhagia, haematuria, we are liable during an attack to 
have a recurrence which should be guarded against ; but in the 
sanguine or hemorrhagic diathesis, this is so persistent that it is 
liable to occur even in the retina of the eye, being most abundant 
around the optic nerve entrance. It is frequently associated with 
white spots and areas due in part to leucocyte-like cells, in part to 
degeneration of retinal tissue. Slight febrile symptoms are the rule. 

Anaemia is often divided into simple and pernicious, the latter 
term being applied to it when due to bad food, conjoined with 
pregnancy or lactation, or repeated pregnancies, or digestiv^e or 
intestinal disorders. Malarial influences in the production of 
haematuria give us the best and most common illustration of per- 
nicious anaemia. It is not well to call the profound blood change 
that is set up by direct nervous shock, fright, grief, very perni- 
cious, as it is a factor of simple anaemia. 

The cause for anaemia should be sought for in two directions, 
diminished activity of blood formation, or excess of activity in 
blood destruction. 

The degree to which the haemoglobin may be diminished 
without being fatal, is about one-fifth of its normal quantity. 
After the blood is drawn we observe irregular massing of corpus- 
cles into pear-shaped, biscuit-shaped or globular forms, and the 
coloring matter accumulating in the corpuscle at one point, indi- 
cating a greater proneness to form changes in healthy blood. 
At the same time can be seen small fragments of corpuscular 
matter, evidence of the disintegration of the corpuscles. 



BACTERICIDES. 



47 



In our diagnosis of anaemia neither the spleen, nor lymphatic 
system is to show any evidence of change ; if they do, then it 
may come under another head. 

The theory of the blood formation of the bone marrow has not 
been sustained. The alterations in the blood and marrow in the 
form of altered corpuscles are met with in cancer, and they seem 
to be dependent on the cachectic state rather than the cause of 
it, and not in anaemia. 

There are three other blood diseases that bear a close resem- 
blance and analogy to anxmia — a resemblance due to the factor 
common to all of them : the diminution of the oxygen-carriers 
of the blood. In anaemia, a decrease of red corpuscles ; in 
chlorosis, an imperfect evolution of the blood ; in leucocythsemia, 
an increased production of white corpuscles and an incomplete 
conversion of them into red ; in pseudo-leucocythaemia there is 
•deficient formation of red corpuscles ; in leucocythaemia, hyper- 
trophy of spleen almost invariably present ; in pseudo-leucocy- 
thaemia, the lymphatic system greatly infiltrated. 

Chlorosis is essentially a disease of nervous origin ; centres of 
life are depressed, hence the process of cure is slow but pro- 
gressive. 

In the treatment of anaemia general principles must be ob- 
served as to the removal of cause, enjoining quietness or rest in 
recumbent posture, attention to clothing and secretions, abund- 
ance of fresh air and sunlight. The true aim in treatment is to 
introduce, as quickly as assimilation will take it up, the most 
nutritious food with mineral acids, iron, cinchona and other 
tonics. The nourishing diet embraces milk, raw eggs, restora- 
tive soup, raw beef, essence of beef, blood, fish, poultry, roast beef 
■and mutton, at stated intervals with pepsin if digestion is feeble. 

Our best remedies are those that increase blood formation 
most rapidly. Aromatic sulphuric acid and sulphate of quinine : 
■one ounce of the former to thirty grains of the latter. Dose — 
fifteen to twenty drops thrice daily in water ; or compound tinc- 
ture cinchona and simple syrup, of each two ounces ; to which 
add two drachms of muriatic acid. — Mix. Dose — a teaspoonful 
thrice daily in water. The greatest possible benefit is derived 
from peroxide of hydrogen in anaemia, it acts as a scavenger to 
the blood, it is a life-giving element, oxygenizes every tissue, 
increases the red discs. 

Benefit will be derived from iron, provided it does not cause 
irritation or fever, or provoke constipation, the acetate or muri- 
ated tinctures or iron by hydrogen. 

To prepare the acetated tincture, take a pound of lath nails and 
•cover with good strong, sharp cider vinegar, or dilute acetic acid ; 



48 



DISEASE GERMS. 



steep for ten days, then strain. Dose — Half a teaspoonful in a 
glass of water three times in twenty-four hours, or fifteen drops 
of the mu dated tincture in the same quantity of water, and as 
frequent. Iron by hydrogen operates well in the following com- 
bination : 

Iron by hydrogen, thirty grains; sulphate of hydrastin, thirty 
grains ; sulphate of quinine, twenty grains ; solid extract nux 
vomica, eight grains. — Mix. Make thirty pills. One every 
four hours. 

In administering those remedies, select one preparation of iron 
to one of tonic ; give each every four hours, two hours apart. 
Open bowels with nutritive enemata or suppositories. 

As the patient progresses to recovery glycerite of ozone 
should be given, as it supplies deficiencies in the blood. It is 
an invaluable remedy in anaemia — aids powerfully in the restora- 
tion of the devitalized fluid to its normal constituency. 

When recovery takes place, a change of air to the sea shore 
is good, fresh food if available, is judicious. 



The term anchylosis signifies a fusion or 

Anchylosis, union of the ends of bones in a joint, in which 
lymph, one of the products of inflammation, has 
been effused and become organized either into ligament or bone. 
This naturally divides it into two forms, true 2ind false, the former 
in which the effused lymph has become thoroughly organized 
into bone ; the latter in which it is simply ligamentous. 

Bone or ligament, neither tissue in a joint being of original 
formation, nor so vital, is capable of absorption with modern 
remedies, and the aversion existing among a very large percent- 
age of physicians against interfering with stiff or anchylosed 
joints is removed. 

The precaution of removing the urate of soda or uric acid from 
the blood by the uric acid solvent should always be observed, as 
it is not desirable to have either of those agents liberated in the 
joint during treatment. 

It has been demonstrated in thousands of cases that ozonized 
clay will excite and procure absorption of all adventitious matter 
in the form of fibrous tissue, that class of tumors in the breast, 
stomach, bowels, ovaries. 

The action of the ozonized clay made into a poultice with cold 
spring water, and applied to either a true or spuriously anchy- 
losed joint is destructive to the inherent elements of the lymph in 
whatever state it may be ; has marvellous power of absorption of 
the disintegrating mass, and its prompt elimination from the body. 



BACTERICIDES. ^O 

It acts by enclosmosis, penetrates right to the mass, and will cause 
the lymph to gradually disappear. 

The peculiar faculty in effecting this is, that the clay must pro- 
duce no irritation, 7io pain, no redness of the cutaneous surface. 
It must be applied daily, and as it is very hydroscopic, will not 
retain its ozone verv^ long unless in a dry state ; it is best to mix 
a little, what is to be used at one time. 

There are numerous old cases in which bony union is perfect 
— ^joint immovable; on these the clay will act well in diminishing 
the calibre of the effused products, but on the phosphate of lime 
it exercises no chemical action, hence in true anchylosis, forced 
rupture, a breaking up of organized products is often necessary. 

The more general use of one of nature's products will speedily 
rid us of a class of deformity very common. It is well to bear in 
mind in the management of all cases of anchylosis that the secre- 
tion of synovia is much augmented by increased nutrition of the 
brain, so that in all cases, while guarding against the formation 
of uric acid, the vital elements of brain nutrition should be stimu- 
lated with oats, kephaline, etc. 



A swelling, pouch, sac or tumor, caused by the 
Aneurism, dilatation of the coats of an artery. It may em- 
brace one or all the three coats of the vessel, and 
may extend a long distance. When all the coats of an artery are 
dilated, but not ruptured, it is called a true a?icurism. Dilatation, 
with rupture of one or more coats, constitutes a false aneurism. 
The internal and middle coats are frequently ruptured or removed 
in patches by the detachment of foreign particles or the burrow- 
ing of disease-germs ; the blood then comes in contact with the 
external cellular sheath, dilating it into a pouch or sac. The ex- 
ternal wall of the tumor in this case condenses, acquires a cover- 
ing by effused lymph, and becomes thick ; and if the patient 
enjoys average health, the sac will become very firm. The divi- 
sion or rupture or tear of an artery may result in extravasation 
of blood into the areolar tissue, and thus form a diffused aneurism. 
Varicose aneurism can only happen when a vein runs over an 
artery, as when the brachial is punctured in opening a vein. 
The blood rushes into the vein, rendering it varicose ; nsevus, or 
aneurism by anastomosis, so common on the heads of children. 

Causes. — The absence of support, inherent weakness of or- 
ganization, a weakened or diseased state of the walls of blood- 
vessels, the deposit of morbid matter in the blood on the walls of 
an artery, as particles of starch, fat, calcarea, tubercle, and these, 
being washed away by the current of the circulation, leave the 



50 



DISEASE GERMS. 



Spot to which they adhered weak or ulcerated, and impair the 
elasticity and vital power of resistance of the vessel ; when, if the 
circulation is excited by mental or physical exertion, as cough- 
ing, straining, lifting, hoisting, pulling, rowing, jumping, the force 
of the circulation presses heavily on the weakened part, and a 
bulging or aneurismal sac is formed. Morbid states of blood 
are favorable for aneurismal tumors. If they arise from local 
violence, they are called traumatic, and spontaneous when they 
arise without local injury — a distinction of no moment. 

Symptoms. — A sac, pouch, swelling or tumor, pulsating syn- 
chronously with the action of the heart, located over an artery, 
which, when equally compressed, is emptied of its contents, and 
when pressure is removed the blood rushes in with a whirring 
sound. They tend to increase in size, and if near the heart give 
rise to different morbid states of that organ. 

Treatment. — Men, from their more laborious mode of life, are 
more obnoxious to aneurisms than females, and are better sub- 
jects for a spontaneous cure by coagulation, as their blood con- 
tains more fibrin and a much greater percentage of red corpuscles 
than women. We shall briefly enumerate the various methods of 
treatment before speaking of nature's method. 

A ligature applied to the main trunk of an artery cuts off the 
circulation, the pulsation in the sac at once ceases, a coagulum is 
formed, which, if vital force is good, is gradually absorbed, and 
the whole mass degenerates into an impervious cord, the circula- 
tion being carried on by the collateral branches. This may all 
look well, but if there is disease of the artery, as there often is, a 
union of its internal coats may not take place, and when the 
ligature sloughs off in one or two Aveeks, secondary hemorrhage 
and death ensue; besides, it is only on the thigh in Scarpia's tri- 
angle, or in the arm over the brachial or about the head that it 
can be applied. It is not adapted for the internal forms which 
are so common. 

Pressure, where it can be applied, is of great efficacy in dimin- 
ishing the flow through the sac. It gives the fibrin of the blood 
a chance to coalesce and cause coagulation, which is ultimately 
absorbed. Electricity, applied by means of several needles in- 
serted into the aneurism, produces instantaneous coagulation of 
its contents. It is best adapted to small tumors. 

Nature's method is the best. Fibrmize the blood, restrain the 
circulation, and coagulation is certain. Begin by the administra- 
tion of a rich animalized diet, beef, eggs, milk, cream. Improve 
the digestive organs and increase fibrin in blood with nitro- 
muriatic acid and compound tincture cinchona, or aromatic sul- 
phuric acid and quinine. After a few weeks, enjoin absolute rest 



BACTERICIDES. r i 

of mind and body, and put patient on digitalis to keep pulse at 
sixty, steady. Fresh, rich food, no alkalies ; do not use acon- 
ite, or veratrum viride, or belladonna, for however valuable 
their action on the heart may be they keep up fluidity of blood. 
After the pulse has been kept at sixty, under care of a skilled 
nurse, for one week, use either ergot or carbolic acid internally 
for about a week, and coagulation of contents of the sac is almost 
certain. Under such treatment patient must retain the recumbent 
position, as that slows the heart's action about twelve per minute. 
The digitalis must be administered in from eight to fifteen drops 
in water, every three hours, never permitting contractions to ex- 
ceed sixty. This drug not only slows the heart, but contracts or 
astringes the heart, arteries and veins ; their calibre is smaller, 
and the tendency is for the blood, if rich enough, to clot in 
hollow organs, as the aneurism. This clotting begins on the 
walls of the aneurism and gradually merges to the centre unlil a 
clot forms. The ergot or carbolic acid must be very carefully 
watched, and discontinued if any bad feelings are experienced 
about the heart. Of all methods this is the best. 



Aneurism of the heart is found in two 

Aneurism, Cardiac, forms : 

I. TJie acute variety depends on a 
laceration of the endocardium and muscular tissue, through which 
the blood passes to form a pouch. In this pouch fibrin is de- 
posited, while at its entrance is a fringed margin with vegetations 
attached. 

2. The c] ironic form results from some inflammatory condition 
of muscular fibre or endocardium. Walls of sac consist of endo- 
cardial and pericardial membranes unbroken, while the muscular 
fibre seems to be replaced by a fibroid tissue. Either kind gives 
rise to obscure and uncertain symptoms ; passage of blood into 
sac may cause a murmur. Death usually occurs suddenly from 
rupture. 

Aneurism of coronary arteries is not infrequent. 



The symptoms of this form of 
Aneurism of Thoracic aneurism are often obscure in their 
Aorta. early stages, bearing a strong resem- 

blance to disease of the heart. If 
the aneurismal tumor be large and is developed quickly, there is 
disturbed action of the heart, with some modification of radial 
pulse ; dulness on percussion around portion of vessel from which 



52 



DISEASE GERMS. 



aneurism springs; cough, wheezing, difficulty of breathing, spit- 
ting of blood, difficulty and pain about back and chest, superficial 
veins of chest and neck swollen. If the aneurismal tumor be- 
comes very large and pulsating, rises out of the chest, producing 
protrusion of sternum and ribs, then the diagnosis is easy. If 
the aneurism presses upon the trachea, there is difficulty of breath- 
ing and cough ; when on one or both recurrent laryngeal nerves, 
aphonia, with troublesome cough, severe paroxysms of laryngeal 
suffocation, pain coming on ■ at intervals ; when on oesophagus, 
symptoms of difficulty of swallowing, engorgement of absorbent 
vessels and glands, inanition and symptoms of stricture. If the 
aneurism is in the ascending, near the heart, the patient suffers 
from angina pectoris, resulting from pressure on the plexus of 
nerves ramifying on each side of the aorta and communicating 
freely with the cardiac ganglia and plexuses of the ventricles. 

Contraction or dilatation of pupil on the affected side, accord- 
ing as pressure is sufficient to irritate or paralyze branches of 
sympathetic nerve. Often blowing murmurs can be detected. 
If the heart be compressed by a tumor, so as to impede the action 
of the valves, a systolic or diastolic murmur will result. Pressure 
on aorta or on pulmonary artery may produce a murmur. In 
false aneurism there is generally a murmur both with entrance and 
exit of blood into the sac ; or there maybe one loud and rasping 
murmur from the passage of blood over the roughened inner sur- 
face of the vessel. In true aneurism, or the mere dilatation of a 
part of the wall, murmurs seldom audible. Even a small open- 
ing into the canal of an artery into aneurismal sac, and a rough- 
ened state of the arterial tunics from degeneration, will give rise 
to a murmur. A peculiar thrilling or purring tremor is often felt 
over the sternum. 

The termination may be death from rupture externally, or into 
pericardium, or into the pleural cavity, or into the trachea, or 
into the bronchial tube ; or the patient may die from exhaustion 
consequent upon long-continued suffering, or there may be a fatal 
destructive inflammation of lung, owing to the compression of 
pulmonary vessels or pressure on pneumogastric. 



Very common in ladies from 

Aneurism of Abdominal falls, lifts, strains and bearing 

Aorta. down efforts in labor. Patient 

describes it as a feeling as if 

something had given way; most generally met with just behind 

stomach. It exists from a mere distension of the descending 

aorta to a large sac ; machinists, especially those pulling long 

heavy bars of steel, are common sufferers. 



BACTERICIDES. 



53 



Empty the bowels ; see the patients before they partake of food ; 
lay them on back, knees drawn up, and the tumor can be easily 
made out. If large enough to interfere with the vermicular move- 
ments of the stomach, the case is not so favorable for a cure. 
If that organ be undisturbed, treatment will soon do its work in 
effecting a speedy cure. 

In aneurism in chest or abdomen all bodily and mental excite- 
ment must be avoided, all prominent symptoms alleviated ; gen- 
erous, reparative diet to be allowed ; not over one pint of fluid to 
be used per day ; great attention to the secreting and excreting 
functions, and in the abdominal, the method of treatment by 
slowing the heart and fibrinizing the blood resorted to. 



Aneurismby anastomosis, or mother's mark, afor- 

Aneurism mation of dilated arteries, veins or capillaries. 

or Arterial Xcevi, met with most commonly in 

Nsevus. infancy and youth. The diseased vessels become 

enlarged, elongated and tortuous, forming tumor 

variable in size, irregular in shape, spongy, compressible and 

pulsating — a murmur being audible. 

Venous Noevi give rise to irregular tumors of a purple color, 
which feel doughy, and are diminished in size by pressure. 

Capillary Ncevi are most common ; for the most part they are 
congenital, begin usually as a red or purplish spot, which gradually 
spreads. They are generally met with on the scalp, or face or 
neck ; rarely on other parts, and involve skin or subcutaneous 
parts, and of all sizes, from a strawberry up. 

Treatment. — When very small and producing no disfigurement, 
and not increasing in size, they are best left alone, as nature often 
effects a spontaneous cure by a coagulation and absorption of their 
contents. 

There are several methods of treatment, a removal by the knife, 
or ligature, which is rarely advisable ; destruction with caustics, 
as brushing it over with ethiate of sodium, or nitric acid, or super- 
phosphate of zinc ; electrolysis and coagulation of blood by gal- 
vanism, or in the application of remedies to excite adhesive in- 
flammation, as injecting with perchloride of iron, or vaccination 
with croton oil, or painting with collodion and tannic acid, paint- 
ing with tincture of iodine. 

Cardiac neuralgia, or as some term it 

Angina Pectoris, cardiac epilepsy, from the fact that some 

cases are accompanied with a warning, a 

partial death of the cardiac nerves, in which severe intermittent 



54 



DISEASE GERMS. 



pain is felt about the heart, with a sense of strangulation and a 
feeling of impending death, or it is a neurosis due to organic 
change in the nerves ; occurs most frequently in advanced life ; 
more common in men than women. It seems to be associated 
with ossification of the coronary arteries and fatty degeneration. 
The cardiac nerves are specially involved in cases of ossification 
of the coronary arteries, as they are in such close proximity 
throughout their whole course, for these nerves not only accom- 
pany the arterial trunks, but pass into the muscular parietes of 
the heart along with the coronary vessels ; for nervous filaments 
can be traced as far as the third or fourth subdivision of the arter- 
ies ; here we lose sight of them, even in the largest animals. The 
pain radiates or shoots through the connection of the cardiac 
plexus with the spinal to the brachial and cervical plexus. 

Causes. — Disease of the brain, morbid states of blood, stimu- 
lants, tea, whiskey, tobacco, sexual excesses, mental excite- 
ment, heart starvation from impure blood, defect in organs of diges- 
tion and assimilation, mal-assimilation, heart badly nourished, 
over-exertion, mental or physical, loss of sleep, liver working 
sluggishly, brain under-fed, the weakened nerves of heart poi- 
soned by products of mal-nutrition or disease-germs, as syphilis ; 
the waste-laden or disease-germ blood produces spasm, worry, 
struggle for existence, etc. It is intimately associated with gout ; 
albuminuria, diabetes and hepatic disorder. 

Symptoms. — Generally the first attack comes on after ascending 
some slight acclivity, or making some slight exertion, or after a 
meal. It comes on with a sudden seizure of excruciating pain in 
the heart, shooting from the breast-bone to back, often accom- 
panied by a feeling of constriction in the chest as if grasped by a 
vise. The pain is localized, still, it may shoot toward the shoulder, 
down the left or both arms, even down to the lumbar nerves. 
This brings the patient to a stand-still ; he fears to breathe, but if 
he chooses to breathe he can do so freely enough ; he feels a sen- 
sation as if of impending death, and a ghastly paleness overspreads 
his countenance. The pulse ma}' be regular, or it may intermit 
or stop, or be feeble and irregular. After a few minutes pain 
suddenly ceases, and the patient is well, but dreads another attack 
or recurrence. At first there is often no lung difficulty, as asthma 
or emphysema or dyspepsia ; it seems to be brought about by 
some trifling exertion, some emotional excitement of heart's ac- 
tion, but as it progresses it does not seem necessar)^ to require an 
exciting cause, as it will come on when he is asleep, the patient 
waking up in a paroxysm of anginous pain — a pain so excruciat- 
ing and commanding that no words can express its intensity; it 
is appalling; it unnerves the strongest mind, and death would 



BACTERICIDES. 



55 



seem to be preferable to such suffering. The sudden violent pain 
produces sickness, faintness, depression of heart's action, pale and 
anxious countenance, coldness, cold, clammy sweat. As the 
struggle passes off patient regains his usual health, often appears 
quite well. Whatever produces depression in the function of the 
fibres coming from the posterior roots of a spinal nerve, and as its 
result pain or neuralgia, produces also depression of function of 
motor fibres coming from the anterior root of the same nerve, and 
as its result sub-paralysis of the parts to which it is distributed. 
Hence we have in angina pectoris two distinct sources of depres- 
sion of the cardiac action ; (i) we have the most depressing effect 
of a pain, the most acute and severe that the human body can ex- 
perience ; and (2) we have the action on the cardiac motor gan- 
glia of the same cause which, acting on sensitive nerves, gives rise 
to this excruciating agony ; for we cannot suppose that the de- 
pression of motor is any less than the sensitive ones ; that is, 
that the epileptic paralysis of motion bears a relation to the acute- 
ness of the pain, which is the index of the depression of the 
nerves of sensation. 

Should death take place as the result of an attack, the heart 
will be found flabby, uncontracted, due to inhibitory paralysis. 
Death is not due to spasm, for if it was it would be instantaneous ; 
whereas, it is gradual, a progressive lowering of the heart's action, 
becoming feebler and feebler until it ceases to beat. 

The main theories that have been advanced to explain the phe- 
nomena of the seizure are, spasm of the heart, depression of car- 
diac plexus, dilatation of heart, and ossification of coronary arter- 
ies. Pain is a symptom of variable significance here ; it is always 
intense, arising and ceasing suddenly, and accompanied with a 
feeling of approaching death. 

Angina pectoris has no relation to fatty degeneration, in which 
there are faintings, cardiac asthma, feebleness of the pulse or of 
the cardiac impulse, with yellowness or pastiness of the com- 
plexion, and an arcus senilis. 

Treatment. — This resolves itself into two distinct divisions — dur- 
ing the fit and intermission. During the fit our measures are but 
palliative, but much more ample than what our forefathers possessed. 
They had only the use of external stimulants and narcotics — vain 
hope where minutes are precious. Modern discovery has changed 
all this. We now have remedies that can be administered by in- 
halation or hypodermic injection, that can give the patient instant 
relief of that terrible pain. 

Foremost among all our modern appliances for this dreadful 
breast pang, we place nitrate of amyl, a drug of great power, a 
volatile narcotic. To obtain a satisfactory result it must be fresh ; 



56 DISEASE GERMS. 

not kept in bottles, but in hermetically sealed capsules or pearls, a 
dose ranging from three to eight drops in each, opened, dropped 
on a piece of lint and inhaled. It is perfectly safe, and may be 
entrusted to the patient with the certainty that he will not injure 
himself by its use. It gives immediate relief, alleviates and re- 
moves the pain. It flushes the face, quickens the pulse and lowers 
the blood pressure on the heart. 

If the nitrate is not procurable, or fails on account of its 
properties being lost in bottles, let the patient inhale a few 
drops of chloroform, and just as it begins to narcotize, inject 
hypodermically one-quarter of a grain of sulphate of morphia, 
so as to have the patient pass from the chloroform sleep into the 
morphia sleep, from which the patient will wake up in about eight 
hours, free from pain, but exhausted. Is there no danger from 
chloroform in fatty or flabby heart ? No, not if carried to the 
point we desire. Nearly all cases of fatty or flabby heart are due 
to heart starvation, and are benefited by such a stimulant if car- 
ried to a certain point, just its slightest effect, from which the 
morphia at once reacts. No diseased condition need deter the 
careful and cautious use of the remedy. In reckless hands it is 
not safe, but with care it is all right. Angina is such a depress- 
ing disease that we need perfect narcotism of the nerve centres 
through which the action takes place — a perfect setting free from 
all depressing influences. 

Ether is also excellent, but not rapid enough in its action. 

Nitro-glycerine gives the most complete relief in angina ; one 
to two drops of a one-per-cent. solution in serious cases gives the 
most complete relief from pain. Administer in water, and con- 
tinue during the intermission thrice daily, increasing the dose to 
eight drops. It lessens the attacks, breaks their frequency and 
force. Lobelia, sambul. and other antispasmodics are of little 
utility. 

However satisfactory our treatment may be with some of the 
above or other remedies during the paroxysm, it is during the 
intermission that the most striking results are to be obtained. 'Dur- 
ing that period the most strenuous efforts must be made to 
improve the patient's general health, and especially to tone up 
his heart ; avoidance of cold, damp, strong exercise, walking after 
meals, sexual intercourse and mental excitement ; rest, warmth 
in open air, driving or sitting is to be recommended. His diet 
must be regulated, to consist of the blandest, most nutritious and 
unstimulating foods, as broiled beefsteak, boiled fish, eggs, milk, 
cream ; avoid everything difficult of digestion, or that will 
give rise to flatulence, or stimulate and thereby weaken the 
heart. Prohibit tobacco, tea, whiskey, etc. The whole sys- 



BACTERICIDES. 



57 



tern must be attended to. Mild laxatives ; an active skin by- 
sponging and friction. A healthy stomach and liver does much 
to improve the tone of the heart, but a healthy brain and pure 
blood will aid more. The irritating plaster, two pieces an inch 
square, or else repeated small blisters, of undoubted efficacy. 

A very persevering course of vegetable alteratives and tonics 
should be resorted to, as phytolacca and iodide of potassa, stil- 
Hngia and iodide of sodium ; mineral acids and cinchona, qui- 
nine and iron. Either the irritating plaster or belladonna plaster 
to be worn constantly over the heart ; the former is preferred ; 
some are partial to the latter. 

While pursuing an alterative and tonic course, changing 
remedies weekly, and keeping two open sores at nape of neck 
freely discharging, then a special class of remedies are to be 
given to improve the faulty nutrition of the heart. We shall 
enumerate a few of those remarkable drugs : digitalis, arsenic, 
sulphur, quinine, phosphate of iron, nux vomica. Digitalis in 
small doses, not exceeding four drops of the tincture thrice daily, 
is invaluable in promoting the nutrition of the heart. Fowler's 
solution, in four-drop doses after meals, is invaluable in cardiac 
neuralgia and weak heart, being a special tonic to the nerves of 
the heart. Quinine, iron, hydrastin and nux increase the nerve 
nutrition, render them less liable to pain, and are especially valu- 
able in all cardiac neuroses. 

More recently cases have been most successfully treated with 
sulphate of sparteine and strophanthus. 



Domestic animals, as the cow, horse, sheep, goat, 
Anthrax, camels, poultry, etc., like man, if placed in a condi- 
tion adverse to their vitality, are liable to have the 
primary elements of their nutrition degraded, changed or 
altered into a disease germ, a giant form of bacteria, which, either 
in their own bodies, or if communicated to man, have wondrous 
power of growth and reproduction in the blood. 

The bacillus anthrax is peculiar to cattle, and may be com- 
municated either by close contact, food or water, or otherwise, 
from one species to another, during which the microbe acquires 
an intensity, virulence and activity which is typically fatal to life. 
Its migration from animals to man is attended with most fatal 
results. The micro-organism is so very tenacious of life that it 
will live for centuries in the wool, hair, hides, dried flesh, or blood 
of the affected animals. The causes are adverse states, as ex- 
posure, insanitary conditions, over-crowding, bad, meagre food, 
neglect ; essentially contagious and infectious. 



58 



DISEASE GERMS. 



Anthrax may attack man in three different ways — mahgnant 
pustule, anthrax oedema, and internal anthrax. 

The mahgnant pustule is usually the result of inoculation, and 
is mo.st frequently met with on the hands, arms, face and neck, or 
some exposed part of the body, and commences as a small red 
point or pimple, which may be painless or attended with a sting- 
ing sensation like that of a wasp-sting. A small papule speedily 
forms, which becomes covered by a flat vesicle which enlarges 
and usually bursts, discharging a clear bloody fluid ; a central 
black eschar forms at the base of the discharged vesicle, and a 
crop of other smaller vesicles form around it. The surrounding 
tissue becomes inflamed, so that the vesicle is seated on a hard 
base, with a sort of erysipelatous blush and swelling extending 
for a considerable distance. 

The central eschar enlarges, and the corona of vesicles, as well 
as the inflammatory sore, enlarges, and the oedema becomes quite 
great, so much so that if seated on the face, the head, neck, and 
shoulders become involved in the general doughy swelling. The 
lymphatics of the neck are seriously involved. 

If the patient weathers the crisis, the central slough separates 
and the wound granulates and heals. 

The constitutional symptoms are those of a malignant poison, 
— rigors, high fever, nausea, vomiting, prostration, sleeplessness, 
labored breathing, exhaustion and delirium. 

Death may occur early or not for several days. 

Internal anthrax is as rapidly fatal with or without internal 
lesions. It is usually brought about by the bacteria giant cells 
finding their way into the blood by the air, food and water. 
Lesions, or rather colonies, of the micro-organisms are found in 
the bowels, liver, spleen, brain and blood. 

The symptoms of the internal are prostration, vomiting, dys- 
phagia, pain, uneasiness in abdomen, colic and diarrhoea, the latter 
often bloody from the first ; collapse and cyanosis. 

Death is often quick. 

The symptoms of the form without internal or external lesions 
are those of extreme prostration and malignancy. 

After death in any of the forms the blood is found filled with 
large bacteria. Thrombosis of blood-vessels by masses of bacilli, 
not uncommonly an artery or vein being filled with a clot or plug 
loaded with germs. 

The recognition of anthrax is often difficult and obscure, unless 
we have a good history, as a wool-sorter, butcher, tanner, or hair 
or wool operative, or an attendant upon diseased cattle, or drink- 
ing water into which the refuse of an alpaca, or mohair, or tan 
factory empties, or is close by. 



BACTERICIDES. 



59 



The prevention of anthrax among our domestic animals is of 
national importance, — the mode is simply good food and care, an 
avoidance of overcrowding, and all insanitary states, abundance 
of pure water, cleanliness, ventilation, etc. 

The blood of all suspected cases of anthrax should be at once 
examined, and if there are present in that fluid stiff and long rods 
as seen in the annexed diagram, ,- ^ ^ ...j » ^ 
and those rods multiply by divi- ^^^^^^^ (^ ^^-^"L^ 

sion of spores and grow into long, "^-P-^/ f^ 0_P^ *! (^ jC^ ^ 

homogeneous looking, straight or iO^^rs'/rO % ' Q/"^/©© 
twisted filaments, then our diag- 'Ip^ o" ^» C^ ^c''^ G) 
nosis is positive, as the germ is q O qV?,o ^ ^ "g) "0*^^(3 
pathogenitic of the disease. To o G)«^ j <^ '''^'^^'^^-?* Q^ 
aid this the spleen is usually large, ^^-7 Q) ^^3* ^ (3 r\ ^ 
full or engorged with the germs. '0 ^ -O^^^t'Q'^Va ^--^ 

The disease can be best studied © ^ * ^^^— ^ ^-^(^Q^ r. 
in its pustular form in a factory in -X^/' (3> ® ^ r^''^.^ * 
which wool is used, or alpaca, mo- ' ,Y '.vD -, ^y" " « ^ 

hair, or the^ fleeces of our own Badllus Anthrax as seen in the blood of a 

domestic animals who have died wool-sorter. 

from the disease. If the serum or any exudation from the pustule 

is placed in the field of the microscope it will give us the annexed 

appearance. 

Bacillus anthrax, the degraded bioplasm of cattle changed 
under adverse circumstances into a giant bacteria, give rise to 

J splenic fever, cattle plague, malignant pustule, 

^ % wool-sorter's disease. A thorough knowledge 

""^***' of this bacillus is of the greatest importance to 
i^\%^ the human race. Its morphological and bio- 
'^ . / logical characteristics have been thoroughly 
9 ^^ ^ ^^^ worked out. It is one of the best of all mi- 
VS^^' **-^ crobes to study out, to cultivate, and give one 
*'=^"" an appreciation of germ evolution. 

^thf pufofaVustuTe'oS The bacillus anthrax will grow in a nutrient 
the hand of a wool-sorter, fluid at almost any tcmpcraturc ; besides, it 
will grow in water and cast off spores, which become permanent 
seeds. The effusions, effluvia from mouth and nostrils of affected 
animals, being germ-laden in a pasture field where decaying 
animal and vegetable matter affords nutrition, the bacillus will 
grow on the surface of the soil. The treatment of anthrax must 
be highly germicidal, and carried out according to the indications 
present ; no time for experimenting, as it runs its course with 
amazing rapidity. If there be fever, antifibrine, in sufficient doses 
to equalize circulation. 

Peroxide of hydrogen is a remedy of rare value, administered 



/' 



6o DISEASE GERMS. 

every two hours in alternation with 15 -grain doses of resorcin. 
These two remedies seem to be capable of annihilating the germ; 
and, to the pustules on the hands, face, or elsewhere, a paste 
made of either iodol or resorcin with an equal quantity of ozone 
ointment. If a good preparation of peroxide of hydrogen is not 
obtainable, then some of the following remedies should be used : 
Con. ozone, in 15 drop doses, alternated with 15 grains of re- 
sorcin every two hours respectively. Concentrated ozone, two 
ounces : chloroform, one ounce. Mix. Keep constantly applied 
over spleen. 

Concentrated tincture of kurchicine is a remarkable germicide 
in anthrax, kills the microbes, and virtually grasps the patient 
from the abyss of death. It must be administered in precisely the 
same manner as in malignant malaria — not a drop of water given 
till the drug has done its work, which will be known by an ex- 
tremely profuse, fetid sweat, prostration, when beef tea and brandy 
must be freely given. 

Mysteriously strange, obscure, sudden death, occurring in the 
families of woolen operatives, tanners, alpaca and mohair sorters, 
should in all cases be regarded with extreme suspicion, and the 
slightest evidence of indisposition on their part promptly at- 
tended to. _^_^ 

Loss of the cerebral faculty of speech and of 

Aphasia, the power of expressing thoughts by writing or 

gesture. A simultaneous loss, in a greater or less 

degree, of the memory of words or acts, by means of which 

words are articulated, and also of intelligence. 

That transitory form so common in the recovery from fevers, 
typhoid and diphtheria, due to congestion or anaemia, from which 
recovery always takes place, is not what we desire to notice ; it 
is the form that is permanent and due to softening of the brain 
from embolism or thrombosis, hemorrhage, or poison of syphilis, 
or due to the absorption of lead, nitrate of silver in hair dyes, 
or the inunction of bismuth and arsenic in face powders, or to 
the terrible effects of nicotine in tobacco. These agents in their 
use cause irritation and softening of the posterior portion of the 
third frontal convolution of the brain on the left side. 

Symptoms, — It may come on either slowly or suddenly, and 
may or may not be associated with germinal softening. It is 
ushered in by loss of the power of speech, which may be regained 
and recur again and again. In some cases words are recovered 
and employed and ultimately lost. Again, speech may make a 
temporary return under excitement, and then leave. Movement 
of lips, tongue and larynx may be healthy. There may be con- 



BACTERICIDES. -5 1 

sciousness of what is wished to be expressed, and yet complete 
inability to express the thoughts by speech, writing or even ges- 
ture. The patient may know the use of an object, but cannot 
name it. They may read, but if they understand what they 
peruse they forget directly, as they will pore over and over again 
the same page. There is the greatest possible diversity in the 
impairment of the mental powers, usually hemiplegia and a com- 
plete breaking down, with the worst form of cerebral disease. 

In cases clearly due to the use of hair dyes, face powders, 
tobacco, syphilis, gout, if not of too long standing, there may 
be hope from the general treatment of chronic inflammation of 
the brain : especially, plasters and blisters to nape of neck, with 
alteratives and tonics. Iodide potassa in alternate use with 
ozone-water. These two remedies are of infinite value in clearing 
the brain of such deleterious compounds. When aphasia is due 
to the use of the peroxide of hydrogen as an auriferous hair dye, 
no remedy is of any avail. 

Loss of Voice from Functional, Blood or Organic 
Aphonia. Disease, operating upon the vocal cords, varies in 
degree from a slight hoarseness to complete dumb- 
ness. There are numerous varieties, as aphonia from absence of 
tongue ; aphasia, the loss of the cerebral faculty of speech by dis- 
ease of the base of brain from nitrate of silver, lead, bismuth in 
hair dyes and cosmetics, and disease-germs as syphilis, tuberculae, 
diphtheria ; aphonia from warts, tumors near the glottis ; aphonia 
fromthe different forms of chronic laryngitis : aphonia from loss 
of nerve power, as in typhoid, and apho7tia from irritation re- 
flected, as in teething, worms, masturbation. 

It is unnecessary to describe them all as they are spoken of 
under their respective heads. There are two forms, however, that 
might be enumerated — functional and organic. 

I. Functional Variety. — Reflected irritation tells badly on the 
larynx. Children often lose their voice in teething, worms and 
the like ; women who suffer from uterine, ovarian or other forms 
of irritation of the genito-urinary organs suffer much and often. 
The irritation of the clitoris with hypertrophy of that organ 
causes a wonderful harshness of voice, rough and masculine. 
Males of effeminate type, sensitive disposition, are great victims 
of aphonia, if addicted to masturbation. The squeaky voice, 
with or without loss, is notorious. Some men will suffer from 
aphonia from sexual excess or a gonorrhea. If this reflected or 
functional form is permitted to continue long, the vocal cords are 
liable to suffer atrophy or paralysis, to become flaccid and power- 
less. 



DISEASE GERMS. 



2. Organic Form. — This is apt to be present in old cases of 
chronic laryngitis, perforating ulceration in the syphilitic or 
mercurial form. It might also follow diphtheria, morbid growths, 
disease of blood and brain. 

Treatment. — This requires great tact and good judgment. The 
removal of causes is of vast importance ; teething, worms, irrita- 
tion of the organs of generation, male and female ; the destruc- 
tion of all disease-germs in the blood, appetite promoted, nourish- 
ing diet, shower baths, irritating plaster to nape of neck, equable 
temperature, 75°, moist atmosphere, inhalation of warm, atom- 
ized sprays of ammonia, tincture of hydrastin, gargles of chlorate 
of potass, bayberry, iodol and oxygen. 

General alterative and tonic course of treatment, using freely 
such remedies as glycerite of ozone and kephaline ; phosphated 
tincture of oats, saxifraga, phytolacca ; and as tonics, quinine, 
iron, hydrastin, nux vomica, fluid extract black willow bark. 
If the cases do not yield, large doses of bromide of potass, 
calabar bean, and tincture of green root gelsemium, to diminish 
irritation of cerebro-spinal axis; atomized sprays of peroxide of 
hydrogen. 



Aphthae. 



This affection is one of the most common of all 
diseases due to the presence of a disease germ. 
This is not surprising when we realize the fact 
that 75 per cent, of our entire population suffer from tuberculae, 
and 50 per cent, from the syphilitic germ. 

Aphthae, properly speaking, consists in a degradation or alter- 
ation of the living matter of nutrition of the mucous membrane 
of the mouth into the disease germ oidium albicans and lepto- 

thrix buccalis. A pure change of 
bioplasm in the mucous and sub- 
mucous coats, which first exhib- 
its itself to the naked eye as a 
point of redness, small, round, 
then effusion takes place which 
elevates it into a vesicle or 
blister. There may be only a few 
or a crop of them, they may re- 
main isolated or coalesce and form 
patches. They may take place 
on the lips, gums, cheeks, tongue, 
palate, tonsils, or extend down- 
wards through the oesophagus. 
Causes are very numerous, all disease germs in the human 
blood, more especially the microbes of tubercle, syphilis; the 
poisons of mercury, lead, etc. 




The Oidium Albicans of Aphthae. 



BACTERICIDES. 



63 



Simple mal-nutrition will so change the embryonic elements 
of nutrition into the disease germ the oidium albicans, which 
when once evolved, is capable of independent existence with pro- 
digious powers of reproduction. 

Associated with the evolution of the germ, there is usually 
profound constitutional debility. 

The germ may be evolved as the result of simple mal- nutrition, 
then there is no real diagnostic mark but the mal-nutrition and 
ordinary symptoms of inflammation and ulceration. 

When the bacilli of tubercle act as the predisposing cause, the 
diagnosis rests chiefly upon the peculiar mottled cheesy appear- 
ance ; usually there are associated with it laryngitis, bronchitis, 
pulmonary tuberculosis. 

The syphilitic form is recognized by the copper-colored ap- 
pearance of the ulcers in which the germ is imbedded. 

That due to mercury and lead has a slate-colored, metallic hue 
in the ulcers and also a peculiar fetor of the breath. 

The form peculiar to infants, Infantile AphthcE, is very apt to 
arise from the imperfect cleansing of the mouth, or the child 
being permitted to lie with the nipple in its mouth. Particles of 
milk lodging in the crevices of the mucous membrane become 
sour or rancid, and give rise to irritation of the mucous mem- 
brane ; or it may be due to heated milk from over-work on the 
part of mother, or the lactiferous fluid may be bad. It may come 
from diseased children kissing each other, or diseased adults 
kissing healthy babes. Once the disease germ is developed in 
the child's mouth, the nipple of the mother becomes similarly 
affected ; vesicles forming, then cracks and fissures, filled with 
colonies of oidium albicans. 

The general health suffers. The child becomes irritable and 
restless ; some fever, debility, cough, vomiting, diarrhea, and 
general want of nutrition. 

The small white blisters become ulcers on the tongue, cheeks, 
gums, palate, tonsils ; breath is fetid, and if they extend down 
there may be difficulty in swallowing ; and if there be much 
debility, the case may merge into ulcerative stomatitis or can- 
crum oris. 

All forms highly contagious and infectious. 

Treatment. — In the treatment of all forms of aphthae we must 
recognize the pathology of the disease, an innervation of the 
powers of hfe, a condition of constitutional debility which predis- 
poses to this peculiar degradation. 

So in the treatment a strenuous effort must be made to im- 
prove the general health by a tonic and alterative course — such 
tonics as preparations of cinchona and mineral acids, avena 



64 DISEASE GERMS. 

sativa, glycerite of kephaline, remedies to correct the mal-nutri- 
tion, and alteratives, as comp. saxifraga. 

All insanitary states avoided and a most generous scale of 
dietetics prescribed. 

In the form of mouth washes or gargles, such germicides 
should be used as will annihilate the germ, painting the microbe 
patches with either aromatic sulphuric acid, or tincture of 
siegesbeckie orient or distillation of jequirity,andthen using washes 
of either infusion of hyssop and resorcin ; or solution of boro- 
glyceride ; or of comp. oxygen ; or a few drops of peroxide of 
hydrogen added to water ; or chlorate of potassa, or chlorate of 
carbon ; or infusion of hydrastis, and boroglyceride. 

If the aphthae has descended, there is usually great prostration 
or debility, and germicides must be administered internally. In 
such cases either the glycerite of sulphur or ozone act promptly, 
kill the oidium albicans, and heal up the diphtheric- looking ap- 
pearance of the mucous membrane which had been so completely 
riddled soft, loose, friable by the germs. 



This term is applied to an engorgement of blood, 

Apoplexy, with or without extravasation of blood, in or upon 
any organ, as the brain, cerebral apoplexy ; in or 
on the cord, spinal apoplexy ; in the lung, pulmonary ; and so on 
with other organs. 

As generally used, the term denotes an exhausted state of the 
cerebral pulp, either with anaemia or congestion — the state of 
vital exhaustion so great as to cause the patient to fall down as 
if from a blow. 

Causes. — Anything that tends to exhaust the vital integrity of 
the brain, whether that cause may be predisposed to by hereditary 
tendency, peculiar types of conformation, aggravated or intensified 
by sedentary habits, high living, protuberant bellies, large heads, 
florid features, short, thick necks, high shoulders, a predisposition 
to hemorrhage. Apoplexy is also engendered by disease of the 
liver, heart, kidneys, ossification and calcareous degeneration, and 
deposits of cerebral blood-vessels, gout, intemperance, embolism, 
impure air, tight neckties, stooping posture. 

Varieties. — Nervous or simple apoplexy^ fatal with a trace, is 
rare ; the sanguineous, or that accompanied with extravasation of 
blood into the brain, very common ; and the third form, the 
serous, in which the serum effused is simply present and has no 
relation to an attack. A stroke or an attack is usually followed 
by stupor or coma, and the comatose condition may cease in 
various ways. It may gradually pass off, leaving the patient well ; 



BACTERICIDES. 



65 



or it may terminate in incomplete recovery, mind impaired and 
some part of the body paralyzed ; or it may terminate in death. 
In the latter case, on examining the brain, we find either no ap- 
pearance of disease, or else extravasated blood is discovered in 
the ventricles, or pons varolii, or to a certain amount in the cen- 
trum ovale majus, or in sac of arachnoid, or there may be a 
copious effusion of serum into ventricles or beneath arachnoid, 
with or without cerebral softening. That form which is fatal 
without any trace is very rare. That in parturient women is 
generally a clot embolism from ergot. 

Morbid Anatomy. — Cerebral hemorrhages are of all sizes, 
from minute capillary extravasations to large clots containing 
several ounces of blood. Preceding the hemorrhage, the ruptured 
vessel is the seat of miliary aneurisms, due to arterio-capillary 
fibrosis, which begins in the perivascular lymph spaces, and 
extends to the tunica intima. ]\[icroscopic deposits, or aneurismal 
dilatations, globular, sacculated or fusiform, are developed in 
innumerable numbers, and it is 
through their ruptured walls that 
the hemorrhage occurs. Besides, 
it is often due to fatty and calcar- 
eous degeneration. 

The general locations of ex- 
travasation are the intraventri- 
cular nucleus of the corpus 
striatum, optic thalamus, cere- 
bellum and pons varolii. 

If the apoplectic clot is not 
immediately fatal, change will 
take place in the clot — the se- 
rum will be absorbed — the 
clot may undergo fatty or other 
forms of metamorphosis, and it 
may become encysted. 

Warnings. — Frequently there 
are no premonitory indications 
or threatenings ; when there is, they are characterized by head- 
ache, vertigo, muscae volitantes, or transient blindness, or double 
vision, ringing in the ears, a feehng of weight and fulness in the 
head, often bleeding from nose, fits of nausea, occasional sense of 
numbness in limbs, loss of memory, great mental depression, in- 
coherent talking, drowsiness, indistinct articulation, and partial 
paralysis of foot, limb, face, eyelids. 

An attack usually begins in one or other of three forms : 

I. Patient falls suddenly down, deprived of sense and motion, 

5 




Cerebral Apoplexy. 

Horizontal section of the cerebrum through a clot 
in the left optic tract. 

A, A. Clots from hemorrhage. 

B, B, Area of tissue stained with blood pigment. 



(56 DISEASE GERMS. 

like a person in a sleep ; flushed or even livid ; breathing ster- 
torous, pulse full but slow, much below the natural standard ; 
often convulsions, or rigidity, or contraction of the muscles of the 
limbs on one side. 

2. Sudden, and it may be excruciating pain in the head, pallor, 
sickness, faintness, often vomiting; frequently the patient falls to 
the ground in a state of syncope, coma. In other cases, instead 
of falling, the pain in the head is accompanied by a slight and 
transient loss of consciousness, then headache, with heavy op- 
pressed feeling in the head, which terminates in forgetfulness and 
coma, from which recovery is rare. Clot of great size is generally 
found in the brain. 

3. Or it may come on with all the symptoms of cerebral hem- 
orrhage, paralysis of one side, loss of speech, but no loss of con- 
sciousness. The paralysis leads to coma, or it may pass off and 
the patient recover ; or it may pass off and death suddenly occur 
in a few hours or days,, or it may terminate in another attack. 

Apoplexy has well marked and general characteristics ; its 
duration varies in all cases from a few hours to as many days. 
Complete and total unconsciousness ; pulse generally at first im- 
perceptible or small, but as the patient rallies, stronger and fuller 
as the shock wears off, but slower than natural and often inter- 
mittent; respiration is slow and embarrassed, or stertorous; frothy 
saliva flows from the mouth, and in bad cases the body is covered 
with a cold, clammy sweat ; face is either congested, swollen, 
livid or very pale; eyes dull, glassy, pupils insensible to light, 
often one contracted or the other widely dilated ; ptosis, or drop- 
ping of eyelids, or squinting, according to the nature of the effu- 
sion and its location ; teeth firmly clenched, power of deglutition 
lost or impeded, bowels constipated, motions passed involuntarily, 
involuntary micturition. When it is of the sanguineous type, it 
is not unusual for neck and even shoulders to show congestion 
and lividity. Incomplete recovery is almost always followed by 
paralysis. 

Trcatmrjit. — If the condition in any of its three forms is sus- 
pected, the patient should be warned to guard against all bodily 
exertion, as running, jumping, lifting, hoisting, or violent mental 
emotion or passion, or straining at stool ; and tea, coffee, tobacco, 
whiskey, beer and venereal excitement strictly forbidden ; heavy 
meals or much animal food, stooping, tight neckties, hot baths, 
and even extremes of temperature to be avoided. Diet to be 
nutritious but light, bedroom cool, well ventilated, to sleep on a 
hair or straw mattress with head high ; hair kept short, shower 
or cold water bathing, daily moderate exercise, bowels to be open 
twice dai^y. Two points of irritation between shoulders kept 



BACTERICIDES. 



67 



discharging, at least one inch square ; a little capsicum in socks. 
If there is vertigo, bleeding at nose and headache, bowels more 
active, bromide" of potassa, tinctures of aconite and belladonna 
administered. If not speedily relieved, wet cups to nape of neck 
-and shoulders. If anaemia is predominant, cinchona, mineral 
acids, with nutritious, easily digested food. 

Suppose an attack to have taken place, and that it is of the 
sanguineous type, with coma, labored breathing, pulse slow, im- 
perceptible almost, the face turgid with blood, almost purple or 
black, neck ecchymosed, etc. Then our treatment would be 
precisely the same as for acute inflammation of the brain : shave 
the head and apply hot water, wet cup nape of neck and shoul- 
ders ; mustard roller to feet and limbs, free purgation with com- 
pound powder of jalap and senna, with a few drops of croton oil, 
and repeat it;. head high; and if stertorous breathing continue to 
be placed on right side; then veratrum viride with bromide of 
potassa ; otherwise, general principles. 

Suppose it is an attack with anaemic syncope; no pulse, sighing 
respiration, cold clammy skin, pale face, etc.; we must stimulate; 
warm water to head, no cups nor free purgation, but stimulants. 
An effort must be made to rouse the patient with stimulating 
enemas, nutritious diet, and a course of treatment similar to 
chronic inflammation of brain. 



Effusion of blood into the cord may take place 
Apoplexy, at any part, and in a small or great degree, either 
Spinal. in its substance or from its membranes. It may 
be a result of active inflammation or of concus- 
sions, blows, falls, over-exertion, degeneration of coats of blood- 
vessels, as fatty, calcareous 
caries of the vertebrae. 

A meningeal hemorrhage 
may extend quite a distance in 
the cord, but generally is cir- 
cumscribed; a clot of varying 
size may involve either the gray 
or white matter, or both. 

TJie symptoms will vary ac- 
cording to the seat of lesion. 
Acute and sudden pain in 
back, sometimes in head ; of 
ten severe convulsion's; diffl- . ^ . .,,,.,, 

, , , . .p , . , . , An ettusion of blood with the substence of the cord. 

cult breathmg if high up, with 

heart's action depressed, with pal& and cold skin; if not high 




68 DISEASE GERMS. 

up consciousness not impaired, the spasm then being confined to- 
limbs. Effusion into substance of cord produces paralysis in all 
parts supplied with nerves coming off below its' seat. If hem- 
orrhage be very slight, loss of power occurs slowly. If effu- 
sion is suspected, a further amount is to be checked hy 
perfect repose and application of ice in an intestine along the spinal 
column. Subsequently, the galvanic cautery followed by poul- 
tices, the faces of which are covered with aconite and belladonna 
liniment. Large doses of bromide of potassa and calabar bean 
with general alteratives and tonics, guarding all points very care- 
fully. 

Extravasation of blood into the lung tissue 
Apoplexy, is usually greater in amount than what takes 

Pulmonary, place in the brain — usually there is a complete 
laceration of tissue, or a cavity of considerable- 
size with the blood in it either completely or semi-coagulated.. 
The apoplectic extravasations are never much circumscribed,, 
usually a mass of blood in shreddy oedematous infiltrated 
parenchyma. It may prove immediately fatal, if the pleura is 
extensively perforated. If the patient does survive the accident, 
recovery takes place either by adhesion of the torn surfaces of 
the lung after the absorption of the extravasated blood, or by 
the formation of a capsule of connective tissue around the clot,, 
after which the latter undergoes a cheesy, cretaceous or pigment 
degeneration, and remain permanently imbedded in the lung. 

Diffused pulmonary apoplexy may occur from a very large 
infraction; it results from disease and degeneration of arteries.. 
A branch of the pulmonary artery may suffer from a small aneu- 
rismal condition, and give way through slight exertion, as running, 
jumping, a fall, fractured rib, gun-shot wound. Disease of the 
coats of the artery may cause it, or erosions from the devastations 
of the cancer germ, or the bacilli of tubercle. Common in males- 
three to one after the twenty-first year. 

Symptoms. — Profound collapse, profuse hemorrhage, extreme 
difficulty of breathing, lividity, are the chief symptoms. Asphyxia,, 
convulsions, due to the bronchi being filled with blood. 

It is often difficult to determine this from other diffuse pul- 
monary hemorrhages. It often goes unrecognized until a post- 
mortem is made. 

Recovery is rare, and only possible when the rent in the lung 
is slight. 

Treatment. — The diffuse form of pulmonary hemorrhage is not 
amenable to treatment, as the patient dies from the hemorrhage 
and shock. Diffusible stimulants with quinine may be tried,, 
administered freely. 



BACTERICIDES. 



69 



A genus of entozoa or intestinal worms. The 

Ascaris. species are very numerous, one of the best known 
is the ascaris hnnbricoides^ commonly called the 
round worm, whicli occurs in the intestines of man and 
some of the lower animals, and bears a striking resemblance 
to the common earth worm. When once in the alimentary canal, 
to which it gains access by its eggs being incorporated in some 
article of food or drink, it produces a deterioration of the general 
health and reflexly irritates the brain, giving rise to cerebral anae- 
mia, which is indicated by the pale face, dilated pupil, indigestion, 
fetid breath, cough, grinding of teeth, rolling of head, spasms. 

An immense number of remedies are in general use for the 
expulsion of this parasite, the most effectual of which is santonine. 
It does not in all cases kill the worm, but acts by making their 
dwelling-place disagreeable to them. 

One or two grains of pulverized santonine should be triturated 
in five or ten grains of sugar of milk and administered every other 
night on retiring, in water, followed the morning afterwards with 
a dose of comp. syrup of rhubarb and potassa to move the bowels. 

As a general tonic to the intestinal tract, so as to brace it and 
prevent the eggs of those parasites lodging in its folds, the ozon- 
ized extract of stone crop should be administered for six or eight 
weeks. 

Ascaris vermicidaris, or thread worm, is a very 

Ascarides. common species, both in children and adults. It 
infests chiefly the lower portion of the colon and 
rectum, great numbers often being present. They are white in 
color, not more than half an inch in length. 

Their presence is indicative of great inherent weakness of 
organization, and their generation due either to eggs swallowed 
in food or drink. 

They occasion intolerable itching, irritation, loss of sleep and 
impairment of the general health. 

In the treatment of ascarides an effort must be made to improve 
the general health by all possible means. A most generous diet, 
gentle exercise, a judicious use of tonics and alteratives. The 
patient should be placed upon the internal use of Virginia stone 
crop for three months. 

Before the usual daily evacuation of the bowels, an injection of 
any one of the following agents, infusion of quassia, golden seal, 
wormwood, goldthread, stone crop, or a solution of boroglyceride ; 
resorcin, naphthaline, will be found of great efficacy. 

On retiring in the evening the bowels should also be copiously 
injected, so that its contents may pass off; then about two ounces 



jQ DISEASE GERMS. 

of ozonized witch hazel injected and permitted to remain over 
night. In this way a speedy cure is effected. 



An effusion of serum into the cavity of the abdo- 

Ascites. men may arise from numerous causes, although the 

two principal are peritonitis and disease of the liver 

1. In acute, but more especially in chronic, inflammation of the 
peritoneum, effusion of serum takes place in great abundance, but 
the inflammatory process may subside, leaving the cavity of the 
abdomen pretty well filled up with fluid, when effusion still pro- 
gresses onward owing to a distension or unravelling of the peri- 
toneal fibres or sacs. 

2. All morbid states of the liver, whether it be an inflammatory 
process or due to the gland being blocked up by disease germs 
or microbes, causing an interstitial death or destruction of the 
hepatic cells, with either hypertrophy or atrophy of the gland. 
Microbial engorgement of the liver is a more common cause of 
enlargement than either alcohol or mercury. Enlargement is a 
more fertile source of effusion than atrophy, from the oblitera- 
tion or wiping out of its proper structure by fatty, amyloid or 
cystic degeneration, blocking up the portal vein, obstructing its 
normal circulation. 

In addition to those two principal sources of dropsy of the 
abdomen, there are always more or less exosmosis of serum from 
the blood in disease of the heart, spleen, kidneys, anaemia ; 
besides, it is often the result of extensive burns. 

The recognition and diagnosis of ascites are not by any means 
difficult. The history of the case and the physical appearances 
are good points as to whether the dropsy arises from an ob- 
structed or clogged-up liver, or from chronic peritonitis. If from 
the liver, the sallow or yellow skin, congested conjunctiva, 
brown-coated tongue, cough, dulness on percussion of the upper 
lobe of the right lung, pain in shoulder, liver indurated either 
small or large, drowsiness, urine loaded with bile ; whereas, if 
from chronic peritonitis, none of the above symptoms will be 
present, but the upper portion of the body will be greatly ema- 
ciated, features pinched, countenance anxious, skin shining, super- 
ficial veins dilated, abdomen greatly enlarged. 

Ovarian cysts sometimes become enormously enlarged, so as 
to fill up the entire abdominal cavity, and the diagnosis is often 
difficult ; at a late period generally, however, it can be made out. 

A good plan is to cause the patient to stand up, spread the 
fingers of the left hand over the right side of the abdomen of the 
patient, and tapping gently with the right hand the left side of 
the abdomen ; a wave, a sense of fluctuation can be felt undulat- 



BACTERICIDES. 



71 



ing from side to side. This fluctuation or vibration is most 
valuable and reliable. Bowels might be emptied with a dose of 
oil, then the patient placed in the recumbent posture, then on 
percussion there is resonance, bowels floating on the top of the 
fluid. In the recumbent posture, if there is water in the cavity 
of the abdomen, there will be a sense of suffocation from the 
water pressing up against the diaphragm ; great difficulty of 
breathing ; respiratory murmur cannot be heard so low down as 
in health ; tubular breathing; apex of heart elevated and pressed 
to the right side. Very generally there is swelling of the feet 
aiid limbs ; if the heart and kidneys suffer, cedema of the face and 
arms. There is a general depreciation of vital force, — debility, 
emaciation, prostration, want of appetite, sleeplessness, inability to 
lie down, invariably ending fatally when due to organic disease of 
the liver. 

In the treatment of these cases, success usually attends our 
efforts when due to peritonitis ; but when dne to organic dis'-^ase 
of the liver, the effusion may be removed again and again, but it 
will re-accumulate, because the cause does not permit of removal. 

The removal of the water from the cavity of the abdomen is 
effected thus : — the patient must be built up in every possible 
manner, placed upon the richest diet, and every possible means 
taken to improve h's general health. A few days before any 
strenuous effort is made to remove the effusion by the three 
emunctories of the body, the patient should be either placed 
upon an infusion of digitalis, or upon the tincture of stro- 
phanthus. The action of either of these two remedies gives tone 
to the heart, — unlocks the flood gates of the body. These reme- 
dies should be followed up with diaphoretics, of which the alcoholic 
vapor bath is probably the best; diuretics, of which hair-cap mo.ss^ 
squills, bitartrate potassa and apocynum are efficient; hydra- 
gogue cathartics, as mandrake combined with nitrate and bitar- 
trate of potass; squirting cucumber. 

These means failing, an alterative course should be tried; all 
remedies failing, then the abdomen should be tapped. 



This term is generally used to designate sus- 
Asphyxia. pended animation, produced by the non-conver- 
sion of the venous blood of the lungs into arterial. 
The supply of air being cut off, the unchanged venous blood of 
the pulmonary artery passes into the minute radicles of the pul- 
monary veins,- which require arterial blood to excite them ; more 
or less stagnation takes place in the pulmonary capillaries, and 
death frequently ensues from this cause. Besides, the non-oxy- 



72 



DISEASE GERMS. 



genized blood is very poisonous to the brain, and has no stimulus 
to the ventricles of the heart. 

It is believed that asphyxia occurs before the oxygen has dis- 
appeared from the blood, because it is held by the haemoglobin 
so firmly that the tissues cannot obtain it. Thus, suppose no 
oxygen is admitted by respiration. It is well known that all the 
blood in the body passes through the heart and lungs in the time 
of one complete circulation, that is, in about twenty seconds; and 
we have it on eminent authority that in this time one-third 
of the oxygen is used up by the tissues. According to the per- 
cussion theory, the stroke of the left ventricle arterializes the 
blood, that is, liberates the oxygen from the haemoglobin, and 
this arterialized blood is carried to the tissues. The haemoglobin 
does not get sufficient time to recombine with the oxygen, because 
of the successive strokes of the heart and the vibrating thrill kept 
up in the arterial ramifications. The free oxygen is used up by 
the tissues in the capillary circulation to the extent of one-third. 
After leaving the capillaries, the tworthirds of oxygen again re- 
combine with the haemoglobin, and in this condition return to the 
heart, along with one-third of haemoglobin that has lost its 
oxygen. In ordinary circumstances this one-third would again 
obtain oxygen from the alveoli of the lungs; but if all the oxygen 
there has been used up, of course it cannot obtain any oxygen. 
The blood flows from the lungs to the left ventricle, when it is 
again arterialized, and again sent out through the arteries ; but as 
there is now a large amount of free haemoglobin present in the 
capillary circulation, it will seize hold of a part of the oxygen, 
and the tissues will obtain less than the usual supply. With each 
successive circulation, the amount of oxygen available for the 
tissues will become less and less, until the tissues receive none, 
because all the oxygen set free by each beat of the left ventricle 
is seized hold of in the capillary circulation by the reduced 
haemoglobin. The tissues die from want of oxygen, because 
there is too much reduced haemoglobin present, a substance 
having a greater affinity for oxygen than the tissues possess, a 
result that would probably occur, as in drowning, in the time 
of six or eight complete circulations, that is, in three or four 
minutes. 

Causes. — Whatever prevents the ingress of air into the lungs, 
as effusion of lymph in acute laryngitis; congestion of the lungs 
in pneumonia; drowning, strangulation; obstruction of the larynx 
by foreign bodies ; inhalation of chloroform, carbonic acid gas, 
other poisonous gases; narcotic poisons; injuries to the medulla 
oblongata; dislocation of the spine in cervical portion. 

In all forms the treatment resolves itself into the removal ot 



BACTERICIDES. , ^73 

foreign bodies; or water; allowing an ingress ot pure air into the 
luncrs, and in inducing^ warmth and circulation. 

AspJiyxiafrom Drozvning. — The first effect felt by a drowning 
person is an urgent feeling of anxiety in the chest ; the pulse 
becomes weak; the respirations become less, and the blood of a 
venous hue. The venous blood acts as a narcotic poison on the 
brain — produces insensibility, loss of voluntary motion ; surface 
becomes of a livid hue ; the heart ceases to beat ; the sphincters 
relax ; body sinks to the bottom. 

If life is utterly extinct, the pupils are dilated, jaws clenched, 
fingers and thumbs contracted, face pale. 

Reanimation may take place from five minutes to three-quarters 
of an hour after immersion. 

Asphyxia from Strangulation.— T]!^ first effect of tightening the 
cord around the neck is the suspension of respiration, and en- 
gorgement of the brain with blood ; then sensibility decreases ; 
■epileptic convulsions come on — suffusion, lividity, turgidity of the 
face and upper part of the body; eyes open; features distorted; 
hands clenched ; sphincters relaxed. If the air is not perfectly 
•excluded, the sufferings are: engorgement of head and brain 
greater. The action of the heart becomes more active as the 
■death-struggle progresses, and continues beating after respiration 
has ceased. 

Asphyxia from Poisonous Gases. — Carbonic acid gas is the most 
common — burning charcoal. 

The usual symptoms being a deep sleep, with intense, throb- 
bing headache, with weight and heat, especially about back of 
head ; strong pulsations and.tightness across the temples ; vertigo ; 
increased action of the heart, and often violent palpitation ; con- 
fusion of ideas ; failure of memory ; nausea ; hysteric sobbing. 
If the vapor has been breathed for some time, the symptoms will 
be : noises in the ears, partial or total loss of vision, disturbance of 
the senses. 

Asphyxia, under the above conditions, depends upon accumu- 
lation of carbonic acid gas in the lungs, the want of oxygen in 
the blood — the natural stimulus of living tissue. 

Appearances zvhich Indicate Death. — Total suspension ot 
breathing and heart's action ; eyelids half closed and pupils 
•dilated ; jaws clenched ; tongue appearing between teeth, with 
frothy mucus about the mouth and nostrils ; fingers semi-con- 
tracted, with coldness and pallor of the surface. 

Treatment of Asphyxia from Strangulation or Suffocation, 
Anaesthetics, Gases, etc. — 

Rule i. To Maintain a Free Entra)ice of Air into the Wind- 
j)ipe. — Cleanse the mouth and nostrils ; open the mouth ; draw 



74 



DISEASE GERMS. 



forth the patient's tongue and keep it forward ; an elastic band 
over the tongue and under the chin will answer this purpose. 
Remove all tight clothing from neck, chest or waist. Make sure 
that there is no foreign body lodged in pharynx, larynx or ceso- 
phagus. If water is there, place patient on abdomen, over a 
hogshead and give half a dozen rapid rolls. Then 

Rule 2. To Adjust the Patieiifs Position. — Place the patient 
on his back, on a flat surface, inclined a little from the feet 
upwards ; raise and support the head and shoulders on a small^ 
firm cushion, or folded article of dress, placed under the shoulder- 
blades. Supposing natural respiration has ceased, proceed- — 

Rule 3. To Imitate the Movements of Breathing. — Grasp- 
patient's arms just above the elbows, and draw the arms gtntly 
and steadily upwards until they meet above the head. (This is 
for the purpose of elevating the ribs, and thus expanding the 
chest and drawing air into the lungs.) Pressure on the breast- 
bone will aid this. Repeat these movements alternately, deliber- 
ately and perseveringly, fifteen times in a minute for two or three- 
hours, or until a spontaneous effort to respire is perceived; imme- 
diately upon which, cease to imitate the movements of breathing^, 
and proceed to induce circulation and warmth. Should a warm 
bath be procurable, the body may be placed in it up to the neck» 
continuing to imitate movements of breathing. Raise the body- 
in twenty seconds in a sitting posture, and dash cold water against 
chest and face, and pass ammonia under the nose. Patient 
should not be kept in the bath longer than five or six minutes. 

Rule 4. To Excite Inspiration. — During employment of above 
method, excite nostrils with snuff or ammonia, or tickle throat; 
with a feather. Rub chest and face briskly ; dash, alternately,. 
hot and cold water on them. 

Rule 5. To Excite Circulation and Warmth. — Wrap patient 
in dry blankets and commence rubbing limbs upwards, firmly 
and energetically. F'riction must be continued under dry 
blankets or over dry clothing. 

Promote warmth of body by application of hot flannels, bottles 
or bladders of hot water ; heated bricks, etc., to armpit, over 
stomach and heart, between thighs and to soles of feet. 

On restoration of life, when power of swallowing has returned^, 
a teaspoonful of warm water, warm brandy and water, or coffee, 
should be given. Patient should be kept in bed ; disposition to 
sleep encouraged. During reaction, large mustard plasters to 
chest and below shoulders will greatly relieve distressed breathing. 

In cases where the base of the brain is weak, or where the nar- 
cotic, or gas, or anaesthetic operate with peculiar violence upon 
that part of the nervous organism, the jaws become not only 



BACTERICIDES. 



75 



clinched, but immovably rigid, so that the mouth cannot be 
opened ; then the following method of resuscitation must be 
enforced. It is of special utility to the drowned. 

The Method of Artificial Respiration for the Treatment of the 
Droivned. — Rule i. The moment patient is taken out of the 
water instantly turn him downward, with a large, firm roll of 
clothing under stomach and chest. Place one of his arms under 
his forehead, so as to keep his mouth from the ground. Press 
with all your weight for three or four, or five seconds, each ti ne 
upon the patient's back, so that the water is pressed out of lungs 
and stomach and drains freely out of mouth. Then : 

Rule 2. Quickly turn patient, face upward, with a roll of 
clothing under back, just below shoulder-blades, and make the 
head hang back as low as possible. Place patient's hands above 
his head. Kneel, with patient's hips between your knees, and fix 
your elbows firmly against your hips. Now, grasping lower part 
of patient's naked chest, squeeze his sides together, pressing 
gradually forward, with all your might, for about three seconds, 
until your mouth is nearly over patient's mouth ; then with a 
push, suddenly jerk yourself back. Rest about three seconds ; 
then begin again, repeating these bellows-blowing movements 
with perfect regularity, so that the foul air may be pressed out 
and pure air drawn into the lungs, about eight or ten times per 
minute, for at least one hour, or until the patient breathes 
naturally. 

Note. — The above directions must be used on the spot, the first 
instant the patient is taken from the water. A moment's delay, 
and success may be hopeless. Prevent crowding around patient, 
as abundance of fresh air is important. Once he breathes be 
careful not to interrupt it. If they are very long apart, carefully 
continue between them the bellows-blowing movements, as before. 
After breathing is regular, let patient be rubbed dry, wrapped up 
in warm blankets, a little brandy and water can be given in small 
occasional doses, and then be left to rest and sleep. If no physi- 
cian is near, any bystander can carry out these rules, as it 
requires no expert. 

The above method is undoubtedly the best for the ejectment of 
fluids from the stomach and thorax ; with it there is no need 
in opening the mouth, which is usually closely clinched, and of 
drawing the tongue forward, which is impossible, the position of 
the patient obviating this necessity. The compress on is most 
complete, and capable of the most delicate adaptation ; it can be 
performed by one person in almost any situation, and continued 
as long as there is any use. It is the essential method in drown- 
ing, as it empties the water-logged thorax, relieves the filled 



;76 DISEASE GERMS. 

bronchi, releases the immovable diaphragm, and thus makes 
respiration possible. 

In the first position, a roll of clothing under the stomach 
and thorax makes shoulders the highest point ; the nostrils and 
mouth the lowest. The displaced fluids run downwards, cleans- 
ing the upper air passages, which are perfectly drained. Then 
the pressure upon the back causes a complete ejectment of the 
fluid, and we have a free passage for air established ; an open air- 
way and imitation of the natural movements. 

The best method of compression is to place the thumbs at the 
bottom of the cartilages of the ribs along their front part. The 
force then applied to the ribs is through the medium of the 
thoracic walls, so distributed as to give no shocks, no violence, 
but cause the ribs to move in their intercostal spaces. 

A person of the most average intelligence can easily understand 
the two rules laid down. The kneeling position is not tiresome ; 
the parts to be pressed are raised to the hands ; the weight of the 
body is the chief force, and there are intervals of complete rest. 
It is true, the rate of respiration is one-half slower than other 
methods ; but even with that, there is more oxygen supplied than 
a partiall}^ asphyxiated person can breathe, or bear, or assimilate ; 
besides, it has the advantage of allowing better diffusion and 
minimizes superfluous disturbances. 

It is of especial advantage in drowning, because in that form of 
asph)-xia the jaws are inseparably clinched, the slippery tongue 
is receded into the pharynx, and the epiglottis has fallen back so 
that no air can enter, and our first method cannot be carried out. 
It is very doubtful whether it is not the best for chloroform and 
syncope ; it is certainly the quickest. 

In asphyxia from chloroform, same management, and cloths 
wrung out of boiling water over heart, even to vesication. 

Intense Cold. — Cold acts chiefly from without, freezing inwards, 
causing serous congestion of the three great cavities, with giddi- 
ness, inability to see, weakness and rigidity of limbs ; almost 
imperceptible respiration and pulse; tendency to profound sleep, 
or coma. Patient must be placed in a room without fire, and an 
attempt made at restoration of circulation and sensibility by rub- 
bing the body with snow, or ice, or cold water. Frictions with 
flannels, long continued ; very gradual application of warmth; a 
stimulating enema, warm milk, with capsicum, coffee, beef-tea or 
warm wine. 

Syncope, — Fainting, sudden prostration. Remedies are : recum- 
bent posture, to slow heart twelve or fifteen beats per minute ; 
head low, cold air ; cold water dashed over head and chest ; 
smart beatine on chest with a wet towel ; friction or mustard 



BACTERICIDES. 



77 



plasters over region of heart ; small quantities ot ammonia or 
brandy. 

The syncope in ansemia and chlorosis must be cautiously treated, 
with brandy, wine, carbonate of ammonia and beef juice, given 
both by the mouth and rectum, with artificial heat over the heart 
and extremities. The recumbent position should be maintained 
until the action of the he^rt is nearly normal. 

Narcotic Poisons. — Patient to be placed on side, head slightly 
raised ; cold affusion ; heat to extremities ; stimulating applica- 
tion to chest and back ; the use of stomach pump. The antidote 
with tea, or coffee, or solution of acetate of ammonia, or one drop 
of a one-per-cent. solution of nitro-glycerine upon the tongue 
will often excite the heart to action. 



An irritation of the nerves that supply the circular 

Asthma, muscular fibres of the bronchi, causing spasm or 
contraction. This irritation may be in the periphery 
in the bronchi, or in the medulla oblongata, so that paroxysms or 
fits may be induced by reflex or direct mechanism, that is to say, 
the stimulus to contraction may be central in the medulla, or it 
may be in pulmonary or gastric portion of the pneumogastric, or 
in some other part of the nervous system, besides the vagus, and 
being transmitted to the medulla by incident, is thence reflected 
by motor filaments. 

A very good plan is to arrange causes under three divisions : 
([.) Central causes in the medulla oblongata. (2.) Peripheral 
causes in the bronchi, lung, stomach, heart. (3.) Affections of 
blood. 

(i.) Often hereditary; pecuHar types of conformation; idio- 
pathic. 

(2.) Reflex; disease of heart, stomach, lungs, alimentary canal, 
skin. 

(3.) Germs in blood irritating the weakened cerebral bulb or 
periphery, as tubercle, syphilis, rabies, gout, etc., so that asthma, 
has always at the root of it some central nervous irritation, or 
some peripheral source of it. 

The causes embraced under these, then, are very numerous, 
as diseases of the chest and abdomen, some latent skin disease, 
certain winds, changes in atmosphere, especially dryness, with 
increase of oxygen and diminished electricity ; inhalation of 
disease-germs or irritating substances, the micro-organisms of 
plants, flowers, hay, malaria, gout, rheumatism ; non-acclimati- 
zation or incompatibility to soil, location or country. If there 
is no apparent cause, blood-germs, as syphilis, rabies, tuberculse. 



78 DISEASE GERMS. 

An asthmatic is thin, of a nervous temperament, round-shoul- 
dered ; countenance expressive of attacks of suffering ; cheeks 
hollow; voice rather hoarse; slight cough; suffers from nervous 
dyspepsia. 

Symptoms. — Languor, lassitude, debility, headache and drowsi- 
ness, often digestive derangement ; or it may occur suddenly 
without any of those signs. Most generally the patient falls into 
a sleep, when he suddenly awakes with a sense of suffocation or 
constriction about the chest ; smothering and difficulty of breath- 
ing increases until there is a most fearful struggle for breath. 
Patient gets right up in the sitting posture and assumes various 
positions to facilitate respiration. Chest becomes distended to its 
utmost limit. The contractions of the circular muscular fibres of 
bronchi are so great that they offer a perfect obstruction to the 
entrance or exit of air. On placing ear to the chest, no natural 
breathing audible, but dry murmurs, loud wheezings, shrill whist- 
lings are heard. Pulse becomes small, feeble, almost impercepti- 
ble ; eyes staring, protruding from sockets ; countenance anxious ; 
lips purple ; temperature of body falls to nearly 8o° Fahr. But 
after a while of intense suffering, the ski* becomes bathed in a 
copious sweat. After that usually the spasm breaks and the pa- 
tient obtains relief Cough, with some expectoration ; paroxysms 
ceases, and patient falls asleep. 

One attack may follow another, or there may be a series of 
light attacks violent enough to keep patient up in his chair to 
midnight. Attacks may come on every night or at long inter- 
vals — often periodical. Asthma is very capricious, kept up by 
some climates, some aromas, gases, houses, beds, etc. During 
the interval or between attacks patient enjoys moderately good 
health. Men are more frequently attacked than women. 

Asthma, denominated hay, ragweed, roses and the micro- 
organism of plants and trees does not differ in symptoms. The 
bacilli of the vegetable kingdom acts as an irritant to the peri- 
phery of nerves in the bronchi ; it is reflected to the bulb and 
transmitted back — hence the spasms. 

The duration of asthma is apt to be tedious if not arrested 
promptly at the start. Its effects or results are, thickening of the 
circular muscular rings, with effused lymph, causing a permanent 
narrowing of tubes and wheezing respiration ; dilatation of the 
air vessels into sacs or pouches, as in emphysema; dilatation of 
ventricles of the heart from emboh'sm ; general break ino^ down of 
the nervous system, nervous dyspepsia, alkaline diathesis, etc. 

Treatment. — During the attack, if the stomach is loaded, an 
-emetic of lobelia ; or if suffering from constipation, copious 
-enemas. Then the great object in treatment is to relax bronchial 



BACTERICIDES. ^q 

spasm. For this purpose some of the following remedies should 
be tried, selecting one until one is procured that is effectual. 

Lobelia, useful in a number of cases ; when it produces nausea and 
•collapse the attack often ceases. Compound powder is best form. 
A cup of strong coffee will often ward off an attack ; so will 
a strong glass of hot whiskey punch. 

Inhalation of chloroform or other anaesthetics, like ether, are 
of little utility. Iodoform dissolved in ether and inhaled may be 
useful if due to catar*-h. 

A dose of two grains of iodide of potassa, the same of car- 
bonate of ammonia, with twenty drops of tincture of belladonna, 
may ward off an attack. 

Sulphate of sparteine is an effective remedy in asthma — it begins 
to act in about thirty minutes after it has been taken by the mouth, 
.and its action lasts from about five to six hours. This rapidity 
of action, at first consisting in a stimulation of the heart, rise of 
-arterial tension not occurring until a little later, indicates the use of 
sparteine in asystolic conditions of valvular disease where a speedy 
effect is desired, giving it superiority over more slow'ly acting 
drugs in asthma. 

In these conditions, too, a small dose should be employed (one- 
-sixteenth to one-quarter of a grain), since in these doses sparteine 
.seems powerfully to stimulate and regulate the heart with the 
smallest rise of arterial tension, perhaps not more than is the 
normal accompaniment of increased cardiac force. 

Diuretic effect is most marked with fairly large doses, half a 
:grain to two grains ; with small it is not so evident, but is often 
present. Flushing of the surface of the body occurs in from 
one to two hours after administration in most cases. 

Nitrite of amyl, five drops on a cloth and inhaled, or iodide 
of ethyl, six to ten drops inhaled; either one increases the bron- 
chial secretion, gives instant relief Their effects are transient but 
often curative. Nitrite of amyl in alcohol operates like a charm, 
as follows : Alcohol, half an ounce; water, one ounce and a half; 
ni4:rite amyl, three drops. — Mix. Add to half a tumbler of ice or 
cold water and drink at once. The alcohol keeps up the action of 
the nitrite of amyl for some time. Such a combination relaxes the 
arterial vessels to their minutest subdivision, relaxes organic mus- 
cular flbr#. 

One or more drops of a one-per-cent. solution of nitro-glycer- 
ine produces, within a few minutes, a diminution of tension and 
wonderful relief in breathing. Its effects are marked and durable. 
The fluid extract of quebracho is used most successfully in 
asthma. A teaspoonful, repeated every ten minutes, relieves the 
difficulty of breathing. 



8o DISEASE GERMS. 

The fluid extract of euphorbia piluHfera has a most dtcided 
effect in nearly all cases of asthma. 

Catalpa of most use in chronic nervous cases 

Members of the medical profession are disgusted with the end- 
less complications and combinations of antispasmodics, and have 
sought other remedies, as jaborandi and its alkaloid, pilocarpin. 
The powerful revolution which that remedy produces in the dis- 
tribution of the blood, has a most beneficial effect in asthma, attract- 
mg the blood to the skin and salivary glands, and by diminishing 
its volume through the copious perspiration and salivation. The 
interstitial changes in the lung after its exhibition is followed by 
amelioration of all the symptoms. Its use requires care and cau- 
tion. The alkaloid, by hypodermic injection, is preferable to the 
fluid extract, in doses of about one-third of a grain. During the 
action of drug, recumbent posture. 

Antispasmodic fumes may be used in the absence of better 
remedies ; they owe their properties chiefly to ammonia, or some 
acro-narcotic, nitre paper, stramonium, belladonna and lobelia ; 
cigarettes produce when inhaled intense hyperaemia, as may be 
seen in the buccal, pharyngeal, laryngeal mucous membrane of 
habitual smokers, and exudation which tends to soften and detach 
obstinate mucus. With such remedies, we endeavor to overcome 
spasm ; and with the use of the bromine compound as laid down 
under hooping-cough, in doses of a teaspoonful every three 
hours, we make an effort to ward off attacks, and in the interval 
we try curative measures. 

Curative Treatment. — Great care and diligence to ascertain 
cause or causes. If there seems to be a catarrhal condition, 
treatment as laid down under that head ; if there are latent germs, 
present in the blood treat accordingly. Dogs licking children's 
hands, in whose mouths the germ of rabies are often present, is. 
a fruitful but unthought-of cause of asthma in adult life. Power- 
ful alteratives, as iodide of potass and ozonized glycerine ; indeed,, 
these constitute the most certain way of curing asthma, whatever 
its origin may be. Blisters or irritating plasters to nape of neck 
on both sides, an open sore. If there are any reflex conditions,, 
remove them. If digestion is weak, cinchona compound and 
mineral acids, pepsine, gentian. If there is evidence of malaria, 
tincture iodine, green-root tincture of gelseminum with quinine. 
If no cause can be discovered, a general alterative and tonic 
course. 

Rosin-weed and a large list of worthless drugs are now dis- 
carded in the cure of asthma. 

Every possible means taken to improve the general health by 
tonics ; the most nutritive diet, regular mode of life ; daily use of 



BACTERICIDES. gl 

the cold shower or sponge bath ; removal of dyspepsia ; meals to 
be taken at such hours that digestion may be completed before 
retiring to bed. Flannel clothing. To sleep on hair or straw 
mattress ; bed in all cases to be insulated from the floor or wall by 
glass castors, so as not to permit the electrical forces to be drawn 
off. A suitable house, location or climate selected. 

As to the effects of asthma, thickening of the rings of the 
bronchi, alteratives, irritating plaster are of great utility ; other 
terminations managed on general principles. 



One of the most common diseases of the spinal 
Ataxia cord, and consists in an increase of its interstitial 

Locomotor, connective tissue, forming a ribbon-like sclerosis 
of the white posterior columns and horns of the 
cord, and posterior roots of the spinal nerves, leading to gray de- 
generation, with peripheral structural change in the cranial nerves. 

These changes usually begin in the lateral part of the posterior 
column in the upper lumbar and lower dorsal regions and extend 
upwards and downwards, and in old chronic cases the sclerosis 
may even extend to the medulla oblongata, 

Ataxia is most frequently met with in men (rarely in women), 
generally between the ages of twenty and fifty. 

Neurasthenia acts as a predisposing cause ; whereas, anything 
which will impair the integrity of the nervous system, as cold, 
wet, mental and physical overwork ; masturbation, sexual ex- 
cesses ; depression of spirits ; deleterious food ; insanitary condi- 
tions ; poor blood; prolonged lactation ; the use of tobacco; sup- 
pression of the menses ; blows ; falls ; concussions, act as excit- 
ing causes. It may either be an attendant or a sequela of dis- 
ease germs in the blood, more especially the microbe of syphilis ; 
pneumonia, diphtheria, fevers, and the like. 

Ataxia is generally ushered in with nervous prostration, fol- 
lowed by a gradual disturbance of sensation, loss of co-ordinating 
power of the lower extremities, with indications of paralysis. 
There is sometimes temporary diplopia and color blindness, with 
unequal contraction of the pupils. The course of the disease is 
slow and progressive. In a large majority of cases, in the pre- 
monitory stage there is intense pain in the limbs, of a sharp, tear- 
ing character ; incontinence of urine ; spermatorrhea or nocturnal 
pollutions ; sexual hyper aemia ; but most generally there is a per- 
fect loss of sexual desire. Extreme weariness, nausea, vomiting, 
aching in the stomach, with a sense of formication and numbness 
in the skin, with a tightness or girdle sensation round the body 
are present in a number of cases ; while in another class we 
6 



82 DISEASE GERMS. 

liave rectal, vesical and nephritic neuralgia, with cerebral cis- 
turbance. 

The nervous disturbance is very variable, a sense of numbness 
in the hip, a pricking sensation in the knee joints, a sensation of 
some soft substance between the feet and the ground, an un- 
steadiness of gait ; walks like one intoxicated ; if the feet are 
brought closely together, the eyes closed, the body will sway to 
and fro and then fell ; patient is compelled to watch his feet while 
walking. Later on he throws out his feet and hands with forcible, 
irregular, jerking movements. The loss of co-ordinating power 
is so great that the patient by and by is unable to walk. Marked 
loss of sensation in feet and legs and of temperature. Sensation 
blunted, senses impaired, but the higher cerebral faculties are 
rarely impaired. The abolition of the tendo-reflex is one of the 
diagnostic signs of the disease. 

A peculiar inflammatory affection often attacks the joints, knee 
hip, shoulder, elbow, which often terminates in a complete disor- 
ganization of the articular surfaces. Paralysis of the sphincter 
muscle of the bladder and rectum, bed-sores and numerous other 
distressing symptoms. 

The recognition of the disease is based entirely upon the symp- 
toms enumerated, and it cannot possibly be confounded with any 
other malady. 

The efficacy of treatment depends a good deal upon the stage 
at which it is commenced. An alterative and tonic course is 
the most reliable. The utility of comp. saxifraga, phytolacca, in 
alternation with cinchona and the mineral acids cannot be doubted. 
The glycerite of kephaline, tincture of oats, comp. tincture mar- 
ticaria, in alternation with tincture of belladonna, cannabis Indica, 
phenacetin merit a trial. 

Locally to the lumbar region of the spine, an irritating plaster 
9-inch X 6-inch, longways across, should be worn so as to keep up 
an absorbent action, but never to cause an ulcerated surface — on 
about one half the time, off the other. 

The use of electricity, by faradization and otherwise, is of little 
benefit compared with warm baths of sulphuret of potassium, 
alternated with cold baths and massage. These are of great 
efficacy. 

The suspension treatment is barbarous in the extreme; there is 
nothing in it to commend it to common sense, far less science. 
Bowels should be scrupulously cared for, well regulated. 

The diet and mode of life should be such as is most conducive 
to the highest degree of health. Everything which will preserve 
nerve-force and prevent exhaustion. 



BACTERICIDES. 



83 



Pulmonary collapse or atelectasis is a condi- 

Atelectasis. tion of the lungs in which there is a partial or 
total absence of air in the alveoli. 

Congenital atelectasis occurs in feeble infants or those born pre- 
Tnaturely, where the nares or other parts necessary to respiration 
are plugged with mucus. 

Pulmonary collapse is more rare in adults than in infants. 
Any disease or condition which weakens or obstructs the power 
of inspiration may induce it, such morbid states of the brain, 
light clothing, paralysis of the vagus ; syphilitic disease of the 
<ord ; in bronchitis, that is the catarrhal-pneumonic form, in which 
the bacilli are abundant, where they crowd the bronchi and tena- 
•ciously aggregate together, forming a plug in a bronchus — not 
permitting air to enter. Collapse from aneurisms, hydrothorax, 
tumors, pus, air, very common. 

From the total mortality of infants nearly thirty per cent, is due 
to collapse. 

The pathological condition of collapse or where lung substance 
lias not been penetrated by air is, engorged with blood, looks like 
a piece of liver '* splenified," will sink in water ; fatty degenera- 
tion, cell and germ proliferation soon occur in the collapsed part. 
The entire lungs may be affected or only part. 

It may be suspected or recognized in the new-born by feeble 
Ibreathing, very slight motion of the chest, a low, almost inaudi- 
f'ble w^hining cry, lividity and coldness of the extremities, constant 
^sleepiness, often muscular twitchings and convulsions. Child 
cannot nurse. Since the foramen ovale and ductus arteriosus so 
•often remain open in congenital atelectasis, anomalies of the cir- 
•Gulation may cause asphyxia, convulsions, suffocation and death. 
.Blood clots often form in the cerebral sinuses. When collapse 
•occurs in advanced life during the progress of acute capillary 
bronchitis or some other affection of the respiratory organs, there 
is labored breathing, dyspnoea, frequent cough, with muco-puru- 
lent expectoration, frequent respirations, from seventy to one hun- 
dred per minute. Passive hypersemia and oedema of the ex- 
tremities are common results of pulmonary collapse. The pulse 
is small, feeble ; the skin cool, urine scanty. An interval between 
inspiration and respiration. 

The physical signs are, an absence of intercostal movement, 
dulness or percussion over the collapsed lung ; respiratory 
sounds feeble or absent. Later on bronchial breathing and 
bronchophony. Rales due to associated bronchitis, coarse and 
sonorous. 

Its recognition from pneumonia is easy : there is no fever, 
no flush on the cheek, no prune-juice expectoration — from the 



84 DISEASE GERMS. 

tubercular bacilli, in which there is hectic, wasting, cough, microbe 
in sputum, etc. 

Well-marked atelectasis is very fatal, especially if complicated 
with the mycelium of hooping-cough, or the germs of pneumonia 
or pulmonary tuberculosis, or asphyxia. 

Treatments — In the new-born the treatment should be the hot 
bath, followed by dashing cold water on the nuchal region, which 
excites strong inspiratory impulses ; kept rolled up in warm flan- 
nel, 80° F. 

Rubbing, friction, stimulating liniments, massage ; a reapplica- 
tion of the bath. 

The salts of ammonia and potash are most admirable remedies. 

Small doses of lobelia and bloodroot are most admirable drugs,, 
to relieve bronchi, carried to emesis to dislodge clot or plug. 

In all cases tonics, stimulants and active nutrition are indicated. 



Blows, violence, strains, tension of blood- 

Atheroma. vessels measurably weaken their coats and pre- 
dispose them to disease. This may involve a 
large area of a vessel, but most generally it is limited to points 
or patches. If there be extraneous or adventitious matter in 
the blood, as there is in tuberculosis, syphilis, cancer, gout, 
rheumatism, lead poisoning, chronic alcoholism, waxy, fatty,, 
calcareous and other forms of degeneration. 

Some of these states or conditions give rise to an inflammation 
or irritation of the internal coats of the vessel, which give rise to 
the multiplication of cellular elements. Granular, fatty degenera- 
tion of these speedily give rise to arterial sclerosis. When this 
commences, first the internal and by and by the middle coat fol- 
lows, a point or focus of deposit which comes from the blood 
current. This deposit, a mere pellicle at first, takes on a yellow,, 
atheromatous condition. 

The changes begin in the centre of the patch ; when duly 
completed it contains a putty-like mass of cholesterin crystals, 
fat granules and crystals of fatty acids. When there is little or 
no fatty change in the patches the process is called *' sclerosis^ 
and they are stained dark brown. When these processes progress 
slowly, calcareous granules infiltrate the tunica intima, and later 
on form thin, friable, calcareous plates just underneath the original 
internal pellicle. 

Arterial sclerosis is peculiar to advanced life and to males ; 
any artery of the body may be affected, but the larger trunks are 
more susceptible to this change. When so, they become still 
more enlarged, irregular, friable. 



BACTERICIDES. 



85 



Nature frequently makes an effort to rid the vessel of the 
offending material. Then the stiffened calcareous coats break ; 
chinks are formed, into which blood flows, which after a time 
becomes melanotic. In large vessels the middle coat often dis- 
appears entirely, connective tissue taking its place. Destruction 
of the middle coat almost invariably gives rise to aneurism. 

The symptoms of atheroma are often obscure : heart failure, 
mechanical rigidity, pulse almost imperceptible, coldness of 
extremities, extreme debility, dry gangrene ; apoplexy, epilepsy, 
dementia, petrification. 

Special organs may atrophy, lungs become emphysematous ; 
general bankruptcy of all parts of the body. 

The diagnosis is often difficult ; if near the, heart, paroxysms 
of angina pectoris ; other parts, different symptoms. Calcifica- 
tion of arteries gives rise to aneurism. 

Atheroma is justly regarded as an incurable disease, but if it 
were possible to recognize it early enough much good might be 
effected by charging the blood frequently with proper doses of 
comp. oxygen, hydrogen peroxide, which has the effect of 
causing a dissolution of the deposit, whatever it may be. 



A want of nourishment ; a morbid condition 

Atrophy, resulting in deficient nutrition of the body, or a 
part of it ; a decay or waste of substance. If cer- 
tain causes exist it may attack any organ, gland or tissue. 

Atrophy of the Brain. — Cerebral atrophy may be congenital, or 
the result of old age. It may follow cerebral hemorrhage, or 
softening, or induration, or tumors, or chronic inflammation, or 
effusion. Injury, or destruction of vessels, or calcareous degene- 
ration induces atrophy. Masturbation wipes out the typical 
fissures of thought and invariably brings about a shrinkage ; so 
do sexual excesses, but not in such a marked degree. The use 
of alcohol, opium and tobacco induces anaemia of the brain, 
which is followed by atrophy. 

The infantile form of marasmus of the brain is generally due 
to defects in the parents, as tuberculae, syphilis, mercury ; to 
maternal impressions, injuries. 

Brain liable to be atrophied is irregular, hard, misshapen, 
owing to defective fcetal development. 

Physiologically the brain begins to diminish in size and weight 
after the sixtieth year, in drinking men and masturbators much 
earlier. 

Slight atrophy belongs to old age, bnt interstitial wasting of 
the connective tissue belongs to habits and germ-laden blood. 



86 DISEASE GERMS. 

The greatest waste of brain substance in any known disease is 
paralysis of the insane, where the cerebrum is often only one- 
half its size and weight. 

Cerebral atrophy is attended by a general failure of the mental 
faculties and senses. Memory is first impaired, movements are- 
unsteady, then accompanied by tremor. Patient sleeps the 
greater part of the time. Incomplete paralysis accompanies 
these atrophic changes. Epileptiform seizures are often fre- 
quent. 

Such symptoms as headache, vertigo, irritability of temper,, 
decided weakness of memory, thickness of speech, change m 
the voice, hallucinations of untold riches, terrible outbursts of 
rage, followed by complete imbecility. 

Atrophy of the brain in time involves the medulla, implicat- 
ing the life centres situated therein ; deglutition and respiration 
are much interfered with. 

Senile atrophy can never be mistaken for any other brain- 
lesion, as it comes on slowly and steadily in advanced life, and 
is progressive. Congenital atrophy is very apt to terminate- 
fatally about the fourth year. 

Improvement of the general health is the most important 
indication in treatment. Gentle exercise ; bathing twice daily., 
followed by massage and faradization of the entire body. The 
diet should be generous and the bowels carefully regulated, and 
some of the following cerebral stimulants should be tried : Tinc- 
ture avena sativa; glycerite of kephaline ; ozonized water, etc. 
General alteratives and tonics. 

Atrophy of the Heart. — This consists in a diminution in the 
size and weight of the heart. It is described as simple, concen- 
tric and eccentric ; but these terms are scarcely necessary, as all 
cases of true cardiac atrophy are concentric ; that is, are accom- 
panied by a diminution in the capacity of its cavities. In some 
cases, wasting of the cardiac muscle is attended by an increase of 
intermuscular connective tissue ; in such cases, there is a decrease 
in the size, but a very marked diminution of its contractile power. 
A decrease in size and number of the muscular fibres often takes 
place, due to morbid states of the pericardium, which is often ad- 
herent, indurated, puckered, opaque. The tendency of all forms 
of muscle waste is to fatty degeneration ; when the cardiac muscle 
reaches that point it is called yellow atrophy. In atrophy due to 
old age, the heart muscle is brown, due to extensive pigmentation. 
' The common causes of cardiac atrophy or wasting are an im- 
poverished brain, exhausting disease, germ-laden blood, as in 
phthisis, syphilis, cancer; typhoid or any morbid state, accompanied- 
by defective nutrition, may produce atrophy of the heart-muscle ;; 



BACTERICIDES. 



^7 



old age, pressure from pericardial effusion, morbid growths, aneur- 
isms operate by pressure, causing constriction, fibrous thickening 
of the pericardium, atheroma, thrombosis, may cause atrophy. 
It is not infrequently congenital, associated with the dwarfed in- 
tellectual faculties of children w^hose fathers may have been ine- 
briates. 

Cardiac atrophy is easily recognized by the decreased area of 
dulness over the region of the heart, its diminished contractions 
and respirations; enfeebled heart-power; impulse feeble; sounds 
indistinct ; lowered temperature. 

That form which results from local interference with the nutri- 
tion of the heart, as adhesions and thickening of the pericardium, 
tumors, presents symptoms nearly analogous to those of a fatty 
heart. 

The prognosis of any special case will depend upon the cause 
and extent of the atrophy ; when it passes into fatty degenera- 
tion, which is known by its irregular action, sense of suffocation, 
or by the presence of pericardial adhesions or effusions, the prog- 
nosis is most unfavorable ; the atrophy of old age is not neces- 
sarily fatal. 

In the treatment of atrophy of the heart, physical exercise and 
mental excitement and study must be avoided. The diet should 
be generous to a fault, highly animalized, indulged in freely. 

Some of the following remedies should be tried, so as to stim- 
ulate or promote growth of muscle fibre : 

Iron, arsenic, mineral acids, preparations of cinchona are in- 
variably serviceable in all cardiac affections attended by feeble 
nutrition and heart failure. 

Sparteine sulphate excels all known remedies as a cardiac tonic, 
and cactus, strophanthus, convallaria are also good. 

Atrophy of the Lung. — Is commonly due to senile changes 
incidental to old age ; emphysema ; general marasmus : hydro- 
thorax ; pressure from tumors. 

An atrophied lung is small, dry, anaemic ; pigmented, or 
marbled by lines or dots ; some degree of fatty degeneration 
always piresent, most invariably accompanied with numerous 
complications. 

The most prominent symptoms are difficulty of breathing; 
oedema and coldness of the extremities ; cyanosis ; a pigeon- 
breast appearance of the thorax, moving as if it was in one piece. 

Atrophy of the lung admits of no treatment. 

Atrophy of the Prostate, — The greatest therapeutical use of fl. 
ex. of the saw palmetto, even greater than its nutritive action, is 
the restoration of the glandular structure of glands. Atrophy of 
the testes is a common result of spermatorrhoea, masturbation, 



38 DISEASE GERMS. 

sexual excesses, varicocele, but atrophy of the prostate is much 
more rare ; still it is common, generally associated with prosta- 
torrhoea, from self-abuse or imperfectly cured gonorrhea. No 
greater calamity could befall a man, for when it exists the force 
of ejaculating the semen is impaired or entirely gone. Besides, 
when the gland wastes or withers, there is a deficient or scanty 
secretion. 

Cases of this kind occurring in practice require nice tact and 
judgment; remedies used must have a vitalizing effect on the 
entire genito-urinary tract, as well as a general alterative and 
tonic course. It is true the saw palmetto and kephaline excel 
all other remedies, but it is not to be understood that when these 
drugs enter the body that they intelligently avoid all other parts 
and reach directly to the prostate and brain. No ; they have an 
effect upon the entire body, more or less. Not a gland that is 
not stimulated when the palmetto is administered, not a fissure of 
the brain that is not roused into activity under the influence ot 
the ozonized glycerite of kephaline. Those two remedies are 
indicated in all prostatic affections, in atrophy, prostatorrhoea, 
inflammation, congestion, etc. 

In addition : direct medication of the prostate can be effected by 
the introduction of ozonized urethral bougies prepared either 
from damiana or salix niger, and also by the use of rectal sup- 
positories prepared from the same agents. 

Atropliy of the Testes, due to varicocele and like causes, best 
treated by local stimulation, bathing the scrotum with oil of pal- 
metto berries ; wearing a suspensory ; a general constructive 
treatment. 

Atrophy of Muscles. — Muscular structure may waste its fibres, 
become small, pale, inelastic, and its proper texture usurped by 
fat. This may happen from non-use ; from injury to their nerves ; 
from the presence of microbes, eating up the neurine or pabulum 
of nerves, as in fevers and microbial disease ; from the presence of 
the amylobacta of rheumatism ; from shocks, concussions of the 
spinal cord, and a variety of other causes. 

Its recognition is easy ; there is wasting, a decided decrease in 
size of the aftected parts, its temperature diminishes, sensation 
impaired, numbness, formication, imperfect nutrition ; if the 
patient is young it fails to grow in proportion to the rest of the 
bod\'. 

The process of wasting may or may not be painless. If the 
nerves are irritated by disease germs circulating in the blood, 
there will probably be pain. 

The wasting of muscular structure, if not arrested, is proeres- 
sively onward to fatty degeneration ; that is, the muscular fibres 



BACTERICIDES. 89 

3re usurped by fat, a non-vital, inelastic body, devoid of contrac- 
tility and all power of motion. 

This can be easily ascertained by placing the positive pole of a 
■battery near the insertion of the muscle supposed to be affected, 
.and the negative near its insertion, permitting a pretty strong 
-current to run, gradually bringing the two poles within about 
four inches of each other. If muscular fibre be still good, the 
Tiiuscle, in a few seconds, will bulge up or contract at its centre 
between the two poles of the battery. If muscular structure has 
-degenerated, that is become usurped by fat, the muscle will 
remain quiescent and exhibit no sign of contractility. 

Treatment. — Once it is positively ascertained by the above test 
that the muscle has lost its contractility and undergone fatty 
•degeneration, no known remedy is of any avail; but if there be 
:a slight motion or evidence of contraction between the poles of 
the battery with a fair current, a cure can be effected if the cause 
can be removed. Suppose slight evidence of contractility exists, 
a careful examination should be made to ascertain whether or 
not there exists in the blood or other vital structures of the body 
.any microbe or disease germ, such as the microbe of syphilis, 
cancer, tubercle or the bacillus of fevers, or diphtheria ; and if 
such exist the patient should be placed on special bactericides to 
kill the microbe, and a general tonic course, embracing such 
remedies as cinchona, mineral acids and very nutritious, highly- 
fibrined food. 

To the affected muscle or muscles, massage, which will embrace 
stimulating frictions, baths, electricity for a specified time, once or 
"twice daily, so as to stimulate growth of muscular fibre, and this 
to be continued for a period of some months. 

If there be pain, there are microbes present, nibbling at the 
^thered or blighted nerves, hence the need of potent germicides. 
If those germs have caused stiffness rigidity, they should be 
mianaged on general principles. 



Consists of an irritation, inflammation, with a 
Balanitis, shining, glistening redness, or excoriation of the 
covering of the glans penis and inner aspect of 
prepuce. Some call it balanitis when the glans only are affected, 
.and balanitis-posthitis when both glans and internal lining mem- 
brance of prepuce are involved. The distinction is unnecessary 
-and altogether uncalled for, as the two conditions are essentially 
the same. 

Causes. — Excessive sebaceous secretions around corono, glandis 
often give rise to it in boys and virtuous young men, and cause 



go DISEASE GERMS. 

anxiety, which ignorant or knavish physicians will magnify into^ 
something venereal, so as to extort a fee. Rubbing of clothes, 
chafing in hot weather, masturbation, a natural rankness in some 
women, will cause it in highly-organized and susceptible men ;. 
catamenial discharge, and the venereal germs. From whatever 
cause it arises, it can be communicated to the opposite, sex hy 
contact ; as the parts, whether dry or freely exuding muco-puru- 
lent matter, are freely covered or filled with bacteria. Anti- 
septic precautions should be rigidly observed ; destruction of 
the dressings, and great cleanliness, especially about the hands,, 
lest any of the matter reaches the eye. 

Symptoms. — Heat, redness, itching about the glans. In some 
cases it is of a smooth, shining redness; in others, a muco-puru- 
lent discharge. On uncovering the glans, by drawing back the 
prepuce or foreskin, patches of redness and excoriations are per- 
ceived, with flakes of curd-like matter. If there be swelling of 
fore-skin, or if its sphincter fibres are irritated, it may be con- 
tracted, so that it cannot be drawn back over the head of the 
penis, so that retraction is impossible, and then there is phimosis.. 
There are many reasons why the foreskin should be drawn back 
in cases of this kind ; there may be a perforating ulcer, a chancre,. 
or an abscess, or mortification may be taking place ; bubo from 
the irritation may take place ; there may be a gonorrhea, or aoi 
indurated or infecting chancre. 

Vulvitis in women is an analogous affection. 

Treatment. — Draw the foreskin gently back ; make a wash ol 
permanganate of potass, ten grains to the pint of water, or a 
tablespoonful of boroglyceride to the pint; take a small sponge, 
saturate with the wash, and squeeze it so that it drops from a 
height of twelve inches on the affected part. Continue this 
douching till the pint is used ; do it tHree times a day. After 
having performed this, press gently a fine piece of muslin, or silk,, 
on the affected part, so as to dry it ; then smear over glans and' 
prepuce with ozone ointment. When the foreskin can be drawn 
back, this plan will effect a cure in a few days. The ozone 
ointment could be .spread on a thin layer of cotton-wool if desired. 
In cases where the foreskin cannot be drawn back, take a small 
gonorrheal syringe, and inject round and round it with same 
wash. If an ulcer, or chancre, or gangrene is suspected, circum- 
cision, slitting up of prepuce ; or sometimes it can be relaxed 
with a warm poultice and belladonna. If there is danger of con- 
traction, a little cotton-wool smeared with ointment should be- 
kept applied. 

Mothers should be instructed to draw back the foreskin in the- 
daily ablutions of the child, and apply a little oil to unite witli> 



BACTERICIDES. 



93 



the sebaceous secretion, and then wash off. Young men should! 
follow same practice every day. This would not only promote 
health, vigor, and growth of the penis, but would do much to- 
prevent masturbation, nocturnal emissions. 

It would have a salutary effect. The oil need not be used 
unless there is the white, cheesy secretion ; it will suffice to drop- 
cold water on its neck, with the foreskin retracted, or drawm 
back. 

The poison of venemous reptiles- 
Bites of Rabid Animals and rabid animals is a living 
and microbe, which when introducedi 

Venomous Reptiles. through the true skin enters the- 

circulation, where it grows with, 
prodigious rapidity, excretes ptomaines freely. The micro-organ- 
isms from all bites either have a tendency to destroy the blood 
or by their ptomaines the nervous system. In the former case, a. 
species of erysipelatous inflammation of the skin and cellular tissue 
is predominant ; in the latter, a peculiar train of nervous symp- 
toms, as intense pain in the wound, radiating in the course of the 
nerves ; prostration, faintness, rapidly followed by feebleness of" 
pulse, bilious vomitings, difficulty of breathing, profuse sweatings,, 
jaundice, convulsions. 

The treatment of the bites of all rabid animals should be : aL 
ligature above and below the bitten part to prevent if possible- 
the ingress of micro-organisms into the blood, or nerve cells ; wet; 
cups, hot fomentations if cups are not handy, free incisions with-, 
abundance of hot water, peroxide of hydrogen, to encourage free 
bleeding and annihilate all microbes ; after the wound has bleed 
freely and been thoroughly cleansed of microbial matter, it should 
be dried, and wood ashes or caustic potassa freely applied, then 
irrigation with ozonized vinegar, followed again with a spray oF 
peroxide of hydrogen, or chloride of ammonia in a poultice. 

Immediately, or as soon as possible, bactericides should be- 
administered so as to render the blood so thoroughly sterilized 
that no microbe can live in it. This can be effected with ai. 
variety of remedies, subsequently mentioned. 

In the case of bites by rabid animals, giving rise to erysipela- 
tous inflammation, the microbe may be in the cellular tissue 
or blood or 'both; the nearest lymphatics are apt to become- 
engorged with the microbial mass, which gives rise to abscess and. 
doughy swellings. 

In cases of this kind free incisions cannot be resorted to too> 
early, followed by germicide pouhices, as charcoal and yeast :. 
linseed meal and resorcin. 



92 



DISEASE GERMS. 



Before the application of these pouhices, the entire affected 
surface should be painted with an ointment of salicylic acid and 
creasote, or oil of boroglyceride. 

In another class of cases the germ of the reptile or snake 
becomes imbedded in a nerve or its neurilemma, and grows with 
great rapidity, so prodigious that either the germ development or 
its ptomaine may cause death in twenty minutes, the entire 
nervous system becoming perfectly paralyzed, the cutaneous 
surface shrunk and withered and as white as snow, constriction 
of chest, threatened paralysis of the involuntary muscles often 
taking place a few minutes after the bite. In all such cases there 
is no time to wait on the action of drugs, and the quickest and 
safest plan is to procure anaesthesia of the nervous system for 
ten or twelve hours by the copious drinking of good brandy or 
whiskey until perfectly drunk. It must be given in half-pint doses 
•every few minutes to obtain the desired result. It is most extra- 
ordinary the quantity necessary to be given in some cases. 
During the quasi-suspension under whiskey there seems to be no 
pabulum for the germ elaborated, and it dies in the body, the 
bitten person recovering from his anaesthesia or stupor well. 

A still more certain method is to combine liquor potass with 
the brandy or whiskey. The liquor potass completely neutralizes 
snake poison. It should be given in the brandy in ten, twenty 
or thirty drop doses sufficiently often. The brandy stimulates, 
rouses, carries the potash into the blood, and enables it to over- 
take and neutralize the poison in the blood. The saturation of 
the system with the alkali until the secretions are alkaline is the 
point to be aimed at. The permanganate of potassa has the same 
power, but owes its property to the potash alone. 

To all bites of venomous insects, as wasps, mosquitos, spiders, 
•and poisoning with ivy, sumach and other agents, a saturated 
solution of muriate of ammonia, or better still concentrated ozone 
or peroxide of hydrogen. 



A boil or carbuncle is an oil-gland of the skin 

Boils filled with lymph, and interspersed through that 

or l}'mph are to be found the staphylococcus pyo- 

Carbuncles. geims aureus. The microbe is pathogenic of the 

malady, bears cultivation well in chicken broth. 

Carbuncles on^y differ from boils in their size, they contain the 

same microbe. The pus of either will inoculate and reproduce 

the original in either man or animal. 

The primary cause is depression of the vital powers and the 
exciting causes are malnutrition, derangement of stomach and 



BACTERICIDES. g^ 

bowels, and a degradation of normal living matter into bacteria, 
which pass into the blood and find their way into the oil-glands 
of the skin, probably in search of free oxygen. The cause of the 
malassimilation may be overcrowding, bad ventilation, filth, bad 
diet, as pork, meagre, or insufficient or sameness of food, indeed^ 
anything that depresses the stomach. 

Sy^nptoms. — Brown-coated tongue ; nausea ; loathing of food ; 
constipation ; fetid breath ; heats and colds ; fever, with head- 
ache and languor ; inflammation of an oil-gland on nape of 
neck, back, limbs, or anywhere where glands of that class are 
numerous ; gland fills up with the lymph and bacteria, and resem- 
bles a sugar-loaf, apex pointing inwards and broad base on sur- 
face ; vary in size from a pea to a large pear ; the largest are 
usually met with on back. The gland is a regular cyst or sac, 
whose lining membrane is a secreting one. By proper treat- 
ment, before lymph breaks down, they may disappear ; but if 
they progress, lymph breaks down, patient has a rigor, then 
throbbing, and suppuration goes on until either relieved by na- 
ture or art. In some cases there is a large crop, great constitu- 
tional disturbance and danger ; in other cases, a solitary one may- 
create quite alarming symptoms. 

In the treatment of all cases of boils or carbuncles, w^e have a 
bacteria-coated tongue, very sluggish liver, and in order to excite 
a healthy action of the alimentary canal, it is good practice here 
to adminster a rousing emetic of lobelia ; and in order to cause 
rapid absorption of the drug let the patient drink abundance of 
tepid alkaline water, or warm water to which bicarbonate of po- 
tassa has been added. This will aid in cleansing the stomachy 
and the lobelia has a most marvellous effect in retarding and even 
retrograding microbe evolution. This should be followed with 
an alcoholic sweat ; and the bowels freely opened with a saline 
cathartic. 

For a tonic to promote an appetite and keep up a brisk stimu- 
lating action on the liver, a teaspoonful of the following mixture 
should be administered every four hours : 

Compound tincture of cinchona; simple syrup; of each two- 
ounces ; nitro-muriatic acid, two drachms. Mix. Bowels kept 
free with salines, or a dose of the phosphate of soda at bedtime. 

Some bactericide should be given between the respective doses 
of the cinchona mixture, such as either tincture of lycopodium 
glycerite of sulphur, or peroxide of hydrogen, or ozone water, or 
brewer's yeast, resorcin, creolin, sulphide of calcium. 

Some remedy to sterilize or annihilate the microbe. The lyco- 
podium or glycerite of sulphur has a most remarkable action 
upon the microbe of boils, so have the other remedies enumerated 
— one selected which the physicians deem best. 



^4 DISEASE GERMS. 

Locally, if case is seen early, before any indication of the forma- 
:tion of pus, and the patient is desirous to prevent an abscess, the 
boil may be injected with either peroxide of hydrogen or gluco- 
-zone, which will destroy the bacteria, and the lymph will be ab- 
sorbed ; or another plan, a paste of the solid extract of bella- 
donna and resorcin, equal parts, might be tried; or it might be 
painted with concentrated ozone and chloroform. Even more 
i-nergetic discutients might be applied, such as ozonized clay, 
iodized oil, iodol, etc. 

If there is the slightest speck or point of softening, any evi- 
>dence that a change to perfect downward evolution has taken 
place, that suppuration is inevitable, there are several plans 
which can be adopted. In resorting to surgical procedures, it 
must be borne in mind that the shape of the boil is like a regular 
sugar-loaf cone, and for a perfect cure a complete riddance of the 
germ colony, the sac with its contents must be exfoliated or 
thrown off, or destroyed, as its contents are extremely contagious, 
liable to affect healthy parts. 

A most excellent method is to protect the adjacent parts, all 
around the boil, wipe the surface of the boil dry, then take a 
stick of caustic potassa and apply, burning down into the sub- 
stance of the boil. This should be done thoroughly. Subse- 
•quently the action of, the caustic potassa must be neutralized with 
•vinegar, and an antiseptic poultice applied ; latterly it should be 
liealed up with black salve or ozone ointment. 

Another good method is to make a crucial incision down 
through the boil and divide it into four parts ; subsequently treat 
as above. 

Electrotysis may be tried, but it is simply a method of less 
painful cauterization. 

The diet in boils should be the best, and very generous, includ- 
ing beef, mutton, poultry, eggs, milk, with abundance of vegeta- 
bles and fruit. 

Operatives in copper, zinc and tin are 
Brass Founders' liable to several morbid conditions from 
Disease. the inhalation and absorption of the fumes 

of the metals. Most generally the metal 
has an affinity for the fine delicate nerves of the duodenum and 
brain, like lead and bismuth, but workers in brass have a regular 
cachexia produced by the metal, a feeling of languor and depres- 
sion, peculiar sallow hue of skin, with anaemia, and febrile 
attacks like intermittent fever. 

The attacks, however, do not come on with regularity. In 
the stage of chill there is usually constriction or tightness about 



BACTERICIDES. 



9S 



the chest, and in the last stage, which is followed by a profuse 
•sweat, the linen is usually stained with the eliminated metal, and 
it has a brassy odor. 

Poisoning by brass and tin is much more common than is 
■generally supposed. Many of the indescribable derangements 
•of the digestive tract are due to minute portions of those metals 
■finding their way there from various culinary articles, as kettles, 
pots, etc., and also from the cocks and spigots of soda fountains, 
mineral-water bottles, and ordinary water-pipes. An oxalate of 
tin is to be found in every article preserved in tin cans, as toma- 
toes, peas, asparagus, which is exceedingly toxical and capable 
'of producing a well-marked train of symptoms, identical in their 
character with brass poisoning. The preservation and cooking 
of edibles in tin and brass vessels is a prolific source of disease, 
^nd measures of some kind should be adopted to arrest the 
spread of this latent form of poisoning. 

Treatment. — Workmen should avoid the fumes of zinc and 
"brass ; iodide potass unites with them freely and causes their 
•elimination. In some cases lobelia emetics are of great efficacy, 
followed by cinchona and mineral acids ; bowels to be regulated 
^nd alkaline baths used daily. 



The degree of heat that can be borne by 
Burns, Scalds, the human body without causing injury 
depends very much upon the medium 
through which it is applied, as well as the organization of the 
individual. The degree of partial death inflicted upon the body 
may be embraced under three grades, as crytJienia, vesication^ 
Mlceration. 

The danger of burns depends a good deal on their intensity ; 
the extent of surface injured; the degree of disorganization ; the 
importance of the part, the age and power of vital resistance of 
the patient. 

Symptoms. — There is the shock ; state of prostration or col- 
lapse, which is often dangerous. The pallor, coldness, sighing 
respiration, shivering, feebleness of pulse, and other indications 
of imperfect reaction and exhaustion, followed by fever with 
congestion or effusion in or upon brain, lungs, bowels ; or it may 
be reflex, and produce spasms, convulsions, or there may be the 
tedious, dragging symptom of hectic during the stage of cicatri- 
zation or otherwise. Besides the above, the arrest of the insensi- 
ble perspiration of the skin naturally gives rise to a tendency to 
serous effusion in one or all of the three great cavities, and if the 
burn partakes of the character of a blister, there are grave changes 



96 



DISEASE GERMS. 



that take place in the blood, especially if the blister is extensive.. 
The serum in the blister is found not to be water from the blood,„ 
but rich fibrinous liquor sanguinis — and this exudation of blood 
plasma causes the blood to be thicker, more concentrated, and its- 
relative proportions of corpuscles and plasma modified to even a. 
fatal extent. This concentration of the blood reduces the blood 
pressure, and retards the flow of lymph, and interferes with the 
general nutrition of the part. 

Treatment. — The first point is to bring about reaction by dif- 
fusible stimulants and artificial heat to the extremities. After 
reaction, open bowels with castor oil or cascara. If reaction is 
imperfect then administer aconite and serpentaria for fever. If 
there are reflex symptoms, as spasm, antispasmodics by mouth 
and rectum, followed by bromide of potass and calabar bean. 
Pain must be relieved with hyoscyamus and opium. Repeat 
until comfortable. Any congestion of brain, lungs, bowels to be 
treated on general principles. If tonics are required, let them 
be cinchona and ammonia. Give plenty of fluid nourishment, as; 
milk, beef- tea, raw eggs, juice of raw beef, or raw beef extracts. • 
In all cases relieve pain and nervous irritability. 

Locally, to burns, nothing can excel the carbolic acid and olive 
oil ; one ounce of the acid to six or ten of the oil, according to 
age and thickness of skin. It stimulates, destroys micro-organ- 
ism, and aids healing ; saturate lint and apply. The following is 
excellent in burns or scalds : Boroglyceride paste, eight ounces ; 
two-per-cent. solution of cocaine, one ounce ; resorcin, half an 
ounce ; mix ; absorbent cotton, a sufficient quantity to hold the 
above in suspension. Apply to any burn. Instant relief of pain, 
all inflammatory symptoms arrested, bacteria destroyed. Any 
application that will exclude air from the injured surface should 
be applied until this is procured ; as molasses, lard, and flour, 
vinegar or starch, and white oxide of zinc and oil. In burns of 
the second degree (blisters) do not puncture nor interfere with 
the cuticle. The great danger of burns in this stage is due tO' 
the amount of liquor sanguinis in the blister, and death is due 
to the blood changes so induced in that fluid. This, of course,, 
is best remedied by the juice of meat. The dressing in all cases 
should be changed thrice daily, and precautions taken against 
deformity. 

Inflammation or partial death of the mucous 
Bronchitis, membrane of the bronchial tubes. It may be 
acute or chronic, and affect the larger or smaller 
tubes, or both; or one or both lungs throughout, or only a por- 
tion of them. 



BACTERICIDES. qj7 

A very dangerous form of inflammation, 

Bronchitis, accompanied with great fever and prostration, 
Acute. and danger of a spread of the inflammation 

to the vesicular texture of the lungs, or a plug- 
ging up of the bronchi with effused lymph and collapse, or inflam- 
mation of the substance of the lung with blood, lymph, liquor 
sanguinis, etc. 

The causes are usually cold, damp, wet, exposure to vicissi- 
tudes of weather, inhalation of irritants, etc. 

Syinptonts.— Shock, with indications of prostration, violent 
headache, with rigors, and a high grade of fever ; pulse often 140 ; 
respirations from thirty to forty ; heat 105° up ; a sense of intense 
soreness or rawness over the affected part ; tightness or constric- 
tion of the chest; hurried or excited respiration, with rough 
wheezing ; incessant hacking, dry cough at first, afterwards 
expectoration of viscid, glary, frothy mucus, and afterwards of 
muco-purulent matter ; pulse, although frequent, is weak ; tongue 
heavily coated, nausea, great anxiety, with indications of pros- 
tration and collapse. 

Inflammation of the main trunk or large-sized tubes is attended 
with much less danger than the smaller branches. In the 
smaller branches, there is a greater tendency, in a fit of coughing- 
or excitement, for the tube or tubes to be blocked up by thick 
viscid, tenacious phlegm, which, on taking a deep inspiration, is 
liable to be pushed down ; acting as a cork, preventing the air 
from reaching a lobe of the lung, hence collapse. A portion of 
lung not filled by air becomes quickly hepatized or vesicular, 
emphysema is produced ; so that in either case we have a vital 
organ incapable of aeration. 

On percussion of the chest in bronchitis, the lungs should 
exhibit resonance and clearness from top to bottom ; at least, no 
marked aeration should be detected, with the exception of 
increased resonance in emphysema, or the dull, flat sound of 
hepatization in collapse. 

On auscultation, in the early stages, dry sounds or rales can 
be distinctly heard, like air rushing through a red hot tube. If 
heard over the main trunk or large branches, it is called rhonchus ; 
if over the small branches, sibilus. Rhonchus to the large, sibi- 
lus to the small. Sibilus bespeaks danger ; rhonchus almost free 
from it. These dry sounds are usually only heard the first iQ.\sf 
days, for once the inflammation has terminated in effusion and its 
products have poured out from the inflamed membrane, those 
dry sounds are displaced by moist sounds, called large crepita- 
tion, if over the large tubes ; small crepitation if over the small. 
So rhonchus and large crepitation are the dry and moist sounds 

7 



98 



DISEASE GERMS. 



of large air passages ; sibilus and small crepitation of the smaller 
branches. Its duration, under good treatment, should not take 
over a few days. 

Ireatment, — Recumbent posture in bed, temperature, 70° Fahr., 
air to be moistened by hot steam. If stomach is badly deranged 
and tongue foul, a gentle emetic of lobelia ; if there be constipa- 
tion, open bowels quickly with enemas and salines. Diet to con- 
sist of warm beef tea, warm gruel, or warm milk and arrow-root, 
warm mucilaginous drinks, as flaxseed tea, wine whey ; heat to 
feet. Mustard is to be applied over chest and back, large plasters, 
followed with hot poultices of flaxseed meal and glycerine. 

There are several methods of breaking up the attack. If seen 
early, one is by the administration of large doses of tinctures of 
aconite and veratrum every half hour, till pulse is seventy, and 
then at less frequent intervals. This is a good plan, another plan 
is to administer either antipyrine, or antifebrin till temperature is 
normal ; still another is to give small does of lobelia until the' 
patient becomes slightly nauseated and pulse down, and tlien at 
less frequent intervals. And a fourth good expedient is to use 
iaborandi or its alkaloid ; the former in fluid extract, or, if the 
latter, by hypodermic injection. If jaborandi or pilocarpln be 
used, the patient must cease drinking and spit out his saliva 
freely. The powerful revolution which this latter remedy pro- 
duces in the distribution of the blood, has an instantaneous effect 
in attracting the blood to the skin, relieving the bronchial mucous 
membrane. Its action is quick in giving relief; besides, it 
favors the expulsion of the obstructing plug in the air passages, 
prevents the formation of viscid mucus, prevents the swelling of 
the large bronchial glands and initiates reparator\' process in the 
bronchial tract. In an urgent case the four methods might be 
combined. As soon as the urgent symptoms are perfectly con- 
trolled, an alkali, such as the muriate of ammonia or chlorate of 
potassa, or carbonate of ammonia or potassa. The effects of 
alkalies are very marked, indeed. They soothe, soften and aid 
expectoration, and if given in combination with an acid, the dry 
rales subside and are replaced by moist ones; expectoration 
copious, and cough less frequent and less troublesome. Con- 
valescence to be established upon alteratives, as the ozonized 
n-lvcerine, phytolacca, and tonics, like quinine and mineral acids. 



ma)' be a sequel of an acute attack, 
Bronchitis, Chronic, or it may come on of itself from the 

same causes that produce the acute, 
or from the presence of microbes in the blood. 



BACTERICIDES. qq 

Symptoms. — General symptoms -of nervous prostration, lan- 
guor, lassitude, debility, face white, features sharp-pointed ; 
nervous dyspepsia ; phosphates and chlorides in urine ; great 
emaciation, harassing cough, even habitual ; great difficulty of 
breathing, shortness of breathing ; sometimes a sense of soreness 
or rawness, in other cases this is absent. The lungs in ordinary 
cases should be clear from top to bottom, but as it generally 
assumes one or other of two forms, this may not be the case. 
One form, without expectoration, tends to emphysema ; the other, 
with copious expectoration, leads to pulmonary consolidation. 
The former will have unusual resonance on percussion ; the 
latter, dulness. If there is expectoration, it is copious, and 
aggravated by exposure to cold or damp, bad living or change of 
temperature. There is little rhonchus or sibilus in chronic 
bronchitis, but abundance of moist crepitation, large and small. 
In all cases the nutritive disturbance proceeds from the surface of 
the bronchi and gradually spreads to the stroma of the lungs, 
terminating in atrophy or in sclerosis. Dilatation of bronchi, 
with condensation of surrounding tissue, often results ; some- 
times a sort of bronchial catarrh, with excessive muco-purulent 
discharge. The winter coughs or colds, recurring annually, are 
but the precursors of more permanent forms of bronchial inflam- 
mation. When 
interstitial sub- _______.,^___^.^;:rr==3c^>i:v^.^.^'^ o 

stance of lung is -^^ ^^~^~^^^^^-^^ ^ ,-_w-<^ 

greatly affected ~^-<C:-^^^ ^<^ 

m eiiner lOlIIl, conferva of bronchitis as found in the sputum of all chronic cases. 

non-aeration of 

blood to a limited extent, which gives rise to a blueness of nails* 

or lips, slate or even livid appearance of skin, especially of the 

lower extremities. It is essentially a chronic affection, lasting 

years, seldom directly fatal, but may be so by the causing of other 

diseases. 

In chronic bronchitis there is always a true ulceration of the 
bronchial mucous membrane, and a degradation of the living 
matter concerned in its nutrition into bacteria, which are found 
in great abundance in the sputum ; not however in such immense 
quantities as in chronic laryngitis, still, enough co place chronic 
bronchitis as a somewhat contagious disease. 

There are invariably present in every case of chronic bronchitis, 
no matter whether it be simple, tubercular, syphilitic, the vege- 
table microbe, the conferva. It is the presence of the original 
germ, and this latter, which renders it such a stubborn malady. 

Treatment. — This is varied, but embraces certain well-defined 
principles. A warm, moist atmosphere, which contains a small 



100 DISEASE GERMS. 

amount of oxygen, is the most suitable; flannel or silk clothing, 
especially next to skin; daily bathing, alkaline or acid, followed 
by inunction of warm olive oil to the amount of three or four 
ounces ; diet and drink to be warm and of the most nourishing 
kind, such as milk, eggs, boiled fish, broiled tenderloin steak, 
with abundance of cooked vegetables. Warm food and drink 
are powerful expectorants, and in all cases it is well to have the 
patient drink a cup of hot coffee or milk before getting up, or 
warm beef tea. Stomach to be looked to with tonics, and bow- 
els carefully regulated. All physical and mental exertion or 
excitement to be guarded against. On the front and back ot 
chest there is no liniment or stimulant that can equal the irritat- 
ing plaster. It should be worn as much as possible, at least 
one-half the time. If the irritating plaster cannot be tolerated, 
then painting the chest with concentrated ozone should be 
resorted to. 

As it is a chronic disease there should be a persistent course 
of alteratives and tonics, changing them weekly ; the tonics before 
meals, alteratives two hours after. Such alteratives as ozonized 
glycerine, compound syrup phytolacca, ozonized saxifraga, with 
iodide of potassa, and tonics, ozone-water, solution of quinine, 
tincture cinchona, compound golden seal. 

Besides the above there must be a treatment with expectorants 
and bronchial stimulants, so as to arrest or mitigate cough and 
promote a healing process in the bronchi. For this purpose 
various preparations of ammonia are expectorants, such as muri- 
ate of ammonia in syrup of squills, carbonate or citrate of ammo- 
nia in syrup senega ; chloride or bromide of ammonia in syrup of 
ippecac. ; nitric acid and compound - tincture cinchona; tolu, 
conium, and belladonna ; balsam copaiba dropped on sugar ; 
cubebs and extract horse-radish ; benzoate of ammonia in port 
wine ; lobelia and blood-root. 

It is impossible to mention a single curative remedy; whichever 
affords the greatest relief should have the preference. 

Besides the above, the greatest benefit is to be derived from 
the inhalation of moist, warm, medicated antiseptic vapors several 
times a day. The remedies to be of any utility must be anti- 
septic ; such as sulphurous acid, creosote, chlorate or permanga- 
nate of potassa; tincture of benzoin, benzoate of soda, resorcin, 
naphthaline, creolin, concentrated ozone, boracic acid, carbolic 
acid, and a variety of others. The inhalation of stimulating- 
antiseptics proves very beneficial in all cases, and is one of 
our valuable aids in cure. The action of a disinfectant and 
stimulant on the ulcerated surface, with its destructive influence 
on the germs, is of great benefit ; and one thing can be said of it 



BACTERICIDES. lOI 

— that it in no way interferes with the use of constitutional and 
internal remedies. It is best to be used frequently, for half an 
hour or more at a time, and as often as four or five times a day, 
but in no case must either its use or strength excite any cough. 
The physician will find himself taxed to the utmost in the selec- 
tion of the particular remedy to be used ; and the patient will be 
required to second his efforts by a persevering adherence to the 
treatment prescribed by him. There should be at least three 
inhalations per day ; the remedy used every time should be a 
germicide. 

Alteratives, tonics, inhalation, and a very free use of expecto- 
rants is undoubtedly the best method of treatment in patients 
under forty-five years of age. When chronic bronchitis occurs 
over that, the use of expectorants is of doubtful efficacy, often 
injurious. 



is a peculiar and dangerous form of chronic 

Bronchitis bronchitis, occurring in persons over forty-five, 

Senilis or in the aged, and is due to natural decay or 

degeneration of the bronchial mucous membrane, 
as a result of age. It is spoken of under various names, as 
catarrhus senilis, bronchitis of the old. It seems at first to con- 
sist of a general inflammation of the capillaries of the tubes, fol- 
lowed by atrophy and interstitial death ; sometimes comes on in 
an acute form, attended with great danger ; more generally it is 
insidious, making its appearance with great difficulty of breathing, 
and excessive secretion of frothy mucus. Its symptoms and 
treatment are the same as chronic bronchitis, with the exception 
that, as a general rule, expectorants operate badly, aggravating 
the symptoms, whereas under tannin or vegetable astringents there 
is a remarkable amelioration. 



consists usually in acute catarrh, laryngitis, 
Bronchitis, bronchitis, general and capillary. It is usually 
Infantile, due to cold, and is easily recognized by its ten- 
dency to asphyxia, difficulty of breathing, great 
congestion of the skin, perpetual cough, general restlessness, in- 
creasing prostration, and in fatal cases, somnolence, muttering, 
delirium, coma. 

General management as to warm, moist atmosphere, warm 
bath, oil to chest and throat, aconite and belladonna for fever, 
and a free use of lobelia are our best remedies. One heaped tea- 
spoonful of pulverized green lobelia, and the same quantity of 



I02 DISEASE GERMS. 

carbonate of potassa to a tcacupful of boiling water, allowing- 
it to cool and settle ; and begin by administering half a tea- 
spoonful every hour, half hour, or less frequent, giving it largely 
morning and night to procure free vomiting. The vertical posi- 
tion of a child's stomach during the early years enables it to vomit 
easily; and this act is indispensable in children, because they 
swallow the products of inflammation, lymph, mucu-purulent 
matter, etc., which, in themselves, tend to aggravate the symptoms 
and keep up a sort of hectic fever. 

There are no remedies so useful in infantile bronchitis as 
lobelia and potassa ; the latter softens, while the former keeps up 
free expectoration. 

As the case improves; ipecac, tolu, senega, squills, wild 
cherry, etc. 



This is simply a form of chronic bronchitis, in 

Bronchitis, which there is a drying up of the lymph and 

Plastic. muco-purulent matter in the tubes, in which they 

become solid in the shape of the tubes, tubular 

concretions of exudative matter within bronchi. 

Symptoms. — The same as the chronic, to which are to be 
added expectoration of casts of tubes, or of moulds of notable 
size, preceded by a great difficulty of breathing, dry, hacking, 
racking cough, followed by hemorrhage, and the haemoptysis 
often excessive. Small casts are expelled easily, while large 
ones, especially if fibrinous, are not easily got rid of, as they arc 
congealed and adherent, sometimes a pure congelation of lymph 
or blood. Such bodies, by their irritation, often give rise to re- 
newed irritation. It is even more troublesome and intractable 
than the chronic form. 

Treatment, same as for chronic, with the exception that such 
remedies as carbonate of potassa, chlorate of potassa, muriate of 
ammonia, iodide and bicarbonate of potassa should be given 
more freely and repeatedly; hemorrhage arrested with digitalis 
in preference to gallic acid or iron. 



Usually chronic, and due to the inhalation of 
Bronchitij. , particles which irritate, inflame and ulcerate 
Mechanical, bronchi. For example: file-makers, knife- 
grinders, carpet-shakers, dust of coal in 
miners, cotton, woolen and silk operatives in factories, and other 
occupations. It is customary to so designate the bronchitis. 



BACTERICIDES. IO3 

Chronic bronchitis occurring when there are 
Bronchitis, disease-germs or morbid states of blood ; germs 
Microbial, arc apt to colonize in the weakened, ulcerated 
mucous membrane of the bronchi, and greatly 
aggravate the difficulty. We have the vibrios of typhoid fever 
irritating a feeble bronchi tract ; the latent germs of rabies, the 
germs of syphilis, tubercul?e, etc., gout, rheumatism and other 
blood poisons. According to the germ or poison present, the 
bronchitis is so named. The symptoms are much worse, usualK' 
double, especially the emaciation or wasting debiHty is very great; 
night-sweats, copious or excessive mucu-purulent expectoration. 
Alteratives and tonics, same as chronic bronchitis, and special 
drugs to destroy germ or neutralize blood poison in each indi- 
vidual case. 

Especially in the tubercular and syphilitic forms, these 
microbes in their growth and development excite so much thick- 
ening as to form a false or germinal membrane around the tubes 
— these are occasionally thrown off, creating great constitutional 
disturbance and danger by hemorrhage. The microbes also 
excite more ulceration from the germs eating the tissues, follicles, 
glands and coats of the tubes, causing great excavations — germs 
active in destruction, freely excreting ptomaines which give rise 
to hectic, great suffering, rapid emaciation. 

The profession at large should in all cases search out in the 
sputum for the proper germ, and in seventy-five cases out of a 
hundred, they will find in all cases of chronic bronchitis, that either 
the microbe of syphilis or the bacillus of tubercle is at work 
in the production of the grave lesions that exist. 



Hay fever, siTmmer catarrh ; often severe, with 

Bronchitis, asthmatic symptoms superadded; due to the 

Hay. micro-organisms of plants, or bacilli of hay and 

other grasses, causing a degradation of the normal 

bioplasm of the respiratory mucous tract from nose down to the 

air-vessels. 

Symptoms. — Quite complicated ; headache, suffusion of e}'es, 
sneezing, irritation of nose, fauces ; larynx, bronchi, often 
greatly congested ; cough, and the other physical signs of acute 
bronchitis. It is a sort of combination of acute catarrh, with 
sub-acute laryngitis and bronchitis. 

Ireatment. — Removal of cause, if possible. Quinine is the 
best preventive. If chiefly catarrhal, a solution of boroglycer- 
ide in infusion of golden seal with nasal douche. Some of the 
following remedies to give relief — compound lobelia, ammonia in 



I04 



DISEASE GERMS. 



some form, citrate of caffeine, belladonna, etc. If they fail, gen- 
eral treatment for chronic bronchitis. 



This is characterized by an enlargement of 
Bronchocele. the thyroid gland. The entire gland may be 
affected, or its centre, or either lobe. The 
swelling is usually unassociated with pain, and causes little incon- 
venience, beyond the deformity it produces, unless it presses upon 
the adjacent parts. 

Causes are very varied. It may be due to water impregnated 
with lime or magnesia ; to tubercular ; to irritation, reflected from 
the organs of generation to the nerves that supply the thyroid, 
causing enlargement and congestion ; to uterine disease, or an 
anaemic condition of blood. 

It is a true hypertrophy and is divided into three forms, accord- 
ing as the vascular, glandular or connective tissues are involved. 

1. Vascular Goitre is most common in this country, and con- 
sists merely of engorgement, congestion from suppressed men- 
struation, masturbation, gonorrhea, amenorrhcea. 

Branches of the sympathetic nerve covering the anterior por- 
tion of the uterus, clitoris, penis, are reflected over the mamma 
and thyroid, hence the connection. Besides, the gland, from its 
peculiar function of aiding in controlling the circulation in the 
brain, is very profusely supplied with blood-vessels and is liable 
to take on congestion from very slight causes. Vascular goitre 
often terminates in rupture of vessels, blood absorbed and 
recovery. In other cases calcareous degeneration may take 
place. 

2. Glandular or Cystic Goitre consists in a development ot 
the glandular capsules and their distension, and is filled with a 
gelatinous fluid. 

3. The entire transformation of the structure of the thyroid 
into a calcareous or chalky mass. 

Symptoms. — The whole gland may be swollen or only the 
centre or side of it. Frequently no inconvenience but the de- 
formity. In other cases distressing symptoms are produced by 
the pressure upon surrounding parts, and respiration and deglu- 
tition may be rendered painful and difficult by the compression 
of the trachea or cesophagus. In other cases severe constitutional 
symptoms, as ana^^mia, palpitation, mental depression, dyspepsia; 
irregularity of uterine function, as scanty menstruation, profuse 
leucorrhcea. 

Its duration is somewhat tedious ; much more common among 
women than men. 



BACTERICIDES. 



105 



Treatment, — The cause must, if possible, be ascertained and 
•removed ; such as Avater, or irritation, or disease. Then a gen- 
eral alterative and tonic treatment inculcated, with the very best 
of food. Whether caused directly by tuberculse or not, that con- 
dition is inseparable from it; hence special drugs for the destruc- 
tion of that germ, such as iodine and bromine in their various 
forms, tincture of iodine, iodine and glycerine, iodide of starch, 
iodoform. Bromine is not so active. Fluoric acid in an alter- 
nated solution is acquiring great repute in the cure of a great 
number of cases. Locally, ozonized clay is extremely effica- 
cious, taking care to cause no redness of the skin. 



The bursa mucosa are membranous 

Bursal Swellings, sacs situated about the joints, particu- 
larly the large ones of the upper and 
lower extremities. They lie under the tendons, act as cushions, 
their internal lining membrane secrete an oily fluid which is de- 
signed to lubricate the surfaces over which the tendons play. 

In consequence of irritation, such as pressure, bruises, sprains, 
contusions, etc., the secretion becomes excessive, and they swell, 
become inconvenient from their size. They are generally round 
or oval. 

An effort should be made to excite absorption by pressure ; by 
painting with colorless iodine ; by concentrated ozone. All fail- 
ing, a seton should be inserted through it. 

A bunion is simply an irritation, inflammation with thickening 
of the bursea mucosa at the ball of the great toe. 

To these the gutta-percha solution with iodole ; or else the 
collodion and tannic acid might be conveniently applied. 



is a term applied to irritation, inflammation of the 

Bubo lymphatics of the groin. It may consist either of a 
simple irritation, or may depend on absorption of 
venereal germs into the lymph channels. 

Causes. — It may be caused by a simple inflammation of 
urethra, by balanitis, by masturbation or sexual excesses, long 
walks, horseback exercise, in-growing toe-nail. It may be due 
to the presence of the venereal germ, chancres, etc. 

Symptoms. — The gland swells, becomes indurated and tender, 
fills up with lymph, and when the lymph breaks down, a suppur- 
ation takes place ; there are rigors and pain, burning, throbbing. 
In some cases, fever and great difficulty in walking. 

Pathology. — The contents of bubo are microbial, if not the 



Io6 DISEASE GERMS. 

germs of syphilis or tubercle, then the microbe. Streptococcus- 
pyogenus is always and invariably present. 

Treatment. — In order to prevent the irritation of the lymphatics 
of the groin, all applications to any morbid condition of the 
genital organs should be of a soothing nature. No caustics or 
irritants should be used, or, if used, those should be selected that 
cause no pain ; all applications to be of a soothing character. 

There are various remedies and modes of management, if they 
once form, in order to prevent suppuration. 

Gentle pressure, with plantain leaves next the skin, or iodo- 
form ointment, or phytolacca, or stramonium ointment, with 
iodide potass. The ozonized clay, without pressure, or hot 
poultices. 

If it is soft in centre, if pain is throbbing, poultices ; if desirous 
of hastening it forward, slippery-elm poultices, hot, with a good 
quantity of bicarbonate of soda in them during day, and linseed 
poultices during night. It may open itself, or have to be opened. 
In either event, it must be borne in mind that it must heal from 
the bottom ; that its internal lining membrane or sac must be 
destroyed, as it is a true secreting membrane ; so, if opened by 
the knife, the incision should be made in four different directions,, 
so as to destroy its sac and permit it to heal from the bottom. 
If it opens itself, then, after its contents have been thoroughly 
evacuated, inject the sac with tincture iodine and iodide of potass, 
so as to destroy the secreting faculty of the internal lining mem- 
brane of the sac. 

The practice of aspirating buboes in the face of such an amount 
of microbial matter, is essentially wrong — even injecting them 
with peroxide of hydrogen is not admissible ; {\'^^ openings and 
counter openings is the rule. 



are either superficial or deep-seated elevations of 

Bullae, the skin, having fluid contents, differing in color, 

or Blebs, shape and progress, and varying in size from a pea 

up to that of a goose's ^g'g. 
Blebs are described as large vesicles; but this fails to explain 
their pathological character. Bullae, blebs, vesicles may contain 
serum, lymph, blood, pus ; and be variously colored according 
to the character of their contents. They may be of various 
shapes, globoid, hemispherical, oval, crescentic, conical. They 
may be situated upon an apparent sound skin, or there may be 
an inflammatory areola. 

Bullae may persist or rupture ; they may dry up, or degenerate 
into ulcers ; they may collapse after the escape of their contents^ 



BACTERICIDES. 



107 



and their sac become adherent to the base from which it was 
originally raised. Vesicles represent the second stage of burns 
or scalds, their contents are the liquor sanguinis of the blood ; 
but when they occur in the most depraved or debilitated states, 
as in syphilis, tuberculae, leprosy, erysipelas, gangrene, their con- 
tents are the microbes or micrococci of the respective disease 
germs, which act as the factor of the eruption. 

The treatment to be successful must be essentially germicidal, 
adapted to annihilate the special germ present, and at the same 
time eminently constructive. 



Calculus, or stone, a hard concretion, formed 
Calculus, within the body in consequence of the deposition 
of the solid matters which usually remain in solu- 
tion. The concretions found in the brain, gall duct, kidneys, blad- 
der are calculi. Urinary calculi is a disease of all ages, but most 
common in advanced life in the male sex ; more frequent among 
the gouty ; those who lead an indoor life ; very rarely met with 
among those who live in the open air, eat little animal food, or 
use no alcoholic drinks. 

The early stage of calculi generally presents itself in the form of 
gravel, shown by the passage of small portions of a gritty sub- 
stance which may be seen in the urine as a deposit of little sand, 
or like grains of cayenne pepper. When such deposits occur fre- 
quently in passing urine, either in the warm or cold state, we may 
apprehend the formation of calculi ; especially if there be symp- 
toms of irritation of the kidneys and adjacent organs. 

The chief varieties of calculi are : Uric acid, ureate of am- 
monia, soda, lime, phosphate of ammonia, magnesia, lime, oxalate 
of lime, carbonate of lime, cystine, xanthic bile and all its chemi- 
cal constituents. 



Under certain conditions, such as with an excess 
Calculi, of amylaceous, carbonaceous, saccharine food, malt 
Biliary, and alcoholic drink, together with monotony, indoor 
life, imperfect ventilation, non-aeration of the blood 
takes place ; the bile becomes thick, crystallizes, forms an obstruc- 
tion to its own escape, It is absorbed in great quantities, constitut- 
ing the phenomena of jaundice. 

The chemical composition of the human bile : water, 850 parts ; 
bile salts, 91 ; fat, 9; cholesterin, 2; mucus and coloring matter, 
29 ; salts, 7, in 1,000 parts. The secretion of the bile is continu- 
ally going on, but somewhat retarded during fasting and acceler- 



io8 



DISEASE GERMS. 



ated during the taking of food. The bile formed in the hepatic 
cells is discharged into the minute hepatic ducts, passes into the 
larger trunks, and from the main hepatic duct into the duodenum. 
The gall-bladder is a true reservoir for holding the bile, for the 
wants of economy. 

It IS supposed that an ordinary-sized man secretes from twenty 
to forty ounces of bile in twenty-four hours. 

A thick, clotty, or crystallized condition of bile may arise from 
a variety of other causes, not so common in early life, unless due 
to malaria, but after thirty- five very common among the seden- 
tary, or in those who lead a physically inactive life, much more 
common among women than men. Pain, paroxysmal over the 
region of the gall-duct, with vertigo, nausea, vomiting, biliary- 
coated tongue, injected conjunctiva, constipation, favor the idea of 
the formation of biliary calculi. 




Section of a large gall-stone, showing successive layers. 
A. External crust. — B. Intermediate portion. — C. 
Nucleus. Natural size. 




Crystals of cholesterin from gal 
stones, showing the character- 
istic plates, with one corner 
wanting. X 200. 



In all cases, calculi are made up of either a deficiency, or re- 
dundancy of certain elements of the bile; a scantiness of its watery 
elements, it may coagulate ; an excess of cholesterin, it may 
crystallize. 

When the symptoms of gall-stone passing the duct are present, 
the curative indications are to facilitate its passage into the intes- 
tines, to relieve pain and prevent inflammation, which the presence 
of an extraneous body if large is calculated to produce in the 
duct. This is best effected with large doses of gelsemium. Dose 
after dose relaxes the duct and favors the expulsion of the calcu- 
lus. Warm bath, hot fomentations, are of great benefit. 

Between the attacks, solvents should be tried, to cause a chemi- 
cal disintegration of the calculi, and for this purpose the ozonized 
uric acid solvent should be preferred above all other remedies. 
Under its influence the calculi break up, disappear, without any 
trace in copious, bilious evacuations, which it produces. I have 



BACTERICIDES. 



109 



used this remedy in several hundred cases and found it an excel- 
lent solvent for those stones. It 
is well enough one or two days 
of each week to administer com- 
pound tincture of cinchona and 
nitro-muriatic acid, with phos- 
phate of soda, sufficient to keep 
the bowels free, but in all cases, 
five days out of seven, the patient 
should be placed upon the uric 
acid solvent ozonized. There is 
little doubt in my mind that this 
remedy owes its powerful solvent 
properties to the combination in 
it of chionanthus virg.and dioxide 
of hydrogen. The same prepara- 
tion is efficient in nearly all dormant 
states of the liver. Diet has a 
marked influence upon the quality 
of the bile, vegetables and fruit 
have a marked influence upon the 
•bile, with lean meats proportioned 
to the wants of the system. 




L. Section of a gall-bladder filled with biliary 
calculi. This bladder contained 260 gall- 
stones. At B are single calculi showing 
facets. 



One of the most prevalent affections among men 
Calculi of all ages and stations of life. It is true that it is 
of often a sequel of gonorrhea, the germs migrating 

Prostate, back to the compressor urethra and prostate. Mas- 
turbation, excesses, dalliance, perversion of the 
sexual appetite, the wearing of condums, irritation of sedentary 
life, the use of velocipedes, instruments, drugs, passage of concre- 
tions, uric acid, stricture, licentiousness, reading modern literature, 
keep up a species of continued congestion of the prostate and 
mucous membrane of the urethra, which later on assumes the 
status of inflammation, penetrates deeply into the follicles of the 
gland. Then appears a moisture, sexual congress becomes im- 
perfect, increased frequency of micturition, bearing down uneasi- 
ness in the perinaeum and anus, slight pain or rather uneasiness at 
termination of micturition, tenderness around the prostate on the 
passage of a sound, an inability to urinate when making the at- 
tempt. Progressively onwards the case progresses, for .it never 
remains stationary. There is increased micturition, with a diminu- 
tion in the force of the stream, with dribbling after urinating, the 
lesion extends to the neck of the bladder, which, when partially 



I 10 DISEASE GERMS. 

full, causes frequent erections and erotic desires with nocturnal 
seminal emissions. Later, partial or complete impotency. These 
cases diverge into numerous channels ; in some there is a dis- 
charge of mucus from the urethra, in which spermatozoa often 
appear when straining at stool and also in the urine flakes, pros- 
tatic shreds, consisting of pus, prostatic epithelia, spermatozoa. 
A rectal examination reveals the prostate large and tender, with 
pain in the back. Reflexly this irritation is transmitted to the 
base of the brain, causing a state of mental incapacity, nervous 
bankruptcy. Here then is the affection which afflicts nearly all, 
young, middle-aged and old men — one that is sapping our very 
vitals as a nation. 

Nations owe their longevity, progress and courage to the in- 
tegrity, strength and vigor of their sexual power. The damaged 
prostate is a greater manufacturer of diseases and death than the 
glaring gin palace and secret brothel, as the condition of our male 
population demonstrates. 

The treatment of this affliction should be general and local ; 
all stimulants should be avoided ; nourishing food and tonics are 
indicated ; bowels regulated ; urine kept slightly alkaline ; moder- 
ate exercise, and sound elevating mental culture, and in general 
re-invigoration and construction of the brain. 

In chronic urethral and prostatic hyperaesthesia few remedies 
operate more beneficially than the introduction of the soluble 
ozonized gelatine damiana bougies, inserted right up to the neck 
of the bladder, permitted to remain and dissolve about three times 
a week. 

The cocaine suppository exercises a sedative influence over the 
motor sexual and urinary centre in the spinal cord; this influence 
extends along the anterior portion to the reflex centre, but if 
there is reason to suspect an atomic condition of the prostate 
ducts, such a motor stimulant as phosphated tincture of oats is 
indicated. 

If this state of chronic irritation be not effectually cured, it will 
inevitably terminate in hypertrophy of the prostate, with calculi. 

Calculi of this gland are either of the phosphatic or mulberry 
variety. The same treatment as for hypertrophy. 

Pichi, as prepared in the uric acid solvent ozonized, has a won- 
derful effect upon the prostate, causing it to disgorge calculi. 

Hydrogen peroxide also operates well, administered in alterna- 
tion with iris versicolor and phytplacca. 

Electrolysis of the prostate is of great utility. 



BACTERICIDES. j i i 

Concretions in the kidney vary much in size and 

Calculi, composition. They are found in all ages, but most 

Renal. common in the adult male, and in all parts of the 
kidney — in the pyramids, cortical substance and 
pelvis. 

Owing to mal-assimilation, perverted nutrition, to the presence 
of microbes and their ptomaines ; to destructive metamorphosis ; 
there is an excess and precipitation of certain elements, which are 
either in excess, or fail to be eliminated. Usually they begin in 
this way ; certain elements are in excess, either uric acid, phos- 
phate or oxalate of lime, constituting one or other of the three 
forms of gravel. A precipitation takes place of either uric acid 
or oxalate of lime. A colloid material composed of mucus, or a 
blood globule exist in all as a starting point ; these molecules 
attract others, they increase by aggregation of molecules. 

Certain constitutional states are favorable for the elements of 
precipitation, and all that is necessary is a point of attraction and 
aggregation. 

The cause of calculi appearing in the kidney is often very ob- 
scure, but uric acid deposits are the most common ; but deposits 
of lime and triple phosphates are common, This leads us back 
to the primary cause, the formation of uric acid and phosphate of 
lime and the constitutional conditions favorable to their develop- 
ment. 

Renal calculi vary greatly in shape and differ in their composi- 
tion, and may be deposited in the tubes of the pyramids, in the 
cortical substance, or in the pelvis of the kidney. 

In adults, the urate of soda in the form of crystals ; in the aged, 
carbonate and phosphate of lime. 

All the different urinary calculi may be impacted in the 
nriniferous tubes, rendering Ihem impervious ; they vary in num- 
ber and in size, from a pin's head to a walnut. A kidney may 
contain one or a great number ; large ones may fill the whole 
pelvis ; small ones constitute kidney gravel. A calculus impacted 
in the pelvis of the kidney may assume a large size and produce 
great anatomical changes. 

The presence of calculi in the kidney gives rise to uneasiness, 
to a dull, aching pain in the loins ; to occasional twinges of sharper 
pain after motion or exercise of any kind ; pain in the groin, re- 
traction, possibly pain in the testicle of the affected, aching, 
amounting to pain, in the anterior part of the thighs, itching at 
orifice of the urethra. 

Urine contains pus, blood and epithelium from the kidney. All 
symptoms aggravated by anything which disturbs the patient. 

The passage of a portion of the stone, or the whole of it, in- 



112 



DISEASE GERMS. 



variably gives rise to renal neuralgia, which manifests itself in 
sudden intense pain in the kidney, constant desire to micturate, 
tenesmus of the bladder, great retraction of the testicle, collapse. 
Hoiv to Diagnose a Stone in Kidney, and its Character. — There 
will be severe backache ; traces of pus in the urine. After exer- 
cise, especially on horseback, bloody urine. There will likely, if 
stone is any size, be epithelium of the pelvis of the kidney, as 
well as blood corpuscles. The diathesis will guide us as to the 
kind of stone. But the nervous irritation is so great, in all cases, 
that if it begins as uric acid, it at once becomes phosphatic ; the 
reflex nervous irritation creates that diathesis. Health suffers, 
loses strength and flesh. Stone gradually becomes larger ; excites 
suppuration ; fills up the body of kidneys, and renders them use- 
less as secreting organs, and 
gives rise to uraemia. In addi- 
tion to the above, there are the 
minor symptoms of kidney irri- 
tation ; itching at the orifice of 
urethra, aching in thighs, retrac- 
tion of testicle. 

Passage of Stone into and 
th'ougJi the Ureters. — A patient 
suffering from the above symp- 
toms has a sudden seizure of 
intense pain in the kidne\% with 
nauseau, vomiting and great 
•prostration ; a partial suppres- 
sion of urine ; symptoms in- 
crease; pain moves down along 
the course of the ureters, and 
the moment stone drops into 
the bladder all is well. In addition to the above, there may 
be all the indications of kidney irritation, and even ha_^maturia. 

Indications of the Presence of Stone in the Bladder. — Severe 
attacks of pain in the bladder, perina^um and at glans penis, either 
brought on or aggravated by exercise. Frequent micturition 
from the irritable bladder, or there may be continence or inconti- 
nence of urine ; or even if patient can make water freely, there is a 
feeUng as if bladder was not thoroughly emptied in the act of 
urinating. Urine is likely to contain pus to a greater or less ex- 
tent, often thick, ropy, tenacious, muco-purulent matter, and per- 
haps blood. Always blood corpuscles and vesical epithelium 
under microscope. The act of micturition suddenly stopped, in 
large percentage of cases, by stone being forced against the neck 
of the bladder, when, if the patient suddenly throws himself upon 




Vertical section renal calculi, showing the dif- 
ferent layers, a, uric acid nucleus ; b, oxa- 
late of lime: c, phosphates of lime, and 
magnesia and ammonia. 



BACTERICIDES. 



I I 



his hands and knees, thus causing the stone to move away, the 
flow of urine returns ; tenesmus, prolapsus of the rectum, very 
common. None of those symptoms are to be positively relied 
on, not one, until a metallic sound or silver catheter is introduced, 
when the bladder is full, and the stone felt by its impulse on the 
fingers, and the pecuHar click is heard by the ear. One examina- 
tion should not suffice, it should be made at least three times, on 
different days, before a final opinion is given."^ 

Trc anient of Stone in the Kidney, if Uric Acid or Red Gravel 
is the Cause. — Plain, nourishing food, milk, eggs, fish, animal food, 
nothing to increase uric acid ; avoid alcohol ; mucilaginous drinks, 
linseed tea, infusion of marsh mallow ; daily bathing, flannel 
clothing ; belladonna plaster over kidneys ; check hemorrhage ; 
alteratives and tonics, selecting saxifraga, hydrangea, iodide 
potass, solution of potassa, citrate of potash in alternation with 
nitric acid in compound tincture cinchona, benzoic acid and borax. 
Undoubtedly the uric acid solvent ozonized is the most active 
agent known to cause a stone to crumble. To relieve pain, if it 
drops into ureters, inhale a little chloroform. When patient feels 
slightly exhilarated, follow with hypodermic injection of morphia, 
and discontinue the chloroform. 

If the stone has readied tJie bladder, and is small, patient 
might be encouraged to take copious warm mucilaginous drinks, 
with nitrate of potass and cream of tartar ; go into a hot bath ; 
take a large dose of tincture of green root gelsemium ; dry off; 
smear perineum with extract of belladonna; let urine accumu- 
late, and then discharge it forcibly. If that fail, an attempt might 
be made to dissolve it, if acid, by injecting alkalies or alkaline 
solution ; if a phosphatic calculus, acid solutions. Injecting sol- 
vents into the bladder must be done carefully ; the water must be 
tepid, and not too strong of either the alkali or the acid; just 
strength enough for stomach ; the liquor potass, say a drachm to 
four ounces of water; nitric acid dilute, from fifteen to thirty drops to 
four ounces ; used about three times a week. At the same time 



"'^ In order to ascertain the constituents of calculi, the following n ethods are 
adopted : 

Powder the stone and apply heat. If it disappears, it is in all probability uric acid, 
or compounds of uric acid. If there is any doubt, the murexide test may be applied. 
If the stone does not disappear upon being incinerated, it is composed either of phos- 
phates or of oxalate of lime. If it is the triple, or ammonio-magnesian phosphate, the 
application of heat to a piece of the original stone will melt it into a bead; if it docs 
not melt, it is either phosphate of lime or oxalate of lime. If it is oxalate of lime, the 
incineration will convert it into carbonate of lime, which, in acetic acid, will dissolve 
with effervescence ; if it is phosphate of lime, it dissolves without effervescence. Thus, 
with very little trouble, we may, with sufficient accuracy for practical purposes, ascer- 
tain the composition of a calculus. The bases are not ascertained, but this is not 
necessary. 

8 



I i^ DISEASE GERMS. 

the patient should be placed upon an alterative and tonic course, 
with iodide potass in a vegetable alterative, and nitric acid in 
compound tincture cinchona as a preference. In the interval, pa- 
tient should be encouraged to drink freely of an infusion of hy- 
drangea and saxifraga with the uric acid solvent ; three remedies 
of great value in causing the disintegration of all calculi, espe- 
cially the phosphatic ; they are true solvents, causing the stone 
to break down into a mealy powder, which is easily passed by the 
urethra. Their action is purely chemical; they perform what no 
other remedy or combination of remedies can perform. Their 
best effects are to be obtained by infusion ; fluid extracts become 
worthless ; ozone water has a powerful effect on the more solid 
forms, and reduces them to a pulp, which is gradually eliminated 
b\- the urine. (See' Diathesis.) 




^ 



Cancer is a term which is applied to a dia- 

Carcinoma. thesis in which certain elements of the blood 

are degraded, altered or changed into a disease 

germ of the most mahgnant species, thus giving us one of the 

most appalling blood diseases in the whole range of medicine. 

In weakened parts of the body this germ localizes, and receives 

different names according 
to the presence or absence 
of certain adventitious tis- 
sue, as scliirriis^ or stone 
cancer ; medullary or brain. 
Cancer in its varied forms 
is most generally met with 
when vital force is on the 
Microbe of can.er. wanc, flickering out in the' 

areat bulk of cases between forty-five and fifty. Among looo cases 
noted, forty-three is the average. This climacteric period of life is 
obnoxious to the most remarkable changes in both sexes. Numer- 
ous though those cases be, the male is not exempt from alteration 
in structure of pink marrow, lymph canals, bone gland and im- 
pairment of function, although it is the female who essentially 
suffers at the change. The extra source of nerve deterioration, 
or defect of vital elements of brain at this period, gives the ele- 
ments by which normal living matter is change or altered, de- 
(Traded into a diseased germ. Six females to one male are the 
proportion or excess affected, and this can be accounted for by 
their isolation, monotony, grief, worr)', care. When the primary 
elements of nutrition are altered into a disease germ, there is be- 
sides atrophy of the red corpuscles an excess of the colorless 



BACTERICIDES. I j 5 

discs ; and the force behind, the creative power of the blood is 
deteriorated, there being a defective organization which gives 
rise to this degradation of normal bioplasm in the blood. 

TJie predisposing causes which give rise to this change in the 
bioplasm of our blood are somewhat obscure. In some cases it 
depends upon peculiar type of conformation, and is hereditary, 
and like all germ diseases it is pre-eminently contagious and 
infectious. 

The large number of cases that are met with in every-day life 
are acquired in and under the various defects and vices of our 
highly civilized state ; thus we have it more prevalent in sections 
or localities noted for high mental culture, especially if the ner- 
vous system has been enfeebled by grief, anxiety, worry, over- 
work. The peculiar innervation is very obscure and in many 
cases can be traced to sexual neurasthenia, masturbation, sexual 
excesses ; in other cases it can be looked for planted with the 
germs of syphilis or the toxical effects of mercury ; to the defects 
of modern sanitary science, to open sewers, imperfect drainage 
and ventilation, impure drinking water, adulterated food, isola- 
tion, monotony or sameness of living. 

How much the degenerating action ot alcohol, or withering 
effects of tobacco, or other habits, have to do in creating this dia- 
thesis, it is impossible to estimate or even appreciate. 

To a greater or less extent the cancer germ m^ust exist in the 
blood prior to the appearance of any malignant growth, it may 
be a longer or shorter period, or appear as if it was simultan- 
eous ; but a constitutional taint, a diathesis, cancerous germ- 
laden blood, must, in the individual, precede the appearance of 
the tumor and operate as a pre-existing cause in the blood. 
Cancer is never a local disease, without the germs in the blood. 

TJie exciting causes which bring the diathesis or germs into an 
active, local, breeding cancer, are local irritation, such as an 
injury, blow, bruise, contusion, disease, the use of tobacco on lip 
and tongue, violence of any kind, so that it causes the vessels to 
lose their contractility, or tonicity, which state enables the 
liquor sanguinis of the blood with the germs to pass through 
their coats or walls by a process of exudation or exosmosis, and 
deposit themselves in devitalized or ^\•eakened structure where 
they form a colony or nest. 

The most common seat or deposit of cancer germs is in parts 
most subject to irritation, those in exposed locations, as the 
female breast, the eye, the tongue, the lips, the genital organs, 
bones, liver, stomach, uterus, rectum, (.esophagus, lymphatic 
glands, etc. 

Etiology. — The anatomical structure and relation of the part 



I 1 6 DISEASE GERMS. 

and other conditions, together with the special form of degrada- 
tion to which it owed its origin, have much to do with the char- 
acter and mode of formation ; thus scirrJius, or hard cancer, is 
most frequently met with in the female breast, uterus, stomach, 
extremities ; enccpJialoid (brain-like) medullary or soft cancer, 
anywhere; melanotic, charged with a brown or black pigment 
matter ; epithelial or epithelioma, on the skin and mucous mem- 
brane, on lip, anus, tongue, uterus ; ostoid, or bony, anywhere. 
The degree of growth of a cancer depends entirely on the amount 
of degradation of living matter in the blood, the amount of irri- 
tation present, and the status of local depression. If the lym- 
phatics are greatly engorged, vital force sadly deteriorated, it 
renders a cure more difficult. 

Any swelling, tumor, infiltration, may be properly termed 
cancerous, if it completely infiltrates the texture in which it 
arises, spreads, invades the nearest lymphatics adjacent to the 
part affected ; when there is pain in it, stinging, darting, or sharp 
lancinating; or if it is ulcerated and open, the odor of the dead 
germs in the pus or discharge resembling the hydrosulphate of 
ammonia ; in the urine always persistent, dead cancer germs, best 
seen with microscope of 2000 diameters. If it is internal, as the 
stomach, the pain is anterior to posterior. The diathesis or 
cachexia is not always well marked, but if present should consist 
of indescribable languor, or goneness, a sinking sensation at pit 
of stomach, a peculiar fetor of breath ; pale clay- colored stools;, 
straw-colored or muddy skin ; pearly conjunctiva. 

The cancerous diathesis is infectious and contagious. The af- 
fected or germ-smitten radiate or breathe off germs to contami- 
nate all in close proximity. The egress of germs is chiefly by 
the breath, urine, stool and from the skin, or by direct contact, 
inoculation. 

Diagnosis. — Many, very many individuals are literally swarm- 

ine with cancer e^erms, their blood and tissues saturated, the 

& . . . 

lymph channels crowded, but they in blessed ignorance live 

along to a good old age and die, without any cancerous tumor or 
growth being visible. That mysterious languor, that indescrib- 
able headache, that goneness, those aches, indigestion and in 
many cases Bright's disease, which are incapable of explanation, 
could all readily be detected by a careful microscopical exami- 
nation of the urine, sweat, saliva, and blood of the individual so 
complaining, and in ninety-nine cases out of one hundred cancer 
germs will be detected. 

In making a diagnosis, it is not necessary to note the mental 
irritability, the contracted features, sallow skin, pearly conjunc- 
tiva, the odor of the breath, the sinking at the pit of the stomach,. 



BACTERICIDES. ny 

the clay-colored stools, nor the dry, husky skin. It is sufficient 
that we have a thickening induration, or infiltratiort, or tumor, 
and in that there is pain of a sharp, lancinating character, with 
intervals between, and that it resembles a needle or knife ; that 
if the cancer colony is in the chest or abdomen that there is pain 
anteriorly and posteriorly — direct through ; that if the cancer is 
on the* face, breast, or other exposed part, and is ulcerating or 
disintegrating, then there is soreness, rawness, gnawing, as well 
as the intermittent pain, and the smell or odor of the discharge is 
most significant. Besides, in the cancer-juice and urine the can- 
cer germ can be seen with a very low power; We cannot well 
speak of diagnosing such varieties as long as covered by skin. 
The medullary, or acute, or brain-form may be known by the 
intensity and frequency of pain ; if covered, lobulated, doughy ; 
if exposed, one mass of cancer germs ; the hard, or stony feel of 
scirrJms having an excess of fibrous tissue and a few cancer cells, 
and in the early stages little pain ; the cpitJielial, or cancroid is 
easily knov/n from its location, occurring where skin and mucous 
membrane meet ; the black pigment matter of melanosis ; the 
great excess of blood-vessels in fungous haematodes ; the fatty 
feel of the lardaceous ; the bony hardness of the ostoid ; the jelly 
or gelatinous material of colloid ; the leathery patch on skin of 
keloid. As to the engorgement of the lymphatics, they simply 
afford us an indication of the state of the blood as regards germ 
growth — if heavily engorged, germs abundant and active ; if 
slightly, germs few and inactive. 

The characteristics of cancer are definite, and different from 
all other growths or swellings, inasmuch as it is made up parti- 
ally or wholly of malignant germs. There is a large number of 
growths or tumors — some simple and others compound — made 
up of the healthy tissues of the body, as fat, cartilage, and bone, 
which, when occupying their- proper places, are essential to the 
perfection of the animal system ; but when misplaced, may inter- 
fere with normal functions or locomotion, it is indispensable to 
remove. But cancer has no counterpart in the healthy body, 
the very existence of its germs, or their localization, sufficing to 
constitute disease ; and more than that, their colonization in any 
part of the body is destructive, as they use up or convert healthy 
tissue into their own nutrition and growth. 

Cancer, although a large micro-organism, and quite weighty, 
nevertheless is contagious and infectious. It can be carried into 
a healthy organism by air, water, milk, or by contact, and ma}' 
remain in the blood and tissues in a latent condition until favor- 
able conditions exist for their growth. The cancer germ has 
wonderful capacity for resisting death, due to some inherent 



Il8 DISEASE GERMS. 

power it posses. We do not mean that it has the tenacity of life 
of the small-pox germ, neither has it its great power of growth or 
dissemination. 

The symptoms of cancer are well defined. The change of nor- 
mal cells into this malignant germ is usually attended with ex- 
treme languor, lassitude, debility, goneness ; strength and 
energy much impaired ; the skin assumes a dirty yellotv hue ; 
the secretions are arrested, the conjunctiva of a pearly white- 
ness, features contracted, sinking feeling about stomach, stools 
clay-colored ; great loss of strength and energy ; general wast- 
ing, with mental irritability. When the germ escapes from the 
circulation and forms a colony, then we can detect a thickening, 
infiltration, induration, a separable tumor, which rapidly changes 
the structure of a part, usurps its original texture or organ ; 
germs grow by miUions, invade surrounding parts, extend to 
nearest lymphatic and induce general germ poisoning. The 
very moment a malignant germ colonizes itself there is pain, a 
congregation of a few germs resembles a needle ; a larger ag- 
gregation, a knife ; the smaller the colony the less the pain, and 
at long intervals ; whereas in an immicnse collection the pain is 
not only like a large knife darting through the part, but it is fre- 
quent, almost continuous. If the cancerous infiltration occurs 
inside of the chest and abdomen, pain is both anterior and pos- 
terior, which is explained by the character of the spinal accessory 
nerves. 

It grows like all other living matter, and when from a deficient 
supply of nutriment or some other adverse condition, or natural 
death of the germ, disintegration and ulceration take place, a 
foul, excavating ulcer, sanious, fetid discharge, the odor of hydro- 
sulphate of ammonia, which the dead germ evolves, hemorrhages, 
progressive debility, anaemia, nausea, vomiting, diarrhea, complete 
exhaustion, death. 

The tendency of all cases of carcinoma is to death, unless man- 
aged with great skill and long experience. 

Treatment. — The general indications to be -observed in all cases 
of the cancerous cachexia are to build up and maintain vital 
force, the nerve centres ; to promote and increase the powers ot 
assimilation and digestion ; to resort to every possible means and 
known remedies to destroy the cancer germ in the blood ; to 
remove the infiltration or t jmor, if admissible. 

In addition, the most nourishing blood-making food, as abun- 
dance of highly animalized substances, beef, game, milk, cream, 
raw eggs, vegetable phosphates. 

Tonics must be administered in all cases, to promote an appe- 
tite, and energetic digestive agents as trypsin or papoid after 
meals, to give us the most perfect digestion. 



BACTERICIDES. ng 

Baths are of infinite v^alue, these must be of a decided germi- 
cidal character ; they should consist of such agents as iodine, 
chlorine, sulphuret of potassium and sulphurous acid. 

Pain, in all cases, must be relieved with the conium pill. 

The patient should wear flannel clothing and take moderate 
exercise in the open air. 

The liver should be actively stimulated with the kola nut paste, 
the glucoside leptandra and leontodon ; the three in combination, 
in sufficient doses. 

After inculcating the most rigid attention to hygiene, dietetics, 
moral surroundings and the removal of every possible condition 
that would depress, a thorough germicidal treatment should be 
carried out. Such remedies as the comp. saxifraga, ozonized ; the 
glycerite of sulphur; Chian turpentine; chlorate of carbon; 
chlorine. 

The patient should be put upon one of those remedies. Com- 
mence with teaspoonful doses every three hours, and gradually 
increase it; let it be taken upon an empty' stomach. 

These remedies will destroy the germ, act also as a powerful 
stimulant to the lymph canals, pink marrow and other blood- 
forming glands ; just as they destroy or sterilize the germ, they 
eliminate it. The evolution of the germ is arrested and pain 
ceases. 

The action of germicidal remedies is truly marvellous ; as they 
are persistently administered, so the germs are annihilated, and 
a return to health and normal vitality is the result. 

The internal administration of germicides must be carried out 
in all cases. 

If the cancerous tumor is small, an effort might, with some 
degree of hope, be made to kill the mass of germs, and ulti- 
mately absorb them without breaking the skin. For this pur- 
pose, either of the following remedies will be found of great 
efficacy : an ointment of stramonium, ry'i ; chloride of ammonia 
and iodide of potass, fui oii. Mix. Spread on leather and apply 
during the da}', and during the night a lotion of sulphate of man- 
ganese or an ointment of phytolacca ; or lotions of distillation of 
the jequirity ; or ozonized clay ; or peroxide of hydrogen or boro- 
glyceride ; ozone ointment and resorcin. 

We deprecate the use of the knife or caustics in the removal of 
all cancers, and depend upon removing cancerous tumors or mass 
of germs by the application of plasters composed of antiseptic 
materials which will unite with the cancer germs, enter into their 
composition and destroy them. 

These plasters, if properly selected and adapted to the case, 
will give rise to very little irritation. The length of time neces- 



I20 



DISKASE GERMS. 



sary to remove a cancerous infiltration will vary with its size and 
the nature of the germicides used. The length of time necessary 
to heal it up after it drops out, also varies much, the size of the 
cavity, its location, health and vitality of the patient. 

From the large list of cancer plasters in general use by physi- 
cians, we select a few that are the least painful in their applica- 
tion, such as the chloride of chromium and ozone pastes, two 
rapidly destructive agents, when either is applied. They are 
altogether less painful than the chloride of zinc paste, hav^e more 
affinity to enter into the body of the tumor, destroy it and cause 
its perfect exfoliation root and branch without much suffering or 
the loss of blood. 

J^>om the vegetable kingdom we take oak bark, phytolacca, 

yellow dock and sorrel, all 
crushed. Make an extract 
and apply ; or the expressed 
juice of the sheep sorrel alone 
in the form of an inspissated 
extract, and applied on 
leather, will remov^e it ; but 
before these last two are 
applied, the cuticle must be 
destroyed. Another favorite 
paste for the removal of a 
cancerous tumor is to drop 
C. P. sulphuric acid on saf- 
fron, until a paste is formed ; 
when of the proper consis- 
tency it is applied, and 
almost, as if b}- magic, re- 
duces the entire mass of 
germs to a charred mass. If 
the tumor is very large, it is re- 
peated daily until destro\'ed. 
It is unnecessar\' for us to give the different formuhij in use, 
suffice it to say that the chloride of chromium paste is in ver}' 
general use for all large cancers, and the ozone paste for smiil 
ones. These two do their work etTectiv^ely, whichever is used, 
and should be applied daily until the cancer drops oiit, after which 
it is a good plan usually to poultice for a few days so as to 
cleanse the wound thoroughly. Poultices of linseed meal and 
boroglyceride should be applied every three hours, and as soon 
as the granulations exude healthy pus, strap it with adhesive 
strips and dress with either stramonium or ozone ointments, or 
an ointment made thus : Ozone ointment, one ounce ; lac sulphur, 




Scirrhous cancer of the abdomi 



walls 



BACTERICIDES. I2i 

three drachms ; willow charcoal, pulverized, one drachm. Mix ; 
or an ointment composed of ozone ointment and resorcin. We 
shall now describe the microbe in various locations of the bod\\ 

This case (p. 1 20 ) of cancerous infiltration of the abdominal walls, 
involving the skin, cellular tissue and border of the recti muscle, 
■was first removed by the application of the chloride of chromium 
paste ; roots or prolongations destroyed by papoid and thallin ; 
healed kindly under ozone ointment. 

The internal remedies were Chian turpentine, saxifraga, 
Phytolacca. 



Owing to disease of the teeth and nose, the 

Cancer antrum is greatly weakened, and if the microbe of 

of the carcinoma be present in the blood, it is very liable 

Antrum, to be effused into this cavity with the liquid, semi- 
liquid and glandular substances, so often found in 
this locality. The s}'mptoms are aching, uneasiness of the cheek, 
preceded by acute throbbing, pain, rigors, fever, followed by slow 
and progressive enlargement. If unrelieved, there will be bulging 
of the cheek, extrusion of the eye, obstruction of the lachrymal 
duct, depression of the hard palate, loosening and dropping out 
•of the teeth and closure of the nostril. In some cases it will 
burst into the nostril, mouth, or through the cheek. The pain is 
intense. 

The treatment should consist in making a free aperture into 
the antrum by extracting either of the molar teeth, and a trocar 
pushed up through the empty socket into the antrum. If the 
teeth are all sound, then an opening should be made through the 
membrane of the mouth, above the alveoli of the molar teeth, and 
the bone be pierced by a strong trocar. The contents should be 
thoroughly stirred up, whatever they may be, and thoroughly 
evaluated ; the cavity washed out every morning with a solution 
of resorcin, creolin or other antiseptic, and general treatment for 
cancer inculcated. 



This makes its appearance chiefly in the form of 

Cancer epithelioma, although the scirrhous, medullary and 

of the melanotic forms are quite common. 

Lip. Irritation is the grand exciting cause ; the pipe or 

cigar has been mentioned as the principal source of 

irritation, but numerous cases occur where the individual is not 

addicted to this habit. It is also true that it is chiefly the lower 

lip that is affected, very seldom the upper. The great frequency- 



122 DISEASE GERMS. 

of cancer of the lower lip may partially be accounted for by its 
situation, position and mobility. Most generally met with on 
one side. 

As all cases of cancer are both contagious and infectious, it is 
doubtful how many cases may be directly due to the pernicious 
practice of kissing. We are strongly of the opinion that numer- 
ous cases of cancer of the lip are due to direct inoculation in the 
act of kissing. It is a notorious fact that all disease germs may 
be communicated in this way. Daily we see the germs of 
tubercle, syphilis, diphtheria, small-pox, etc., in the vapor and 
exhalations of the mouth, passed from the affected to the non- 
affected. This occurs at all hours and is thought nothing of. 
The indiscriminate kissing of infants is highly prejudicial to the 
little one, its tissues as a rule, are fresh, free from disease germs, 
the activity of growth great, metamorphosis rapid ; in its nurse's 
arms, in the perambulator or carriage, it is the victim of kissing. 
How many of those maids and busybodies who kiss are free 
from the latent seeds of disease, especially disease germs ? What 
are the habits of those maids ? Echo answers — What ? 

The germs of cancer are deposited in early life upon the lips 
of children and are indelibly fixed there, remain latent if vital 
force is averaere, but break out the moment that is shattered. 

The activity or latency of disease germs in those who care for 
children is of great importance ; active or latent they can be com- 
municated by close contact, especially by the mouth, in the 
secretions of which specific germs are always present, and all 
kissed children run a chance of inoculation by the saliva. 

The diagnosis of cancer of the lip is easy, the diathesis, the 
induration or sore on the lip, the pain 
sharp, lancinating, infiltration of the lym- 
phatics. 

The extreme difficulty in the applica- 
tion of any of the plasters at this point 
renders cancer of the lip the most 
eligible for removal by the knife; as a 
general rule it is the best method, push- 
ing local and internal remedies vigorousK- 
after its removal so as to prevent its re- 
currence. 

Some cases arc effectually got rid of 
by either of the pastes, chloride of chro- 
mium, ozone ointment and resorcin. 
A most interesting case of epithelioma of the lower lip in a 
young lady, aged twenty-one. The exciting cause of irritation 
seemed to be the insertion of a peculiar colored thread between 




BACTERICIDES. 12^ 

the teeth. At nineteen a httle thickness was discovered and 
thought nothing of; it kept very painful, gradually enlarging 
until twenty-one, when she sought relief. This case was placed 
upon Chian turpentine mixture, saxifraga, phytolacca, glycerite 
of sulphur, etc., locally. The cancerous infiltration was brushed 
over every morning with lactic acid followed with a paste of 
resorcin and ozone ointment. 

It completely exfoliated in twelve days, leaving a healthy sore, 
but a little gaping. 

To rectify this deformity, a hair-lip pin was inserted and bound 
well in its place with metallic sutures. This was retained for six 
days. The dressing all through was the resorcin salve, it healed 
kindly and left no scar, irregularity or deformity. 



If the germs of cancer are present in the blood of 

Cancer an individual, latent or active, whether they are the 

of the result of heVeditary contagion or infection, the breast, 

Breast, being an exposed portion of the body, is ver}' liable 

to suffer an irritation, a deficiency of life, a relaxation ; 

and these micro-organisms being so small that they can float in 

the air, exude through the walls of the capillaries, colonize, form 

a growth or tumior. The very presence of throwing out germs, 

or infiltration, is in itself irritation which causes more to be 

effused, and when they are thus deposited, they are capable of a 

new and independent existence, with prodigious power of growth 

and reproduction, deriving their nutrition by endosmosis and 

roots or prolongations penetrating into the adjacent tissue. 

The sources of irritation of the female breast are very numer- 
ous, as the handling of the breast and nipple by the infant ; 
articles of modern dress, as corsets ; certain occupations ; keeping 
articles of value in or near the bosom ; and as there is a perfect 
anastomosing, or blending or joining of the nerves of the uterus 
and ovaries, all abnormal conditions of the latter organs' tell disas- 
trously on the breast, so that all diseases of the genito-urinary 
organs are productive of irritation in the breast, as a perversion 
of the sexual act, masturbation, metritis, catarrh, indeed all 
diseases. 

The natural weakness of the left side, the immense ganglia of 
the great sympathetic nerve, reflected over the spleen, heart and 
left breast, tell us in unmistakable language why cancer is so 
frequently found in that breast. Besides, this furnishes a clue to 
why worry, struggle, care, sorrow, mental toil, neurasthenia, aid 
in the same condition. There can be no doubt, irrespective of 
causes already laid down, that monotony, sameness, isolation of 



124 



DISEASE GERMS. 




location, diet, with a toil-worn depressed nervous system, are 
productive of carcinoma. 

The male breast is a mere rudimentary gland, has none of the 

exquisite development of the 
female, none of that high organ- 
ization, very little sensibility. 
Cases in it are rare. A few 
cases, once in a while show 
themselves, due to irritation of 
the buckle of the suspender. 

In a total of looo cases of 

cancer of the breast, of which I 

have taken note, there were 

1 50 cases of encephaloid against 

850 cases of scirrhous. If it 

were possible to obtain statistics 

of all cases of cancer of the 

breast which present themselves, 

we think that the proportion of 

scirrhous breasts to those of 

the medullary would be about 

the same. 

All forms of cancer are met with in the breast ; scirrhous and 

medullary most common ; while epithelioma, fungous hsematodes 

or rose cancer and lardaceous are not so prevalent. 

The recognition, of 
cancer of the breast 
is easy, the pain sharp, 
lancinating, serves to 
distinguish it from all 
other tumors; numb- 
ness of the arm of the 
affected side ; retrac- 
tion and oozing from 
the nipple ; enlarge- 
ment or induration of 
the lymphatics in the 
arm-pit, with the ger- 
mal diathesis which is 
usually well marked. 
The general con- 
stitutional treatment 
for the destruction of 




Tlie same cancer, taken from a pliotograph after remov, 



the cancer germ should be enforced. If the tumor is very small, 
an effort to get rid of it without destroying the skin might be 



BACTERICIDES. 1 25 

tried with the sulphate of manganese lotion or distillation of the 
jequirity, or a combination of the succus belladonna with iodide 
of potass, or the resorcin ointment. 

If too large, or growth too active, then its removal by one or 
other of the germicidal plasters should be decided upon. The 
attending physician is the best judge. 

All such applications are painful, some much less than others. 
These, if active enough, should have the preference. 

A case of open, mixed cancer of the breast (p. 124) ; scirrhus and 
medullary removed by the chloride of chromium paste in nine 
days ; healed up well in twenty-one days. No recurrence. 

All the illustrations in this article are taken from photographs 
of actual cases treated by the most scientific cancer specialists in 
the United States.* 

This case, a lady of immense wealth, widow, seventy years of 
age, had for seven years hid her malady from hernearest relatives. 

It commenced as a small pim- 
ple, and gradually spread until it 
assumed the appearance it has in 
this cut. 

From the back and left side of 
the head, an elevated, ulcerated, 
circular growth is seen to arise, 
measuring 5 yi inches in diame- 
ter. It bled readily, and pre- 
sented all the appearances which 
are usually found associated with 
epithelioma. The general health 
was very poor, and there was 
quite considerable enlargement of 
the post-cervical glands. 

The treatment consisted in the use of tonics, alteratives, includ- 
ing the Chian turpentine mistura, alternated with the ozonized 
glycerite of sulphur. 

A paste consisting of one-half pound each of resorcin, and 

* The treatment of cancer in the United States has been completely revolutionized ; 
the empirical and barbarous methods, the knife and caustics, have been very generallv 
abandoned, and physicians of the highest culture, of the most eminent scientific attain- 
ments and profound skill have adopted the germ theory of its origin, and are to-day 
successfully curing a very large percentage of all cases which come under their cog- 
nizance with bactericides. Among those great luminaries of scientific medicine and 
benefactors of our race, we would respectfully mention E. J. Skelton ^ Sons, 3/. D., 
of Bloomfield, Iowa; Prof. F. I, Mehrman, M. D., of Oakland, California; R. II. 
Randolph, M. D., Portland,- Oregon ; C. V/. Bozihon, lola, Kansas ; Dr. Artcr, 
M. Z>., Lima, Ohio; B. L. Robinson, M. D., McLean, N. Y. ; Ilenrv IVanier^ 
M. D., Sprmgfield, Mass. 




126 



DISEASE GERMS. 







ozone ointment, to which was added ten grains of hydrochlorate 
of cocaine. This was spread on leather and apphed night and 
morning over the entire mass and a httle beyond. 

In twenty -four hours it 
shrivelled up amazingly, and 
so continued for nine days, 
when it dropped off. The 
same remedy, about a half 
weaker, was continued till it 
healed up, which it did in 
twenty-eight days, forming 
an excellent cicatrix. 

A case of epithelioma of 
the forehead, under the charge 
of one of the enumerated 
specialists, was subjected to 
a very similar course of treat- 
ment : tonics, Chian turpen- 
tine mistura, glycerite of sul- 
phur ; locally to the tumor, 
ozone ointment, resorcin, papoid, and thallin. The germinal 
mass exfoliated in ten days, and healed up in a month. Three 
other sarcomatous nodules were forming on the cheek, to which 
the resorcin and ozone ointment alone were applied. Under 
this they disappeared in five weeks. 

This case originated in the removal of hairs by the barium 
depilatory when she was thirty-two, and had taken years to as- 
sume the present size. An excellent cure was effected. 

A very remarkable case of 
epithelioma of the tongue, which 
had been tampered with until it 
assumed a true medullary form. 
The hopeless condition of the 
patient justified a trial of almost 
any remedy. He was placed 
upon a general alterative and 
tonic treatment, including saxi- 
fraga, Chian turpentine, etc. The 
germinal mass protuding from 
the substance of the tongue, was 
first sprayed with peroxide of 
hydrogen, and then brushed over 

with lactic acid, gargle of distillation of jequirity used. Not 
making as much progress as was deemed proper, a ten-per-cent. 
solution of chromic acid was used instead of lactic acid, with the 
best results, the entire mass exfoliating in eight days. 




BACTERICIDES. 




The Chiaii turpentine, glycerite of sulphur, and saxifraga inter 
nally ; and locally the peroxide of hydrogen spra)-, gargle of dis- 
tillation of jequirity used till it 
healed up, taking in all about 
four weeks. 

At the age of forty-four, a' 
small pimple appeared on the 
side of this gentleman's head, 
above the ear, which became 
very painful, and commenced 
to grow slowly and discharge 
sanious, ichorous, cancerous 
pus, with its characteristic 
odor. It continued to gradu- 
ally enlarge for nine years, 
when it presented this ap- 
pearance, a large fungating 
growth, involving the ear. 

W^hen he applied for relief 
iie was placed upon the usual 
germicidal remedies, Chian 
turpentine, saxifraga, Phyto- 
lacca, etc. 

To the large medullary mass of germs, the ozone paste 

was applied daily and care- 
fully watched, fearing it 
might penetrate to the bone. 
In six days the entire mass 
dropped off completely, leav- 
ing neither root nor branch. 
Sore healed kindly in five 
weeks under the ozone and 
resorcin ointment. 

This is the diagram of a 
case of scirrhous infiltration 
of the skin, cellular tissue 
over the antrum. It had 
been gradually increasing 
in size for over two years ; 
pain intolerable, yielded 
kindly to the application of 
equal parts of ozone oint- 
ment and resorcin, which 
was bound over it and ap- 
kept peeling off, growing less and 




Carcinoma on the cheek. 



plied fresh twice daih'. It 




128 DISEASE GERMS. 

less, till at the end of nine weeks it entirely disappeared. The 
internal treatment consist^ in the use of the conium pill for pain, 
and the use of Chian turpentine mistura, saxifraga, phytolacca. 
An excellent cure was effected. 

This illustration affords a most 
instructive lesson as to the utility 
of bactericides in the treatment 
of cancer, the tumor at the outer 
canthus of the eye, on the lid, 
was removed by the knife, being- 
a non-malignant sebaceous ; while 
that at the outer angle of the 
mouth was schirrous, very painful. 
Two lower bicuspids and a few 
cragg}' stumps of teeth were re- 
moved, and then to the cancer the 
ozone paste was applied ever}- 
morning for seven consecutive 
days, when it dropped out, leav- 
ing a clean, healthy-looking sore. The edges were brought 
together by hair-lip pins and a few wire sutures, resorcin oint- 
ment applied, no other dressing. Wound healed promptly, pins 
and sutures removed, and good union effected. He shortly 
afterwards was discharged, with instructions to continue for six 
months the Chian turpentine mistura with the saxifraga. This 
he neglected. 

A month later on, he returned with a hard painful mass be- 
neath the chin, extending to the jaw on each side, but rather 
further to the right than the left side. In the centre of the mass 
below the jaw was a prominent swelling, the size of a marble, 
distinctly fluctuating ; skin ever it red and thin, much pain and 
tenderness ; movements of tongue unaffected ; speech clear ; de- 
glutition, free. 

Four days later on, this swelling beneath the chin began dis- 
charging thin, watery, cancerous pus ; a few days later, as if b\- 
magic, the sore rapidly fungated, and became as large as an 
orange, with the surrounding tissue involved. 

The case looked very gloomy ; Chian turpentine, saxifraga 
and the conium pill were ordered internally, and the ozone oint- 
ment, pound for pound, with resorcin, was ordered to be kept 
constantly applied. In a few days the whole aspect of things 
was changed, the mass commenced peeling and shrinking, and 
in five weeks entirely disappeared. 
Made a perfect recovery. 



BACTERICIDES. 



129 



In this diagram, the ozone paste was applied fresh every morn- 
ing; both tumors dropped out entire on sixth day; subsequently 
dressed with the ozone oint- 
ment and healed up very 
kindly. The internal reme- 
dies consisted of alteratives 
and tonics, embracing saxi- 
fraga, phytolacca and gen- 
eral remedies ; case pro- 
gressed well to a complete 
and perfect recovery. 

This, and all the illustra- 
tions of cases, exhibit 
clearly the utility of bacter- 
icides in the management 
and cure of cancer. The 
desideratum of the age is 
the introduction of more 
potent remedies to destroy 
the germ, and leave healthy 
tissue unimpaired. 

Two scirrhous infiltrations, one on arm, the other on 
forearm. 




It may truly be asserted that, in every 
Cancer of the case of the cancerous cachexia, the liver 
Liver. is impHcated through the agency of the 

germ-laden blood passing through it, espe- 
cially if the liver is weakened by alcohol, malaria, mercury, or 
great mental strain. The varieties met with are scirrhous, medid- 
lary, melanotic, colloid. 

Germs deposit themselves in the interlobular spaces, crowd 
the capillaries, and obliterate them. Rapidity of development is 
the characteristic of the medullary. The melanotic is remarkable 
for its blackish pigment. The diagnosis of cancer of the 
liver is obscure, the loss of weight, strength, and ambition ; 
anaemia, loss of appetite, flatulence, vomiting, constipation, alter- 
nating with diarrhea; jaundice, oedema of the feet; hemorrhages 
from all the orifices ; stools clay-colored, urine scanty. Cancer 
of the liver may run its entire course without pain, without jaun- 
dice, but in the largest proportion of cases there is pain anterior 
to posterior, pain in right shoulder. 

There may be a large bulging over the liver, large smooth nod- 
ules can be felt, and are visible. The nodules are umbilicated, 
and are diagnostic of the disease. 



1^,0 



DISEASE GERMS. 



No curative measures of any avail, the palliation of symptoms 
are all that can be done. 

Cancer of the brain, arteries, heart, intestines, kidneys, gall 
duct, pancreas, spleen, pleura, are all incurable when once estab- 
lished. The only point of decided interest is the diagnosis, 
which, in nearly all cases, can be made out by cachexia, by the 
pain, by the cancer germs in the urine. 



Cancer of the 
Lung. 



All varieties and grades of the cancer 
germ are found in the lung. Medullary or 
encephaloid are the most common, then the 
other forms. It occurs in nodules of various 
sizes, situated through the lung substance, or in more rare cases, 
in larger masses. In either form they cause great destruction of 

tissue and hemor- 
rhage. One lung 
is usually implicated, 
in which the germs 
make great ravishes. 
The etiology of 
pulmonary cancer is 
the same as cancer 
in general ; often 
precedes or is asso- 
ciate with cancer of 
the breast. 

Diagnosis. In can- 
cer of the lung there 
is pain anterior and 
posterior ; in the 
expectoration and 
urine the germ is 
easily detected by 
the microscope. Besides, the cancerous cachexia will aid the 
diagnosis, otherwise, difficulty of breathing, cough, ha^^moptysis, 
rapid emaciation, pleuritic symptoms resemble tubercle. There 
is usually very little difficulty in its recognition. Such cases are 
most unfavorable, and can only be palliated. 




Cancer microbe in tlie lung. 



ancer of the 
Rectum. 



Cancer may be defined to be a disease in 

which certain primary elements of the blood 

are changed, altered, or degraded, by adverse 

states or conditions prejudicial to life, into a 

disease germ. This germ may remain latent in the blood until 

some part of the body is weakened, irritated, damaged, or 



BACTERICIDES. I 3 j 

ulcerated, when the blood so germ-laden passes through the 
weakened part, an exosmosis of the germ is likely to take place. 
Whenever a disease germ or microbe passes out of the bounds of 
the circulation, they acquire a prodigious faculty of growth and 
reproduction. 

The probability or improbability of extirpating a cancerous 
growth depends altogether upon the judicious use of local and 
internal germicides. It is, therefore, a wise rule to adhere to 
in all cases, never to tamper with a cancerous tumor or growth 
until the blood and lymphatics are cleared of germs ; once this 
is accomplished the growth should be seen to. 

A very large number of our people possess a cancerous dia- 
thesis (blood-germ laden with the cancer microbe), and have no 
tumor or growth visible, simply because there is no local irrita- 
tion, no weak part through whose vessels the germ can pass out 
of the bounds of the circulation. 

The exciting causes about the rectum are irritation, fissure, 
catarrh, piles, ulceration, fistula in ano. 

General Symptoms. — The early indication of this distressing 
malady are often very slight, such as sluggishness of the bowels, 
or diarrhea from the presence of germs. As the germs grow, a 
slight discharge of blood, or blood mixed with mucus, or puri- 
form matter is commonly met with. This is at first voided with 
the faeces, or in micturating, or independent of any evacuation 
The quantity of blood thus lost varies from a streak upon the 
fecal substance, to two drachms, or as many ounces. The dis- 
charges are the results of the microbes burrowing in the rectal 
walls, perforating the vessels. 

Gradually the fecal evacuations are impeded in various de- 
grees, obstinate constipation or scanty discharges of thin fluid 
are from time to time ejected. When consistent the fecal matter 
is usually slender or flattened, ribbon-like, or hollowed on the 
surface. Later on evacuations are arrested, and relief is obtained 
at long intervals, and with much agony. This is the common 
run of cases. In others, fecal matter continues to be ejected in 
small pieces. 

The hindrance to the passage of the contents of the bowel is 
occasioned by the cancerous tumor or infiltration. 

Besides, the disease germs paralyze the bowel. The bladder 
is occasionally involved, and the discharge of urine is affected in 
various ways, sympathetically or by that organ being involved in 
the cancerous infiltration. Pain, anterior and posterior, is an in- 
variable attendant upon cancerous disease of the rectum. It may 
be inconsiderable in degree, a mere teazing uneasiness, to one of 
intolerable anguish, without remission. Pain in the rectum and 



1^2 DISEASE GERMS. 

its immediate neighborhood ; over the sacrum ; along the peri- 
naeum ; in the fold of the nates on both sides — when on one side^ 
most frequently the left, down the thigh on its back part, and 
even, but rarely, the calf of the leg. The pain in sacrum is the 
most severe, even to the sphincter, so that the affected individual,, 
if sitting, will sit sideways, or partly supported by two chairs. 

Cancer germs in the rectum give token of their presence by a 
perceptible loss of flesh ; by a puffed waxiness of appearance ; by 
the yellow tinge of the eyes ; by the deep aspect of depression 
and taint of the system ; lymph canals and liver engorged with, 
the germs, the general health is undermined. 

The symptoms will vary with the location and character.. 
Scirrhous, colloid, and epithelial, and soft and fungoid are common 
forms. Usually the deposit is first met with between the mucous 
and muscular coats of the bowel, usually at a single point, low 
down, two and one-half inches up, or so high that it is out of 
reach ; or it involves the whole circumference of the gut, and 
spreads longitudinally towards the orifice of the bowel, as well 
as upwards, perforating in all directions. 

The germs often migrate to the neighboring parts ; to the anus, 
first infiltrating the skin, then ulcerating ; or an abcess and fis- 
tula may come in the ordinary way and extend from the skin to 
the interior of the bowel, and burrow far and deeply into the 
parts. 

When the cancerous deposit is high up, it is liable to eat 
through the bowel and form an immense shapeless mass, in which 
the bowel becomes imbedded. It often becomes adherent to the 
sacrum ; presses upon the nerves. 

In some cases it migrates into the bladder, uterus, vagina, 
ovary, etc., establishing communications by an ulcerative process, 
giving rise to grave complications. 

In tracing cancer of the rectum through its course, we have 
seen that the germ first locates between the mucous and muscu- 
lar coats of the intestines, and follows the course of the blood 
vessels ; most frequently the first deposit is at the distance of 
two and one-half to three inches above the orifice of the bowels. 

Treatment. — Patients so affected should be put upon a general 
alterative and tonic course, with the best of diet and good 
surroundings. Pain must in all cases be relieved with the comp, 
conium pill. Bougies of various kinds should have a fair trial,, 
and should be used for months. They should be made of suck 
agents as will destroy the germ colony in and on the bowel. 

They are made of the following ingredients : 

Resorcin, thallin, papoid, in butter of cocoa. 

Otherwise the general treatment of cancer should be vigor- 
ously enforced. 



BACTERICIDES. 



133 



They should be persevered with, and while using them, if any 
'new growths sprout out and obstruct the canal, they should be 
destroyed by rubbing them over with lactic acid or ozone paste, 
or chromic acid. 

Then the introduction of a bougie, and later washing out the 
bowel. In manipulating a cancerous deposit in the rectum, the 
■only immediate danger to be dreaded is hemorrhage, and this 
must be carefully looked for and skilfully managed. 

Constipation and looseness are equally to be dreaded ; as the 
former is the most common, a laxative becomes necessary. The 
^enema of water in very many cases accomplishes all that can be 
desired. 

The most frequent variety of oesophageal 
Cancer cancer is epithelioma, although scirrhous and 

of the medullary are not uncommon. 

CEsophagus. The infiltration of the mucous membrane 
by the germ begins, then it migrates slowly 
into the muscular rings, invading all the tissues of the oesopha- 
gus, causing stricture of its calibre. Above this narrowing there 
is either uniform dilatation, or a pouch, often as large as an 
orange. If the mass of germs involve the entire oesophageal wall, 
it may press upon one or both pneumogastrics and lead to the 
-development of pneumonia or pulmonary gangrene. 

Two-thirds of all cases of oesophageal cancer occur in males 
between the ages of forty and sixty. 

It is easily recognized by the pain. Anterior and posterior pain 
is one of the earliest symptoms of the affection, beginning dull, 
burning, lancinating, aggravated by the passage of food. As it 
grows the canal narrows, stricture takes place, flatulence, regur- 
gitation of food and vomiting, with steadily increasing emaciation ; 
cough, difficulty of breathing, hoarseness from pressure of the mass 
of germs ; cachexia is well marked, hemorrhages become frequent ; 
the bloody fluid vomited contains large massesof the cancer germs; 
the adjacent lymphatics are usually implicated, and there are usu- 
ally fatal hemorrhages or septicaemia. The average duration of 
cancer of the oesophagus is one year, but many cases succumb in 
a few weeks. 

In the treatment great attention should be paid to nutrition, food 
finely chopped, semi-fluid, entirely fluid. Nutrient enemata 
should be given ; diet nourishing in the highest possible degree. 
Pain must be relieved by dissolving the conium pill, introducing 
it into the rectum. Bougies, armed with papoid, should be in- 
troduced with great care down to the cancerous mass and an 
effort made to dissolve it with papoid or trypsin, combined with 
•thallin. 



134 



DISEASE GERMS. 



usually commences as a small pim- 
Epithelioma of the pie, which continually increases in 

Hard and Soft Palate size, becoming a fungating growth, 

with a grayish white color, raised, 
whose edges soon become hard and everted. With this deposit 
of the cancer germ the surrounding tissues soon become impli- 
cated, the tonsils become swollen and tender, hard and red, and 
gradually ulcerate. The uvula, the pillars of the fauces and the 
free edge of the velum palati also become implicated. 

Progressively onwards, fissures, ulceration in patches over the 
greater part of the soft and hard palate take place ; in some loca- 
tions a mere excoriation ; over all the affected area, not occupied 
with the cancer germ, the mucous membrane is hard and 
thicker. 

The pain is usually severe in these cases. 

The most successful treatment of such cases is to paint over 
the nodules either with a ten-per-cent. solution of chromic acid 
or the pure undiluted lactic acid ; use mouth washes of distilled 
jequirity or boroglyceride. 

The only remedy so far successful in killing the growth of the 
germicidal mass is the Chian turpentine, in half dozen teaspoonfuls 
daily ; this, in such doses, speedily arrests germ evolution in the 
blood, affords complete relief from pain, the enlarged lymphatics 
diminish in size and ultimately disappear. 

Cancers of the hard and soft palate are generally slow in their 
progress and are more tardy in yielding to the action of ger- 
micides. 

Cancer of the pancreas, though by no 
Cancer of the means a disease of very great rarity, is suffi- 
Pancreas. ciently uncommon to call for more than pass- 
ing notice. Its rarity is, as already mentioned, 
not very great. The gland is usually enlarged, but not always. 
Sometimes it is even diminished in size. The growth invariably 
affects first, and most extensively, the duodenal end, or head, and 
it is by means of this peculiarity, as we shall see later, that its 
clinical diagnosis is rendered possible. The growth is usually a 
carcinoma containing large epithelial cells in alveoli, surrounded 
by fibrous tissue. The proportion of the cells to the fibrous tissue 
differs greatly. In some there are many collections of cells, while 
in others there appears to be hardly anything but fibrous tissue. 
It is these latter cases in which the gland is of small size, or even 
shrunk below the natural. Another sort of primary growth found 
in the pancreas resembles the structure of a tubular gland, and is 
called adeno-sarcoma. These two forms originate in the gland 



BACTERICIDES. 



135 



tissue and the excretory ducts respectively, and are called the 
type glandidaire and cxcretoirc. As a rule the cancer does not 
give rise to deposit in many other organs. The liver is the most 
commonly infected, and the smallness and great number of the 
liver growths in this case, sprinkled thickly through its substance 
without altering its shape, are pathognomonic of their pancreatic 
origin ; but they certainly do not always occur. 

The symptoms of the disease have been considered very nu- 
merous and very obscure, but they may be much simplified if we 
place them in their classes according as they depend on the ana- 
tomical position of the pancreas, its function in the general 
economy, and on the nature of the disease which has attacked 
it. To take the last condition first, where the growth reaches a 
large size a tumor may, of course, be felt with more or less dis- 
tinctness in the epigastrium, and the conjectures as to its origin 
will be more or less plausible accordingly. Where it remains 
small it cannot in general be felt at all. 

Pain is more inconstant here than in most other cancers. 
When it occurs it is often felt in the back, often referred with 
more or less accuracy to other parts of the abdomen. When 
these are absent we can only fall back upon the fact that cancer 
of this organ produces, as does cancer in other situations, anaemia 
and emaciation, but these symptoms are more marked and more 
rapid here than elsewhere, in proportion as the gland attacked is 
more concerned with nutrition. Cancer of the pancreas hardly 
ever lasts six months from the first appearance of symptoms. 
Nor is this surprising when we remember that the pancreatic 
digestion combines in itself the features of all the others. Like 
the saliva, it turns starch into sugar; like the gastric juice, it 
digests albumen ; and like the bile, it emulsifies fats. In disease 
of the organ we should therefore expect that traces of defect in 
all these functions should be discoverable ; and of all of them, 
indeed, traces have been discovered. In some cases, though but 
few, stdrch has been recognized in the stools by the aid of the mi- 
croscope. In some undigested muscular fibres have been seen to 
pass away with the fseces or to return in the vomit. Both these, 
however, are less easily recognized and less distinctive than the 
fatty stools which have frequently been observed, and the fatty 
vomit which is occasionally seen. The fat is generally recog- 
nizable by the naked eye as an oily liquid, as waxy lumps, or as 
an actual coating on the {-^ao-^. Sometimes, however, it needs a 
microscope to show the fat globules intimately mixed with the 
mass. An easier plan is to shake up a small piece of the faeces 
in ether, and either evaporate the latter in the tube, leaving a fatty 
deposit behind, or on blotting-paper, which will show the charac- 



136 



DISEASE GERMS. 



teristic translucent greasy stain. In one case at least of pancreatic 
disease fat has been found in the urine, but this seems too rare an 
occurrence to be of any importance. In spite, however, of the 
enormous importance of the pancreatic digestion, its failure does 
not bring about other digestive symptoms with anything like the 
frequency that might have been expected. There certainly is 
often loss of appetite, but it is by no means constant. In a case 
known to us the appetite did not fail till a fortnight before death. 
Pain after food is occasional, but rather uncommon than the re- 
verse. It has been before now suggested that a typical symptom 
of pancreatic disease is a watery diarrhea, but on the contrary, 
many, if not most cases are constipated. One very curious 
symptom remains which, though rare in cases of cancer, is not 
infrequent in other pancreatic diseases, and is even common in 
pancreatic calculus. This is diabetes mellitus. Theories to 
account for it have been equally numerous and unsatisfactory ; 
the fact alone remains. 

Summing up, then, the symptoms already detailed, we are 
obliged to confess that neither those derived from the nature of 
the growth nor, with the exception of fatty stools, those depend- 
ing upon the pathology of the gland can give us any trustworthy 
help to diagnosis ; and even when the characteristic faeces are pre- 
sent it maybe questioned whether they do not depend upon an al- 
teration in the supply of the bile, rather than upon disease of the 
pancreas. Luckily, the morbid anatomy of the affection is more 
fruitful. Cancer always, as before said, involves first and most 
extensively the head of the pancreas, and in this situation it can 
hardly avoid pressing on the common bile-duct as it passes down 
between pancreas and duodenum. The jaundice which is thus 
produced, though in rare cases absent, is by far the commonest 
symptom of pancreatic cancer, and is in itself peculiar. In the 
first place it is commonly very deep, far deeper, for instance, than 
the jaundice typical of cirrhosis of the liver. Next it is very per- 
sistent, not as often occurs in cases of gall-stones, intermittent, or 
as catarrhal jaundice, transitory. Thirdly, the liver is not greatly 
enlarged as in cases of cancer, nor diminished as in cirrhosis, but 
undergoes a curious change. In the early stages it is usually 
swollen, sometimes tender, and may reach to an inch or even two 
inches below the ribs in the right nipple line. But later it begins 
to shrink, and at death is hardly ever found larger, sometimes 
smaller than natural. This change probably is due to cirrhosis 
beginning round the bile-ducts, caused by the pressure of the ob- 
structed bile. When enlarged it might be thought to be a liver 
in the hypertrophic stage of portal cirrhosis, but this is excluded 
by the deepness of the jaundice, and more surely by the fourth 



BACTERICIDES. 



137 



characteristic sign, the distended gall-bladder. The gall-bladder is 
always dilated, and may in some cases reach considerably below 
the umbilicus. This, taken with the deep jaundice, proves that 
both the cystic and hepatic ducts are free, while the common bile- 
duct is compressed or obstructed, and it is this combination 
which is so significant. For the common bile-duct, three inches 
in length, runs for two-thirds of its extent under cover of and 
between the duodenum and pancreas. For the first inch or so, it 
runs into the lesser omentum, and is here liable to compression 
from enlarged abdominal glands. 

Persistent jaundice points strongly either to a blocking up of 
the duct by calculus, stricture, or disease of the duodenum or 
pancreas. 

In all cases of deep and persistent jaundice, with distension of 
the gall-bladder, without symptoms of gall-stones, if the liver be 
but a little enlarged, the disease will in all probability be cancer of 
the head of the pancreas. This diagnosis will be confirmed if 
wasting sets in early and progresses quickly. 

The treatment w^hich is available is to supply the deficiency by 
pancreating the food, before it is administered, and placing the 
patient upon the Chian turpentine mistura, which has a remarka- 
ble effect on the germ-laden pancreas, the ethereal peroxide of 
hydrogen. 



All forms and varieties of cancer are to be 

Cancer of the met with in and on the penis. Usually a 
Penis. result of contagion and infection. 

Scirrhus, epithelioma, medullary, etc., etc. 
A very large percentage of these cases commences with a peculiar 
scaly or horny excrescence on the corona glandis, prepuce, and 
oftentimes on the areola of the nipples. This 
scaly or horny infiltration is in the ?arly stages 
unaccompanied with any decided pain, simply 
uneasiness, misery. A scale from the prepuce 
placed in the field of a microscope gives us the 
annexed diagram. 

If attended to just at this point the growth is 
irrested, and no further trouble. 

There are two methods of procedure, either 
pack the head of the penis and all affected parts 
every night in boroglyceride paste, or apply the 
resorcin paste ; either one will cause a complete 
exfoliation of the morbid tissue, leaving it soft 
and in a healthy condition. 

The usual remedies for the destruction of the cancer microbe 




The horny excrescence 
magnified loo diam- 
eters. 1. The spore 
sprouting into the 
area a and b. 



138 DISEASE GERMS. 

should be resorted to for a period of six months. These should 
embrace active bactericides, saxifraga, Chian turpentine, Phyto- 
lacca. 



The stomach, next to the Hver, is the most 

Cancer of the frequent seat of the locahzation of the cancer 

Stomach. germ in the internal organs. We meet with 

all forms and varieties here ; we enumerate 

them in the order of their frequency as follows : scirrhous, 

medullary, colloid, villous, melanotic, epithelial. 

The germ in two-thirds of all cases deposits itself near the 
pyloric extremity, migrating or infiltrating the stomach upwards,, 
and downwards into the duodenum ; the other one-third of cases 
infiltrates the cardiac orifice involving the oesophagus. 

Scirrhus, few germs, but much fibrous tissue, appears as a 
grayish, white, opaque nodule in the submucous tissue; the germs 
are few, the fibrous tissue abundant, so there is a great hardness 
or induration, which causes contraction of the surrounding 
tissues, and puckering of the mucous membrane. The germs in 
their growth radiate in all directions where there is least resistance, 
forming nodules. A dark slough often forms on those eminences, 
which may ulcerate and expose the cancerous mass ; this may 
either extend deeply or spread widely so that the neoplasm is 
found in all directions. 

The lesions which follow the presence of scirrhus are dilatation 
of the stomach, chronic gastritis, perforation. The medullary 
form begins at the same locations, and forms a large soft nodule. 

Cancer of the stomach occurs most frequently between the 
ages of forty-five and sixty-five ; more common in males than 
females. 

TJie diagnosis is not difficult, we have the cachexia, the 
breath, skin, urine, stools, the pain anterior and posterior, the 
cancer germs in the vomited products, and in urine. 

A tumor sometimes large, hard, irregular, nodulated ; some- 
times small, deep-seated and elastic, can be felt ; which will be a 
guiding landmark to distinguish it from all forms of dyspepsia. 

It is hardly possible to mistake cancer of the stomach for 
gastric ulcer, abdominal aneurism or nervous dyspepsia. 

The symptoms are plain and most decided : pain anterior and 
posterior, anorexia, a sense of goneness, uneasiness, distension, 
with nausea and vomiting, pyrosis, gnawing, lightness in stomach. 

The pain may not be referred to the stomach, but referred clear 
through to the interscapular region; those symptoms put in an 
appearance long before the germs in the walls of the stomaclv 



BACTERICIDES. 1 30 

make much headway. But as germ growth becomes active, 
vomiting is persistent. 

Hiccough, flatulence, constipation are often annoying and dis- 
tressing. Great mental depression, debility, emaciation, haggard 
countenance as it progresses, hemorrhages set in, rusty, brown, 
blackish blood loaded with germs, or if from the bowel tarry. 
The yellowish green color of the skin changes to a jaundice hue, 
chiefly due to the cancerous mass pressing upon the Hver. 

Often febrile symptoms, hectic, tongue becomes loaded with 
the oidium albicans, urine loaded with urates, often serious com- 
plications. The duration is from a few weeks to three years and 
a half. The prognosis is regarded as unfavorable. 

TJie treatment almost altogether consists in ameliorating 
prominent symptoms, so as to afford all the relief possible from 
the pain and vomiting. The diet sho.uld be liberal, nutritious, 
concentrated, with a moderate allowance of milk-punch at stated 
intervals. During the whole course of the disease, the C. conium 
pill should be administered thrice daily for the relief of pain and 
to retard the cancerous growth ; constipation should be overcome 
by the use of kola nut paste. 

Germicidal remedies are often effective in retarding cancerous 
growth, and arresting the development of the microbe. The use 
of one or two of the following remedies at a time are worthy of 
a trial. 

Papoid triturated with salicylate soda and resorcin have proved 
effective in causing the dissolution of the cancerous mass, let it 
be scirrhous or medullary. 

Trypsin has a similiar action, glycerite of sulphur, or the 
emulsion of Chian turpentine, have proved effective. Liquor cerii 
has been of great utility, peroxide of hydrogen in alternation 
with the sulphide of lime. 

The pill composed of papoid, thallin, and sulphonal operates 
well. 

Ozonized clay kept over the stomach has a magical effect 
(acting by endosmosis) in causing a dissolution of the germinal 
mass. It may be bound on over the region of the stomach, but 
never kept long enough applied to cause any irritation. If the 
stomach rejects all food, rectal alimentation will be necessary. 



The most common variety of cancer of the 
Cancer of the tongue is epithelioma. The diathesis being 
Tongue. present, some point of the tongue being sub- 

jected to constant irritation, there appears at 
that point a small unhealthy ulcer, or a deep-seated nodule,. 



140 



DISEASE GERMS. 



usually on its edge ; ulcer becomes circular in shape, with ragged, 
-everted edges and a wide indurated base. The surface of the 
cancerous mass has a dirty white or grayish aspect, later, red, 
papillated, friable, but very hard. 

As it progresses onward, it slowly involves the whole tongue, 
which becomes large, unevenly lobulated, covered with several 
ulcers ; hemorrhages often take place. All the glands of the 
mouth and throat, submaxillary and sublingual are infiltrated, 
and the oral cavity is filled with the cancerous mass. 

Cancer of the tongue is met with most frequently in man in 
middle life, between thirty-five and sixty ; some local irritation, 
.as a carious tooth, the stem of a pipe, is an exciting cause. 

It is easily recognized by the 
sharp darting pain in the ulcer ; 
the pain aggravated by the 
movement of the tongue ; pain 
runs along the course of the 
fifth nerve. As the lymphatics 
become engorged, salivation be- 
comes profuse ; as hemorrhages 
are not infrequent, anaemia is 
soon well marked ; the breath 
is truly diagnostic ; the germinal 
mass destroys healthy tissue 
with extreme rapidity. 

The duration of the disease is 
about fourteen months. 

The destruction of the germ, 
the relief of pain, the mainten- 
ance of the vital powers are the 
principal indications of treat- 
ment, 
a remarkable case ; cured by the 




Epithelioma^of the tongue. 



Epithelioma of the tongue 
application of papoid. 

Ozone paste was applied twice ; the mouth and throat gargled 
thrice daily by the distillation of the jequirity and solution of 
chlorate of carbon ; in the interim papoid was applied. 

Very similar cases of cancer of the tongue, with a fungating 
growth in the floor of the mouth on the left side, involving the 
gum and edge of the tongue for nearly two inches. All the sur- 
rounding tissues densely infiltrated. 

Ozonized emulsion of Chian turpentine was tried, in alternation 
with resorcin, and a sufficient quantity of glycerite of sulphur to 
move the bowels ; growth painted with a ten-per-cent. solution 
of chromic acid and crarcrle of chlorate of carbon was used. 



BACTERICIDES. 



141 




Epiihelioma of the tongue. 



were used alternately every 
hours ; mouth kept moist with decoc- 
tion of slippery elm with a few drops 
of peroxide of hydrogen. i^b ut 
every four days the lactic acid wa^ 
used ; this had an affinity for th ■ 
germs without destroying the norma! 
tissue of the tongue. In two weeks 
the dilute acid was used. 

Case made an excellent recovery, 
healing kindly about the seventh 
week, and remains well. 

This case resembled the above in 
many of its essential features, and in- 
stead of the lactic acid, a ten-per-ceni. 
solution of the ozone paste was usee! 
for killing the germs in the ulcer on 
tongue ; this was brushed freely over 
it, and followed by a mouth wash of 
distillation of jequirity, alternated with 
a wash of peroxide of hydrogen. 

Same internal treatment as the first 
case. 



This is a photographic illus- 
tration of epithelioma of the 
side of the tongue, with a medul- 
lary mass protruding through 
it ; a well marked fissure run- 
ning towards the point and an 
ulcer in the centre ; tongue well 
indurated throughout its whole 
substance. The submaxillary 
glands were considerably infil- 
trated and cancerous cachexia 
well marked. 

This case was placed upon 
comp. saxifraga and phytolacca, 
and the conium pill was admin- 
istered to relieve the pain. 

The large medullary patch, 
the fissure and ulcer in the 
centre, was brushed over with 
the pure concentrated lactic 
acid ; mouth washes of chlorate 
of carbon and rhl^n*nn«-<-ri soda 
thre- 




Epithelioma 011 edge of tongue. 



«4- 



DISEASE GERMS. 



There was immense peeling 
off of the germ-smitten tissue, 
which seemed to make away 
with the induration. The re- 
sults were very efficacious. 
The recovery of the patient 
was rapid, and tongue healed 
up very kindly. 

This case was treated with 
the powdered jequirity, the 
beans decorticated, submitted 
to the action of peroxide of 
hydrogen, reduced to an im- 
palpable powder, blown or 
dusted on the ulcer every five 
days, caused a complete exfo- 
liation each time it was applied. 

Mouth washes of borogly- 
ceride were used every four 
hours, and occasionally a piece 
of resorcin jelly, dissolved in 
warm water, was used for wash 





Cancerous ulcers on tongue. 



Cancerous ulcer on tongue, 

and gargle. The result was ex- 
tremely beneficial, even miracu- 
lous, in ridding the mouth of 
this most destructive microbe ; 
breath became sweet ; the whole 
character of the patient changed 
to one of life and vivacity, in- 
stead of the lethargy of death. 

The internal treatment con- 
sisted in the use of saxifraga, 
Chian turpentine and exalgine. 

The numerous ulcers on this 
tongue, were each, once a week, 
brushed over with concentrated 
lactic acid ; mouth washes of 
chlorinated soda, alternated with 
a wash prepared from the resor- 
cin jelly. 

Case improved rapidly at first, 
but rather slow after sixth week. 

Mouth washes were changed 



BACTERICIDES. 



43 




iCaneer of the tongue, involving its 
mucous membrane and papilla. 



to distillation of jequirity, and one 
of chlorate of carbon. This change 
operated beneficially ; cicatrization 
set in, progressed favorably ; healed 
entirely up in nine weeks. The fluid 
extract of hydrocotyle was used in 
this case instead of the saxifraga, 
and glycerite of sulphur to move 
the bowels. Exalgine was most 
beneficial for pain. 

A most remarkable case of cancer 
of the tongue, in which the microbe 
infiltrates its entire mucous mem- 
brane and its papilla; it has resisted 
the usual remedies. It drifted into 
the hands of one of the eminent 
specialists whose names are men- 
tioned in this article. 

A solution of ozone paste was tried, 
under which it seemed to do well, 
but it was discontinued on account of 
its diffusibility, and a paste made of 
thallin,papoidand glycerine was tried, 
that is, spread over the entire tongue ; 
this caused a dissolution of the can- 
cerous infiltration. It had to be ap- 
plied daily, but operated exceedingly 
well, so that he got rid of it entirely 
about the tenth week. The mouth 
wash used was a solution of boro- 
glyceride and peroxide of hydrogen. 
Internally, saxifraga comp. and Chian 
turpentine were the remedies used. 
The treatment of this case was en- 
tirely different and much more suc- 
cessful. The entire diseased surface 
of the tongue was brushed over with 
lactic acid, the ulcer in centre receiv- 
ing three applications. Mouth washes 
of distillation of jequirity, alternated 
with the chlorate of carbon, were used 
with most success. Large masses of 
dead germs were exfoliated after each 
application. The lactic acid was ap- 
plied six times, a week apart. Healed ""ZS ^\Si^^:^:f:^;\:i^^ 




144 



DISEASE GERMS. 



completely by the ninth week. The internal remedies the same 
a.s in the other cases. 

Cancer of the generative organs is un- 

Cancer of the doubtedly the most formidable affection 

Uterus. to which woman is liable. The liability 

exists at any age, but is most decided after 

thirty years of age, the proclivity existing up to fifty years of age, 

after which the liability becomes less and le^s. 

The forms met with in the uterus are the scirrhous, medullary 
and epithelial. 

The causes which give rise to so much cancer of the uterus 
are repeated abortions, sexual incompatibility and venereal disease, 
which give rise to chronic inflammation or partial death of the 
uterus. A low grade of uterine inflammation lies at the root of 
all female complaints, which continues from year to year until the 
cancer germ is thrown out. It does not necessarily follow that 
all cases of chronic inflammation do thus terminate, but all such 
must be guarded with a jealous eye. 

Mercurialization, monotony, sameness, isolation, solitariness, 
sexual excesses and other states unfavorable to a high standard 
of vitality or longevity, or conditions unfavorable to a high state 
or grade of existence, a degradation of the normal living matter 
of the body takes place into a diseased germ called the cancer 
or malignant bacilli ; true, these germs may also be received into 
the body by contagion and infection like other micro-organisms. 
In whatever manner they are brought about, by spontaneous de- 
gradation in the body, or by local contact, or by inhalation, the}- 
make the human blood their pasture-field, for in that fluid they 
grow and multiply prodigiously if vital force is low. It is a well- 
known fact that an individual with millions of cancer germs in 
the blood may live along to a good old age; if there is no local 
weakness or irritation, there is no colonizing of germs, but let an 
organ or tissue, or part of the body be weakened by anything, as 
the pipe on the lip of the smoker, or a contusion on the breast, 
or anything that will relax or weaken tissue anywhere, then an 
exosmosis or efl"usion, or exudation from the diseased gej'm- 
loaded blood takes place and growth and fruition of the germs 
will go on with amazing rapidity. 

Now, of all organs in the body of modern ladies, none are so 
liable to suffer depression as the uterus ; its intimate connection 
with the ganglionic nervous system ; those millions of little 
brains, those reservoirs of vitality ; its blending with the sympa- 
thetic system render it susceptible of being depressed by emo- 
tions, desires, affections, passions, so that the struggle for exist- 



\ 



BACTERICIDES. j^^ 

ence, exciting literature, certain modes of life, sedentary employ- 
ments, sexual excesses, etc., spend their action upon this special 
organism ; besides, at the climacteric period there are important 
anatomical and physiological changes that cause weakness, such 
as the atrophy and obliteration of vessels, shriveling up of ovaries 
and uterus and suppression of important functions, etc. Cancer 
of the uterus is, without a doubt, the most common and grave 
form of germ disease among women. 

The affection is generally ushered in with symptoms of general 
debility, a gone feeling, headache and backache. 

The neck of the uterus thickened, indurated, notched. In this 
state it may remain stationary for years, while, if the health is poor, 
it may proceed with rapidity towards cancerous ulceration. In- 
flammatory symptoms usually are present and darting pains like 
needles are felt, as if piercing the part, both anterior and pos- 
terior; ulceration follows. The leucorrhoea, which before existed, 
now becomes highly purulent and fetid, so much so that ts odor 
can be detected some distance from the patient ; then follows con- 
stitutional irritation, disorder of the stomach ; patient becomes 
gradually worse, insomnia, pain in the pelvis is constant, with oc- 
casional lancinating pain ; the cachexia is well marked ; the pa- 
tient becomes weak and irritated; paroxysmal hemorrhage, slight 
at first, but gradually becoming excessive and exhausting. 

On examination per vaginam we find the cervix uteri pain- 
ful to the touch; and instead of the natural nipple-Hke projec- 
tion, its surface is broad, hard, ragged, chapped. The extent of 
the induration can be appreciated by an examination per rectum. 

Bladder and rectal complications often set in early. 

If the disease is not arrested the germs eat in all directions, 
vessels are laid open, hemorrhages increase in frequency and in 
amount ; ulceration extends to the bladder and rectum ; and the 
state of the patient is truly deplorable. 

It is only in the earlier stages of the disease that any hope can 
be held out, if later on it admits of no cure, the patient must die, 
and all that can be done is to alleviate her sufferings. 

If seen early or late, the bowels must be kept very regular : 
the vital force must be sustained by a most nutritious diet ; 
daily baths ; the sensorium must be blunted with the conium pill, 
rectal suppositories of cocaine; and pastiles of hyoscyamus. 
Tonics and the general treatment for the annihilation of the germ 
carried out. 

In cancer of the uterus, the Chian turpentine has proved invalu- 
able and efficacious. The mode of administration is to keep the 
bowels regular by the administration of a sufficient dose of the 
ozonized glycerite of sulphur, and give one teaspoonful of the 
lo 



46 



DISEASE GERMS. 



emulsion ot Chian ttirpe^itine thrice daily — the emulsion is thus 
prepared : 

One ounce of the Chian turpentine is to be dissolved in two 
ounces of pure sulphuric ether. This solution has been termed 
the turpentine essence, and the emulsion is made by adding one 
ounce of this essence to a mucilage of acacia (one ounce and a 
half of powdered gum arable and water to nine ounces), making 
a ten-ounce mixture, a teaspoonful of which contains about three 
grains of the drug. 

The vagina should be cleansed out thrice daily with any of 
the following antiseptic washes. 

Boroglyceride, iodine, chlorinated soda, permanganate, resorcin, 
by or with a fountain syringe. 

Our only hope is, if seen early, before the destruction of tissue 
of vital parts has taken place. 

This illustration exhibits an epithelial growth, the size of a 
small crab apple, situated in the posterior wall of the neck of the 
uterus ; it bled freely when touched, and 
thus prevented any further exploration. 

The patient, aged thirty-five, had suffered 
for eight months with pain above the 
pubes, radiating back to the sacrum, with 
profuse muco-purulent discharge of an 
intensely fetid odor. 

The treatment of the case consisted 
in enjoining rest, with tonics and nourish- 
ing diet, vaginal douches were used morn- 
ing and night, consisting chiefly of boro- 
glyceride, creolin, resorcin, and internally 
the Chian turpentine mistura w^as pushed 
vigorously, commencing with one tea- 
spoonful three times daily, increasing 
gradually to ten teaspoonfuls. The growth 
every second day was painted with lactic 
acid. 

This treatment was continued for four 
months, the Chian turpentine being left 
off for three or four days every two weeks 
consecutively. 

About the end of the first week the distressing pain had 
entirely disappeared, both the quantity as well as the factor of 
the discharge commenced to grow less ; in five weeks the tumor 
began to wither, hemorrhages ceased, a new era of life seemed to 
dawn upon the patient. 

Gradually the tumor seemed to waste away, growing less and 
less, till about the fifth month it entirely disappeared. 




Epithelioma — neck of uterus 
radically cured by Chiau 
turpentine mi;>tuni. 



BACTERICIDES. 



147 




Infiltration of the uterine os and neck with the microbe. 



On examining the uterine neck, the stump left was irregular, 

notched out but showed nothing whatever of a cancerous nature. 

In six months from the commencement of treatment she had 

entirely recovered and the normal function of the uterus was 

restored. 

Photographic illustration of a case of incipient infiltration of 
the OS uteri, with the cancer microbe. 

A cure was effect- 
ed in six weeks by 
the following reme- 
dies : Once every 
seven days for four 
consecutive weeks 
the contents of three 
jequirity capsules 
were blown over the 
dotted induration, 
which each time caused a gelatinous exfoliation to peel off; in 
quantity it would fill a tea-cup. The succeeding night the va- 
gina was packed with the boroglyceride paste, which caused an 
exudation of serum with dead cancer germs to the amount of 
four ounces ; the following night two cocaine cones. This plan 
was pursued persistently, one night the boroglyceride, the next 
the cones ; every seventh day the jequirity wafers for four weeks ; 
induration entirely gone. Injections of slippery elm infusion, to 
which either peroxide of hydrogen or sulphide of lime was 
added ; alternated with a solution of resorcin. 

Internal remedies, Chian turpentine mistura, saxifraga and 
tonics. 

This illustration, in which the cancer germ had penetrated 
farther up the uterine neck, was treated precisely as the former, 

with the exception that 
the OS and neck were 
painted every ten days 
with lactic acid, and in- 
jections of boroglyceride, 
chloride of lime were 
used. 

The cocaine cones were 
used per vaginam thrice 
daily. 

Internal remedies were 
Chian turpentine mistura, thallin, phytolacca, sulphide of lime. 
An excellent cure was effected in about four months. 




Epithelioma of the neck of the uterus— the microbe infil- 
tration extendnig into the entire neck — ulceration just 
beginning. 



148 



DISEASE GERMS. 




Epiiheliom i of the neck of the uterus, 
proceeding into the stage of ulcera- 
tion: three distinct fissures. 



This wood cut is a representation of a case of very irritable^ 
and exceedingly painful carcinoma of the os, neck, penetrating 

to the body ; induration, sharp lancinat- 
ing pain anterior and posterior ; hemor- 
rhages and extremely offensive dis- 
charge. The patient was well broken 
down, the cachexia of cancer decided.. 
The treatment here consisted in ap- 
plying the ozone paste directly to the 
three fissures and over the fungating 
nodules. In the application of this 
paste, the greatest care was observed, 
all around the cul de sac well pro- 
tected, the paste was applied by a 
small paint brush, moderately thick and retained two hours ; 
then carefully washed off by repeated douches of castile soap and 
hot water. In a week a large mass completely exfoliated, leaving 
the parts ragged, uneven. These were touched up every few 
days with lactic acid, which gradually smoothed them off. Vag- 
inal injections of boroglyceride, resorcin, creolin and other 
bactericides were used. 

The internal remedies consisted of Chian turpentine mistura, 
with thallin, saxifraga and phytolacca. 

In nearly all cases in which the Chian turpentine was used, 
pain ceased about second or third day ; not so in this case, so it 
was determined to try exalgine for the pain. This remedy was 
dissolved in dilute alcohol, and added to fl. extract of licorice. 
Six grains were administered at three, and six more at ten p. m. 
It had the desired effect, immediate amelioration of all pain ; a 
subsidence of all that inhe- 
rent irritability. This drug 
is a powerful antiseptic, and 
seems to have an affinity for 
the cancer germs. 

The diagram here pre- 
sented, was an epithelioma of 
the posterior neck of the 
uterus, and wall of the va- 
gina ; several nodules ap- 
peared. The growths bled 
freely on the slightest touch, 
and almost filled up the va- ■ ^^'^'^'"'^^"^^ -' ^^^ p-^---- "-'^ -^ '^- "'--• 
gina, and entirely prevented an exploration of the uterus ; the 
lymphatic glands were free, and there was no rectal or bladder 
complication. As there was no plan of treatment left open^ 




BACTERICIDES. 



49 



she was placed upon the Chian turpentine emulsion ozonized, 
alternated with fifteen grains of resorcin, three times daily, to 
be rapidly increased to nine teaspoonfuls, and sufficient doses of 
the glycerite of sulphur administered to move the bowels ; the 
growths were touched three times with a solution of ozone paste 
(one in twenty) ; the vagina washed out thrice daily with boro- 
glyceride solution. With this treatment the germ-growth was 
arrested, and gradually disappeared, and the neck of the uterus 
resumed its normal position. This treatment was kept up for 
four months, pain had ceased ; all infiltration disappeared, and 
the very slight discharge had no odor ; at the end of six months 
entire recovery took place. 

The diagnosis of uterine cancer in the early stages is best 
effected by the microscope ; in the latter stages the growth cannot 
be mistaken, as we have the discharge, its odor and pain to guide 
us. The cancer germ may localize itself in any part, usually the 
cervix, low down near the extreme orifice, or high up near the 
internal ; evolution may begin in the glands near the surface, 
or in their deeper parts. 

The following remarkable case occurred in the practice of 
one of the physicians mentioned in this article. 

A patient after years of suffering, backache, pain in sacrum, 

frequent micturition, a vaginal ex- 

amination showed the os to be 
large and patulous; high up in 
the posterior wall of the cervix 
there was a hard mass the size of 
a bean, which felt like a small 
fibroid. She was not seen again 
for a year, when the neck of the 
uterus presented the appearance 
as is seen in the annexed cut. She 
was placed at the time under an 
active anti-cancerous treatment. 

The entire cancerous nodule was brushed over several times 
with lactic acid. This was followed by packing the vagina with 
boroglyceride paste. The next day this was removed, and the va- 
gina and cancerous infiltration well washed out with a ten-per cent. 
solution of peroxide of hydrogen. The lactic acid was again ap- 
plied, when the cancerous mass began to assume a dirty, leather 
color ; followed by the boroglyceride packing. 

I continued this right along for twelve consecutive days, when 
the entire mass exfoliated and was expelled. The edges from 
which it severed healed kindly in three weeks by the daily use of 
pastiles prepared from the boroglyceride. 




Cancer of neck'of uterus. 



50 



DISEASE GERMS. 



Numerous cases of uterine cancer commence at the inner orifice 
and form a nodule, occupying the whole of the posterior lip. At 
first in a case of that kind, the uterus is a little enlarged, freely 
movable. The posterior lip becomes thickened, and on its an- 
terior surface, a small ulcer appears which gradually extends on 
to the vaginal surface of the lip, a depression form.s with hard 
edges, which soon begins to bleed on the slightest touch. The 
annexed diagram is taken from the frozen dissection of a patient's 
uterus who died while under treatment for cancer of the uterus 
from pneumonia. 

The uterus was extirpated. The organ was then found to be 
three and a-half inches in length ; the walls of the body were 
somewhat thickened, but" appeared to be healthy. The cervix 
was considerably enlarged, the enlargement affecting chiefly the 
posterior wall, and an ulcer was situated on its anterior surface, 

just within the os exter- 
num. The surface of 
the anterior lip was 
papillary. Section 
showed the posterior 
lip to be occupied by a 
mass of the size of the 
kernel of a walnut. 
This reached upward 
to the inner orifice, and 
occupied the whole 
thickness of the wall, 
and it reached down- 
ward to the portio va- 
ginalis, but it had 
nowhere penetrated 
through the mucous membrane of the portio. The growth looked 
to the naked eye as if it were encapsuled, but this appearance 
seemed to be due to the pressure of the growth on the parts 
immediately surrounding it. 

Cancer might develop in the cervix from more than one centre, 
one being; situated near the os externum and the other near the 
OS internum. And cancer might attack mucous polypi growing 
from cervical canal. Cancer appeared to attack the posterior 
more frequently than the anterior lip. It had a tendency to grow 
downward so as to invade the vaginal portion and outward into 
the peri-cervical tissues, and it showed but little tendency to in- 
vade the body, although growth in this direction had been ob- 
served. After having invaded the peri-cervical tissue, its tendency 
appeared to be to grow downward in the cellular tissue around 
the vagina, and outward into the bladder and broad ligaments. 





V 



First commenced as an epithelioma, which eat away the 
neck followed by medull<ry infiltration of the walls of 
the uterus and its entire cavity. 



BACTERICIDES. 



51 



Epithelioma of the 
Vulva 



and infiltration of the glands of 



the 



The patient's age, thirty-nine. She 
states that nearly a year ago a small 
wart appeared on the skin, which she did. not think anything of, 
as it gave her no pain, and was very small. It grew larger. She 
told no one about it, but of her own accord procured some caus- 
tic (acetic or nitric acid) to burn it away. After this she applied 
iodine to it, but it went on increasing, although it did not pain 
her or give her much discomfort, 
and she was able to take long 
walks. 

Last February she thinks that 
she strained herself in the left 
groin, lifung an invalid, for shortly 
after, she discovered a lump there, 
and felt pain from it. She thought 
that it was a rupture. At this 
period the lump on the vulva, 
which had been increasing to about 
the size of a walnut and was grow- 
ing rapidly, and continued so for 
five weeks, when it formed an oval 
mass four inches long by three 
wide. The surface of the tumor. , , 

Lpitreboma of the fxternal Idbia the ap 
was irregularly nSSUred and pejrin<e of the pans when tieatmentuas 

1 1 ^1 • !• commenced. 

cracked; there was a sanious dis- 
charge loaded with cancer germs, great vascularity. There was 
no interference with micturition, although from the induration 
present the infiltration extended in every direction, but chiefly 
back towards the perineal and ischio-rectal regions. 

The very location of this malignant germinal mass precluded 
the use of any remedy but the resorcin, ozone ointment, equal 
parts, which was applied with the happiest results. 

This was applied every morning for six weeks, when the entire 
mass had totally disappeared. 

The internal remedies used were the Chian turpentine mistura, 
glycerite of sulphur, saxifraga, phytolacca. 




Those two terms are used to signify ulceration 
of bone — caries ulceration of the spong\- portion 
of a bone ; necrosis to the same condition when it 
occurs in the hard, cancellous structure — the two 
affections are identical, both are the effect of in- 
flammation in bone, both have the same microbe, the bacilli;^ 
saprogcnes, in addition to the pus germ. 



Caries 

et 

Necrosis. 



1-2 DISEASE GERMS. 

This microbe, when once present in either hard or spongy 
bone, causes softening, molecular degeneration, and destruction 
of the surrounding parts as well as the bone itself. 

Symptoms. — Inflammation of bone, with suppuration and forma- 
tion of sinuses, through which matter flows, in which gritty or 
sandy particles can be detected — bony granules. Introduce a 
probe through one of the openings; the bare, dead bone, or its 
exfoliated, or broken-down portions, can be detected. Discharge 
fetid ; disease chronic, and with great constitutional disturbance. 

Microscopically the microbe can be readily seen by placing 
the discharge in the field of an ordinary microscope. 

As the bacillus saprogenes is a great ptomaine excretor, and 
in consequence of this alkaloid (toxical) being present in great 
abundance in the blood and neurine, we have fever, hectic, colli- 
quative sweats, profound prostration. 

Therefore the treatment should be most energetic and essen- 
tially germicidal. 

If the parts admit of it, the sinuses should be run into one 
opening by making free incisions down to the gangrenous bone, 

\ it should be thoroughly 

^ly^ 5*^«=*" washed out, that is the 
y ^B*#i\S cavity, with a mixture of 
^ .-^^ tojjj- ounces of tepid 

vater in which one 
< Irachm of caustic potassa 
has been dissolved. This 
cts as a detergent. 
vF ' ^ ^*<G^ — Yh'xs should be followed 

Bacillus saprogenes; the iiiii.rolje of caries and necrosis ..... ^ 

With mjections of perox- 
ide of hydrogen ; these to be followed with resorcin ointment ; 
continue this treatment for a week or two. The destruction of 
the germ, the very fact that no ptomaines are excreted, wipes 
out fever, hectic, sweats, prostration. In caries, there is noth- 
ing to hope for but a healing of the bone with deformity; whereas, 
in necrosis, everything is to be gained by a speedy removal of 
the diseased bone and its microbe; so that the treatment should 
be pushed with all the energy possible, managing each case upon 
its merits and peculiarities. 

Internal treatment should consist of tonics, embracing cin- 
chona and mineral acids, together with avena, kephaline. 




A very remarkable disease of the brain and 

Catalepsy, nervous system, characterized by a sudden loss of 

the senses, intelligence and voluntary motion; 

the patient retaining the same position during the paroxysm as 



BACTERICIOES. 153 

that held at the moment of the attack, or in which he or she may 
be placed during its continuance. Seizure may last a few min- 
utes, several hours or even days, without regard to regularity of 
periods. There may be premonitory symptoms, as headache, 
irritability of temper, yawning, tinnitus, vertigo, palpitations, im- 
pairment of mind, confusion of senses, all coming on suddenly; 
the eyes are fixed, either open or shut ; pupils dilated ; restora- 
tion or recovery takes place suddenly, accompanied with sighing, 
pain or confusion in the head, with no recollection of what 
has occurred. No efforts to restore consciousness are 
effectual. Nervous and hysterical women are most h'able to its 
.attacks. 

Catalepsy differs from ecstasy, somnambulism or clairvoyance, in 
its being associated with disease. Absence of mind is, in many 
cases, a mild form of catalepsy. Mesmerism and spiritualism are 
also a species. There is usually little danger from the attacks, 
but the tendency is to terminate in apoplexy, insanity or white 
softening. It is often associated with some organic affection of 
the brain, as a tumor, a bony or calcareous growth. Anything 
that tells badly on the nervous system, as grief, worry, debility, 
intense mental application, the nervous exhaustion of tubercle, 
syphilis, mercury, may give a predisposition to it. 

The exciting causes are, violent mental emotion, as fright, ter- 
ror, suppression of menses, uterine and ovarian disease. 

Treatment. — Embraces general alteratives and tonics, directed 
to the supposed cause. Irritating plaster to nape of neck, skin 
well stimulated, bowels active, shower baths and a persevering 
use of such remedies as avena sativa, glycerite of kephaline, coca, 
erythroxylon, cerebrin. 

Ecstasy differs from catalepsy in every essential, still it is 
analogous in a deep trance. The patient is insensible to all ex- 
ternal impressions and is absorbed in the contemplation of some 
imaginary object. Eyes immovably fixed ; will give vent to 
grand thoughts, mipassioned sentences, form a connecting link 
between the seen and the unseen, between heaven and earth ; 
fervent prayers, beautiful hymns are recited with great fervency 
and zeal. It gives rise to a species of religious fanaticism, 
whereby the person (for filthy lucre) can fall into a trance, an in- 
cipient stage of spirit life, and give strange manifestations. It 
affects women mostly, effeminate men who suffer from hysteria, 
or that peculiar devitalized state of nerve centres. Pecuniary 
gain, faith, imagination, enthusiasm, and an irresistible desire 
to imitate and become notorious, will explain the condition 
oest. 



54 



DISEASE GERMS. 



An opacity of the crystalline or its capsule, one 
Cataract, or both; the effect being to intercept the rays of 

light on their way to the retina. 
Three forms are usually recognized according to situation of 
opacity, viz., lenticular, capsular and capsulo-lenticular. 

Causes. — The causes that give rise to opacity of the crystalline 
lens are either inflammation or degeneration of structure. 

Symptoms. — Hard or lenticular cataract, or degeneration is the 
most common form met with in both sexes between fifty and 
seventy years of age. It causes objects to be seen as if through 
a thick cloud, or gauze; allows vision to be more clear when 
pupil is dilated with atropine, or by turning back to light. In 
advanced cases vision is reduced to distinguishing light from 
darkness. Commonly, one eye becomes affected first ; then the 
other. Movement of iris natural ; when pupil is dilated with 
atropia, cataract can be distinctly seen with a glass of small focus : 
when cataract forms, lenticular opacities can be readily seen by 
the ophthalmoscope. 

Soft, or lenticular cataract of young people, may occur at any 
time of life. Congenital cataract is of this kind, due to disinte- 
gration of the whole substance of lens, which becomes opaque 
and swollen. Symptoms are the same as the hard, only vision 
more imperfect. This form often depends or is caused by a 
defect in the co-ordinating chemical centre in the brain ; hence it 
is common in diabetes, and other diseases connected with that 
part of the brain. 

Capsular cataract is more especially the result of chronic 
inflammation and effusion of lymph into its covering ; opacity of 
a dead white color ; it may affect any portion of capsule. Opacitv 
of capsule always leads to opacity of lens, so that capsulo-lenti- 
cular cataract is very common. 

Treatment. — Various efforts to promote absorption of cataract 
have been tried ; the most successful has been in the early stage 
of hard and capsular cataract, chiefly with iodide of potass inter- 
nally, and by bringing fumes of fluoric acid in contact with the 
eye until the eye manifests a slight congestion. It should not 
be resorted to oftener than three times a week, and must be done 
very carefully, by putting the acid in a wide-mouthed, rubber 
bottle, guarding mouth, nostrils and other eye, and holding it up 
to the affected eye so that its fumes come in contact with the eye- 
More recently, an infusion of pulverized jequirity, eight beans 
to eight ounces, or stronger, if desirable, carefully percolated and 
dropped freely into the eye, produces artificial purulent ophthal- 
mia, in which a shedding, or peeling, or exfoliation of the various 
coats of the eye take place. This repeated at proper intervals of 



BACTERICIDES. 



15. 



time, will gradually invade the lymph deposit of capsular cata- 
ract, and ciuse it to exfoliate and in time remove it. 

The remedy is worthy of an extended trial in all forms of 
opacity, although it is of no use in hard lenticular cataract. 

Common treatment is by operation, and one of three forms is 
usually selected, viz : 

Depression, displacement or couching, by which the lens 
is pushed from its natural position, so as to allow rays to pass 
through pupil to retina. 

Solution or absorption, in which the body of the lens is 
broken up at several sittings, so that it may be absorbed ; only 
successful with jequirity and fluoric acid ; and removal by opera- 
tion. 

Associated with dyspepsia, or alone, affections 
Catarrh of the liver are extremely prevalent. This is to 
of the be accounted for by our ever-present malarial 

Bile Duct, atmosphere ; by the widespread dissemination of 
syphilis ; by our beer-drinking, tobacco-using 
and pork-eating population. These, and other causes, give us a 
people with morbid livers. Whether it be the white liver of 
demon tippler, with his maniacal mind groveling in the earth, 
capable of performing every wrong to his brethren ; or the pink 
liver of syphilis, or the starchy liver of the tubercular, or the 
mercurial liver, with catarrh of the vessels. 

Looking at those causes, common sense asks us — Is our treat- 
ment of liver disease by cholagogues in harmony with nature? 
Do we not rather irritate the liver when we prescribe mandrake 
and kindred drugs ? Are they useful in obstruction of the biliary 
ducts ? Assuredly not. Modern science emphatically points to 
liver stimulants as the proper remedies in all hepatic disease. 

Catarrh of the bile ducts consists in a weak, relaxed, devitalized 
condition of the mucous membrane of the large and small bile 
ducts, the ductus communis and gall bladder. This condition 
resembles all other catarrhal states — hypersemia, followed by an 
abnormal secretion of mucus, with obstruction to the flow of 
bile. 

It usually originates in duodenal catarrh, in which the fungus 
sarcina intestinalis is present, which migrates along the deeper 
tissue of the ducts, dilates them by forming nests or cysts, giving 
rise to dilatations and constrictions. Later on, the lymphatics 
become engorged, then the liver becomes enlarged and nodu- 
lated, with its margins firm and sharp. 

Gastro-duodenal catarrh with proliferation of the sarcinae, gives 
rise to a large percentage of cases of structural disease of the 



156 



DISEASE GERMS. 



liver; a gouty and rheumatic state of the blood, calculi, parasites 
and disease germs in the bile passages. 

The ordinary symptoms of biliary catarrh are, loss of appetite, 
furred tongue, flatulence, nausea and vomiting ; usually some 
pain over the gall duct and liver. As a rule, the bowels are 
usually constipated, unless it be accompanied with extensive 
intestinal catarrh, then there is diarrhea ; the fecal discharges 
are clay colored and contain very little bile; urine dark green 
color and contains bile pigment ; jaundice sets in with its usual 
yellow sclerotic skin, with the usual apathy, drowsiness and 
itching of the skin. As a general rule the liver is enlarged and 
tender, especially in the region of the gall duct. Temperature 
is lowered ; headache ; vertigo ; very great depression of spirits 
and loss of strength are decided symptoms. In some cases there 
is no bile at all in the stools, but very great distension of the 
bowels from gas. 

As the disease progresses, faulty nutrition becomes greater, 
ascites and anasarca with acholia set in. 

The most common complications are pleurisy, pneumonia 
and dysentery. 

In the treatment, the diet throughout the entire case should 
contain no carbo-hydrate; there should be daily baths of water 
acidulated with nitro-muriatic acid. Locally, over the liver, the 
irritating plaster should be applied persistently. Then a selection 
made from two of either of the following, and administered 
internally. 

Peroxide of hydrogen in alternation with the simabicidia have 
a most marvellous action on the gall duct. 

Phosphate of soda, or ozone water, liquefies the bile, lixiviates 
the deposit of cholocrome and other amido acids, and destroys 
disease germs in the liver, or parasites like the liver fluke in the 
gall duct. These remedies, and others, when administered in 
liver disease, should be highly diluted in tepid water, as they act 
speedier, are more easily assimilated, and give us a definite 
result. 

Saxifraga and nitro-muriatic acid are best adapted to syphilitic] 
germ colonization in liver. In these days of national deteriora- 
tion and widespread syphilitic contamination, it would prejudice^ 
no case to examine the mucous membrane of the arch of thej 
mouth to ascertain if it had the copper color, the stamp of the] 
colossal, tissue-destroying germ " syphilis." 

Chloride of ammonium in alternation with the fringe tree,] 
operates well in catarrh of the ducts. 

Salol in alternation with euonymin is also very useful. 

Calcium hippurate is employed in such cases as owe their 



BACTERICIDES. j^^ 

origin to superabundance of uric acid in the system. In physio- 
logical action it coincides with sodium hippurate. It is prescribed 
in doses of five grains. It is said to have produced good results 
with this remedy in the treatment of phosphaturia, and in cystitis^ 
associated with mucous and alkaline conditions of the urine.. 
Moreover, it is claimed to have produced wonderful res'ilts in all 
diseases, which are due to diathesis, uric acid diathesis, tubercular 
incipient cirrhosis of the liver, connected with increased elimina- 
tion of urates and in tubercula. 

Calcium hippurate occurs in the form of a white powder, which 
readily dissolves in water. Lithium hippurate and sodium hippu- 
rate are employed in the same diseases as mentioned above, and 
in the same doses. 

In our climate, Avith its sudden transitions 

Catarrh of the from heat to cold, with its neurasthenic popu- 

Bladder. lation predisposed to all diseases in which 

debility is a factor, gout, rheumatism and the 

very general dissemination of syphilis, with a male population 

notable for damaged prostates and venereal excesses, can we 

wonder that a weak, relaxed, catarrhal state of the bladder is so 

common ? 

The causes which induce catarrh of the bladder are gout, rheu- 
matism, beer-drinking, with tremendous excess of the crystals of 
uric acid ; syphilis, spermatorrhoea, perversion of the sexual 
act, disease of the prostate; the migration of the gonococcus and 
other germs from the urethra; the metastasis of irritation from ad- 
jacent organs ; the natural decay of old age. '*^^->t^ 
Certain drugs, as cantharides, balsam of copaiba. *^ f^ o®*^ ^**' 
etc., are very liable to cause it. Retention of &h^ .<'^'^ 
urme from any cause is a proline source oi __ 
this affection. o=c.. cc=====^ 

- , - , . . A^licrococcus urea, paiiio- 

No matter how caused, contmence or m- genie of catarrh, or ui- 
continence of urine will occur; the evolution <^--tion of the bladder. 
of the micrococci urea, a microbe which is indefatigable in keep- 
ing up acid fermentation in the bladder. The evolution of this 
germ in the bladder in all cases of catarrh adds greatly to the 
difficulty of cure. Besides the micrococcus urea by millions 
there is the pus microbe, and numerous others in a state of 
growth. The urine is scanty, passed with difficulty pain in the 
back and loins, an uneasy sensation in the bladder; if the urine 
is permitted to stand, it deposits more or less mucus ; sometimes 
the quantity is so great that on exposure to cold it becomes solid,, 
and there is oftentimes difficulty in expelling it from the bladder. 
Impotency, loss of sexual desire and power ; nocturnal emis- 



1^8 DISEASE GERMS. 

sions are likely to occur ; sometimes the patient is unable to 
urinate; has a sensation of scalding in the urethra; blood may 
occasionally be seen in the urine. 

Indispensable to a successful treatment the patient should be 
placed upon the very best of food, of the most nourishing charac- 
ter; daily bathing; flannel clothing; external warmth, and bowels 
regulated to once in twenty-four hours. 

Inculcate an alterative and tonic course of remedies, such as 
alteratives and tonics, embracing saxifraga, phytolacca ; compound 
tincture cinchona; mineral acids; coUinsonia; bay berry ; stone-crop. 

At convenient intervals drink either an infusion of buchu, uva 
ursa, praira brava, queen of the meadow, couch grass, triticum 
repens — whichever two should be selected, which diminishes the 
muco-purulent discharge, and one used one week, the other the 
rext. If the patient is unable to empty the bladder, urine should 
be drawn off with a catheter, not a drop of residual urine left in 
the bladder. 

Drinks of a demulcent character to be taken but very sparingly, 
and all alcoholic stimulants rigidly forbidden. 

Besides this general treatment, rest and the destruction of the 
micrococcus urea. 

To effect this, ozonized soluble bougies, composed of either re- 
sorcin, or thallin, or papoid ; one might be conveniently run into 
the bladder daily and permitted to dissolve. This mingling with 
the micrococci effects their destruction. Failing in this the blad- 
der might be injected twice a week with glucozone, or a solution 
of resorcin, or peroxide of hydrogen. If the urine be loaded 
with other germ, besides the micrococci urea, as the microbes of 
syphilis, cancer, rheumatism, the use of the bougies, or injections 
are imperative. 

Internally, the course of remedies must be so modified as to 
permit the introduction of some bactericide to sterilize the blood, 
and to render it so that no germ will live in it or the bladder. 
Select some of the following, either the ozonized uric acid solvent, 
or the peroxide of hydrogen ; benzoate of sodium, or the sul- 
phide of lime. 

Patience, perseverance, with those new remedies and powerful 
germicides, with attention to all minor details, will ultimately 
effect a cure. 

Catarrh is a general term applied to a devital- 

Catarrh, ized condition of mucous membrane. Catarrh of 

Bronchial, the frontal and nasal passages ; catarrh of the 

bronchial tubes, of the pulmonary tissue, of the 

stomach, bowels, bladder, womb, vagina, prostate; in each and 



BACTERICIDES. 



159 



all there is a relaxed condition, an excessive secretion, a degrada- 
tion of bioplasm, into a disease germ of some species, the sim- 
plest of which is the amoeba, the simplest and lowest type of mi- 
croscopic life. 

This disease germ, properly speaking, gives rise to catarrh 
bronchial, while the conferva, bacillus of tubercle and other mi- 
crobes give rise to bronchitis proper. 

This disease germ consists of a simple cell or an aggregation 
of cells, each of which maintains an independent existence, and 
capable of prodigious power§ of reproduction by segmentation in 
a proper fluid, and so light that they may diffuse themselves 
through the atmosphere. They resemble an O or globose form, 
gelatinous or albuminoid, like those in nasal catarrh. No 
nervous system, no organs, no trace of a mouth can be detected 
in them, but contain a nucleus and by looking very minutely at 
them under a high power 2500 diameters, one or two or more 
pulsating spaces can be detected, which finally sprout off Their 
movements are contractile, in which, by inhibitory action, they 
take in nourishment. They spread by contagion and infection, 
and are capable of entering the blood, producing a diathesis, in 
which anaemia and nerve prostration are predominant. 

The mucous membrane in health exudes a sufficie/it amount of 
secretion for lubrication atid no more ; and in that no disease germs 
are present. But the slightest deviation from health, degradation 
takes place and disease germs are present. The symptoms 
and diagnosis same as chronic bronchitis. The profuse ex- 
pectoration and the presence of this microbe are the landmarks 
in diagnosis. 

Catarrh of the bronchial tubes is best and most successfully 
treated with bactericides. They should be inhaled nasally and 
-orally ; taken on the stomach, and also used in bath ; in other 
words, the blood and all the tissues of the body should be so 
saturated with germicides that no diseased micro-organism could 
possibly exist in the body. 

Glucozone is the best of all remedies for inhalation with the 
cold spray atomizer. 

Remedies on the stomach, select from some of the following : 
peroxide of hydrogen, distillation of pine needles, glycerite of 
ozone, ozonized tar syrup, avena sativa, tolu and resorcin, creo- 
sote, carbolic acid and tincture of iodine, terebene. 

For baths, pine-tree-needles extract, which gives us a perfect 
saturation of all the fluids and solids of the body with ozone, in 
which condition no microbe can live. 



l6o DISEASE GERMS. 

A weak, relaxed, irritated state of 
Catarrh, the mucous membrane of the stomach. 

Gastric, in Adults, which gives rise to an excessive secre- 
tion of mucus. Whenever mucus is in 
excess in the stomach, the sarcina^ ventricuH and yeast plant 
make their appearance in more or less abundance, according to 
the state of vital depression present. Whether this sarcinae be 
the result of degraded living matter of the mucous membrane, or 
a true vegetable germ or fungus, or parasite, produced like yeast 
plant by saccharine fermentation and. swallowing atmospheric air, 
is not as yet definitely settled. It has, nevertheless, been clearly 
demonstrated that this fungus, let it be animal or vegetable, grows 
like all other living matter and with remarkable activity, so much 
so that it distends the stomach enormously by its presence and 
makes life a misery. 

Causes. — As eighty per cent, of our entire population suffer 
from the presence of this parasite in their stomachs and more 
than two-thirds of all cases of dyspepsia are of the catarrhal 
form, it is important that the causes that produce it should be 
clearly appreciated. Hurried or improper mastication stands 
first ; in this the food is bolted down, has little if any secretion 
from the mouth glands, no parotid juice, no element in it to pre- 
pare it for gastric digestion, but simply an offending, irritating: 
bolus. Add to this the pernicious habit of drinking at meals 
large quantities of fluids of any kind, but especially iced or cold 
drinks, which completely arrest the process of digestion for the 
time being. Beer and tobacco rank next as great stomach depres- 
sors; so are cold food and drink, ice cream, saccharine and 
starchy food, alcohol, drugs, as bromide of potass, alkalines 
generally. 

Our climate is productive of it, sudden vicissitudes of tempera- 
ture from heat to cold, insufficient clothing, anything that will 
cause congestion of the mucous coat of the stomach with an ex- 
cessive secretion of mucus. Plence it is often brought about by 
irritation or disease of adjacent organs, as morbid states of the 
liver, bowels and rectum, chronic bronchitis, nasal catarrh, tuber- 
culosis of the lungs, and emphysema. 

The instant the mucous coat of the stomach is damaged or irri- 
tated, an excessive secretion of mucus takes place, and simultane- 
ously with that there appears in the stomach of the individual 
the sarcina and yeast plant. As the sarcina appears first upon 
the scene and is the more tenacious of the two plants, it merits our 
primary attention. The fungoid mass or jelly, thick, clear, ropy,, 
cohesive in consistency, placed in the field of a microscope of 
ordinary power, reveals it to be made up of blocks, or squares, or 



BACTERICIDES. 



l6l 




The sarcinse ventriculi as seen 
in the vomit of all patients 
suffering from gastric catarrh. 



cubes, or packages, as seen in the annexed wood-cut, quadrangu- 
lar in form, the' cubes consisting of fours, sixteens, sixty-fours, 
etc. These squares live, grow, propa- 
gate by millions by segmentation, imbib- 
ing nourishment from the degraded mu- 
cus of the stomach, and new additions 
from the same source. 

When this altered bioplasm or changed 
living matter takes place, the sarcina ap- 
pears in the stomach, and finds its way 
into the blood and is subsequently to be 
found in those having this form of dys- 
pepsia in the fluid of the ventricles of the brain, bronchi, 
bladder, rectum, uterus, vagina. 

The presence of this organism, this dangerous parasite, is in- 
variably accompanied with the cryptococcus cerevisia, or yeast 
plant. This fungus is too well known to need a description, 
being present in the process of fermentation. The annexed cut 
gives a true appearance of this plant as seen under the 
microscope in the form of round or oval disk cells, vary- 
ing in diameter from one four-hundredths to one eight-hun- 
dredths of a line, with smaller germs in their interior. They grow 
by protrusion of gemmules, and. germinate from several points of 
the primitive fungus cells. These shoots 
throw off new gemmules and gradually form 
rows of single or branching cells, connected 
together like beads. This peculiar arrange- 
ment of cells, and the fact that they cannot 
be acted on by acetic acid, is characteristic of 
the plant. This fungus exists in great abund- 
ance with the sarcinae in the stomach, and is 
also found in the urine, uterus, fccces, with 
or without the co-existence of saccharine 
diabetes. 

Both the sarciuct and the yeast plant are to 
be found in all domestic animals as well as 
man. 

The presence of two such parasites in the 
human stomach necessarily gives rise to 

Syinptonrs of a pungent, depressing char- 
acter, general prostration, a feeling of gone- 
ness, faintness, emptiness, with all the symptoms of dyspepsia, 
flatulence, acid eructations, heartburn, pyrosis, coldness in the 
extremities ; tongue has a coat, but usually a white fur with 
slime ; breath sour-smelling, with disturbance of the head, 
II 




The yeast plant taken from 
the ejected fluid from the 
stomach in gastric ca- 
tarrh, magnified 200 di- 
ameters. 

]n those celh marked x, 
a young cell is seen grow- 
ing in I he interior ; while 
in the large ceil marked 
xx, there is a simulta- 
neous internal produc- 
tion and external gem- 
mation of cells. 



1 52 DISEASE (;ERMS. 

heart, liver and other organs ; appetite capricious, a craving 
for food, an inabiHty to eat which vomiting relieves — tremen- 
dous spells of eructation of wind, with regurgitation of acid 
fluids, the result of a fermentation in which the sarcinse and the 
yeast plant are in abundance. The congenial abode of the sar- 
cinae is the stomach ; they always can be detected in the mouth, 
in the thick, ropy, glairy mass, brought up by a proper emetic, in 
which they can be seen, living, growing and reproducing by seg- 
mentation. They often attain great size, and break down and die, 
and they may be thrown off by the mouth or pass down on the 
bowels and pass off in a sudden, unexpected attack of diarrhea. 
If they become very large before breaking down and passing 
either by mouth or bowels, they give rise to great abdominal 
distension. 

The presence of the sarcinse ventriculi in either the stomach or 
bowels is the great factor of lactic acid in the human body (rheu- 
matism), and all the accumulated experience of Europe and 
America point to this plant as the precursor of cancer of the 
stomach, catarrh of the colon or rectum, and a factor in the pro- 
duction of tuberculosis. 

The treatment of this form of dyspepsia requires the finest 
tact, skill, and a thorough appreciation of the germ theory of 
disease. The malnutrition due to those parasites, their method 
of feeding being chiefly upon liquids, their removal by washing 
out the stomach, their starving out, their direct* destruction, the 
prevention of the secretion of mucus which loads and obstructs the 
function of the stomach — in order to accomplish all this and more 
too, we must depart from the ordinary methods of grappling with 
disease. 

The general points to observe are, an avoidance of all care, 
worry, or mental strain, no over-work, no excess ; active but not 
fatiguing exercise in open air ; daily cold baths, followed by fric- 
tion ; flannel clothing ; a diet consisting of broiled tenderloin 
steak or chicken, soft-boiled eggs, boiled fish, buttered toast, oat- 
meal mush, baked potatoes and ripe fruit. 

Rigidly forbid veal, pork, salt or corned beef or fish, fried or 
boiled meat, pastry, nuts, sweets, cabbage, tea, tobacco, alcohol, 
all fermented liquors and all liquids at meals. 

Order is Nature's first law, so there must be perfect regularity 
in all things, eating, sleeping, defecation — three meals of solid 
food per day, with proper intervals between, and in this interim 
between there must be no mastication, no nibbling, no odd snap 
or luncheon. The mastication of the food must be thorough, not 
hurried, but so that a proper admixture of the food with the sali- 
vary secretion takes place. Hurried meals are mischievous. 



BACTERICIDES. 



163 



Rest after meals, but no sleep, as the latter retards the digestive 
process. 

Having thus laid down the above and other precautions as to 
food and digestion, one or other of the following methods of 
treatment should be tried : either starve the germ out or 
destroy it. 

Method of starving the germ out. — If this method is decided 
upon, it must be arranged that twice a week, for a period of from 
six to twelve weeks, an emetic of pulverized lobelia leaves should 
be administered thus — the patient, prior to taking it, should drink 
very copiously of tepid water in which bicarbonate of potassa is 
dissolved ; follow this with frequently-repeated draughts of lobe- 
lia infusion (one ounce of leaves to one-half pint of boiling water), 
sufficiently cold to admit of being drunk freely ; continue till free 
emesis and ejection of the germ or parasite or a portion of it takes 
place. Follow this lobelia emetic up by encouraging the patient 
to drink freely of an infusion of kaki (one ounce to the pint) ; add 
to this a few grains of capsicum to render it more stimulating to 
the gastric mucous membrane. The persistent administration of 
kaki infusion at stated intervals arrests the secretion of acid 
mucus in the stomach, braces, astringes the mucous coat, and 
thus cuts off the pabulum upon which the parasites, sarcinae, live 
— and thus it starves. Repeat the emetic every four days ; fol- 
low closely with the kaki. No other emetic will serve the 
purpose ; as lobelia itself is a great germicide in nature, it retro- 
grades all germs, checks their development and growth, steri- 
lizes their micrococci. 

An invaluable remedy for the purpose of starving out the mi- 
crobe is the Virginia stone crop in alternation with ten grains of 
resorcin in liquor cerii ozonized. Thus the remedies thoroughly 
astringe the mucous coat, and prevent the germ receiving nour- 
ishment from the gastric mucus. 

Destroying the germs in the stoinacJi must be adopted or tried. 
Here, of course, it is very difficult to select remedies to be admin- 
istered on the stomach that will enter, unite with, or penetrate, or 
chemically cause a dissolution of the fungoid mass or jelly. 
Besides, patients who have had this parasite in the stomach for a 
long series of years suffer from atrophy of the pepsin glands, with 
functional incapacity. Remedies to be of service here must be 
highly antiseptic and not impair the stomach in any way, but 
rather increase its vigor. 

The sarcina ventriculi is sterilized, completely annihilated, in 
the presence of either of the following remedies : 

Peroxide of hydrogen, a few drops added to water, is most 
effectual. In attacking the fungus it liberates the ozone, which 



164 DISEASE GERMS. 

unites with the fungus and destroys it — does not impair, but 
rather increases, the gastric function — tones, strengthens. 

The sulphide of lime or the chloride, well triturated in sugar 
of milk, is most efficacious. 

Ozone water or comp. oxygen must not be overlooked. 

Ozonized sulphur water,. added to an infusion of columbo, is 
not to be despised. 

Ox-gall, thoroughly washed of all impurities with the dioxide 
of hydrogen, then evaporated to the consistency of molasses, to 
one hundred parts add two hundred of pulverized willow char- 
coal, with ten parts of capsicum ; mix. Make into three-grains 
pills ; one two hours after meals thrice daily. 

Papoid, a vegetable pepsin from the carica papaia, combined 
with the boroglyceride, gives excellent results, as it is one hun- 
dred times more potent in antiseptic power than ordinary pepsin,, 
and acts better on the peptic glands. 



Modern dietetics, adulterated food, early 
Gastric Catarrh precocity, have within these few years back 
in Children. given rise to the sarcinse in children — 
twenty years ago a rare disease. Now it 
is one of the commonest derangements of that period of life 
among rich and poor. It is a constant danger to hand-fed 
babies, and forms one of our chief obstacles to the raising of 
infants. In older children it is of frequent occurrence. It 
seriously affects their nutrition, and interferes with development 
and growth. Mothers term it biliousness. The little one loses 
its appetite, mopes, lies about, has a dull, pasty or yellow com- 
plexion, and looks dark under the eyes. At night it sleeps 
badly, and is restless and irritable during the day. If the tongue 
is protruded, there is a fur on it, with a coat in centre ; the 
breath is sour-smelling ; there is a fulness about the stomach ; all 
indicating catarrh of the stomach, which, with its fungus, inter- 
feres with the digestion of the food. It may be vomited, or pass 
by the bowels, but it leaves the stomach weak, and another crop 
is likely to follow, nutrition is seriously impaired. In addition 
to the above symptoms, affected children complain of pains in 
abdomen and sides, and are likely to suffer from vertigo, syncope 
from pressure upward of the distended stomach against the dia- 
phragm and heart. Bowels usually are constipated. 

These symptoms are greatly aggravated by an injudicious diet 
on the part of the mother, as supplying the child with an excess 
of fermentable food, as potatoes, puddings, sweet cakes, etc., 
which feed the sarcinaj and keep up the dyspepsia, which is a 



BACTERICIDES. 



165 



source of great discomfort to the child and anxiety to the parent. 
The whole system is being fed by an acid, generated by the germ, 
and aggravated by the food, and the child is irritable and exces- 
sively restless. His speech is hesitating ; he may stammer; his 
muscles may twitch; his eyes wink, and he is nervous. 

Nausea and vomiting are not always present. If there is vomit- 
ing, the products are sour-smelling fluid, and thick, ropy mucus. 
Frontal headache is rarely absent ; it is often distressing ; urine 
highly acid, loaded with uric acid. Nutrition is always inter- 
fered with ; the child wastes perceptibly, or there are fainting fits. 

In curing gastric catarrh in children, the sarcinae must be 
either removed, destroyed or starved out. The acrid mucus and 
germ is the constant cause of acidity and fermentation ; they keep 
up a bad train of symptoms. The greatest benefit is derived 
from the peroxide of hydrogen in small doses, frequently repeated. 
This should be alternated with the sulphate of cinchona or some 
bitter tonic. 

The peroxide of hydrogen, combined with an equal amount of 
glycerine, administered in a little water after meals, instantly 
parts with its ozone, which kills the microbe, the factor of gastric 
catarrh. The sarcinae being removed, digestion improves, 
increased assimilation, a priceless boon of the dyspeptic. The 
average dose is fifteen drops to one ounce of water. 

The ozonized cascara sagrada lozenge is a powerful microbi- 
cide. One administered thrice in twenty-four hours is efficacious 
in the destruction of the sarcinae, in destroying the activity of all 
bacteria and micrococci. Its active properties are due to the 
ozone which it contains, and which it liberates in the stomach 
and destroys the microbe. 

Resorcin, arsenic, naphthaline might be tried. 

The Virginia stone crop is the father of a class of remedies of 
the greatest possible utility in sterilizing the sarcinae ventriculi ; 
it is much more energetic in its action than either collinsonia or 
bayberry. It is a drug from which the greatest possible benefit 
accrues in either catarrh of the stomach or bowels. 

Same remedies as in the adult may be tried with success. 

Bowels should be kept regulated by the administration of a 
decoction of flaxseed or slippery elm, to which a small amount 
of olive oil is added. 

Diet carefully guarded ; no starchy or saccharine agent given ; 
nothing to aid fermentation ; toast, milk and lime-water. As 
soon as tongue cleans, appetite returns ; boiled fish, white of 
chicken, lean broiled mutton. It is not well to press the child to 
eat ; rather refrain. To give tone to the stomach and strengthen 
digestive powers, sulphate of cinchona or wine bitters. 



1 66 DISEASE GERMS. 

In order to prevent gastric catarrh becoming a prevailing dis- 
ease among children, mothers must learn, that all sugar and 
starch articles of diet are poisonous to children. They should 
also be made aware* of the great utility of a flannel binder or 
roller next the skin as an indispensable article of a child's dress 
till it reaches three years of age. This roller should reach from 
the armpit to the groin ; not pinned too tightly. The resisting 
power of all children should be fortified by gradually bringing 
their morning and evening bath to cold water. It must be a very 
gradual process in weak children, in all cases followed by active 
rubbing. To bring children to the cold bath, and practice it 
properly, has a most tonic effect upon the system generally, and 
confers great resisting power upon the part of the child, and 
reduces its susceptibility to any change. Mothers should also 
be instructed of the utihty of brisk massage over body after child 
has been dried off. 

Sarcina intestina has all the essential elements 
Catarrh of that found in the stomach, only much smaller 
Intestinal, in size. It is found in the duodenum, and 
throughout the entire intestinal tract ; in the 
vomit, faeces, lungs, blood, urine, in the form of yellow patches,, 
green or reddish. Peculiar groups of four, eight, sixteen, thirty- 
two cubical cells with rounded edges, closely placed against one 
another. 

The fungus gives rise to a functional disturbance of the bowels^ 
independent of any organic lesion. 

Intestinal dyspepsia may be a primary 
affection, brought about by cold, mechan- 
ical irritation or mental depression, or it 
may be brought about by catarrh of the 
T* ^^^3?T® stomach, or by structural changes in the 
" '^ / mucous membrane of the alimentary 

® >^^^^^P^ canal ; altered conditions of the secretions 

d> of the, small intestines ; the presence of 

Sarcin2eintestinaiis--a dwarf form undigested food, or the ingcstiou of im- 

found in the bowels. iMicrobe o ' o 

found in the duodenum in full- propcr food ; an altcratcd state of the 

fledged masses, as \r\ d ; c m ^ ^ - ^ r ,i • . .• 

the small intestine; ^ and a. muscular coats oi the mtestmes, gcncr- 
^^'s« bowel. ,^ll^ accompanies malnutrition. 

In catarrh of the bowels, all or some of the symptoms of dys- 
pepsia are present. Pain may be present, of a dull aching char- 
acter, radiating over the upper portion of the abdomen. Not 
acute, more likely if present, to prevail two hours after the in- 
gestion of food, nausea and vomiting when they do occur, de- 
pend more upon the stomach derangement than upon any intes- 



@0 




BACTERICIDES. 



167 



tinal disturbance. Constipation, gaseous distension of the large 
intestines, are prominent symptoms. The various coats of the 
bowels are so thoroughly relaxed that there are often immense 
fecal accumulation. 

After repeated attacks, general health fails, he loses flesh and 
strength and begins worrying about himself, fearing some organic 
disease. As a rule the appetite is seldom impaired 

To effect a correct diagnosis, administer a large dose of castor 
oil, followed with copious draughts of either an infusion of flax- 
seed or slippery-elm, then take the albuminoid portion of the 
evacuations and place a portion in the field of the microscope, 
and the sarcinae will be seen. 

In the treatment, it is well to regulate the diet. This is import- 
ant; patient should abstain from all fatty, saccharine, or starchy 
substances, and eat solid food, meat and vegetables ; daily bath- 
ing ; an avoidance of tea, coffee, tobacco, and all fermented 
liquors ; a freedom from care and worry ; of drugs which yield 
the best results, collinsonia, stone crop, bayberry, salol, naphtha- 
line, resorcin. 

In intestinal catarrh, the peroxide of hydrogen is invaluable; 
true it does not, like salol, destroy the pathogenic germs, but it 
unites with them, renders their ptomaines inert, and thus the 
tissues, being relieved of the deleterious effects of the ptomaines, 
combat successfully the germs. 

Injection of the bowels above the sigmoid flexure with copious 
injections of creolin are of immense utility. 

The best of all these remedies is the Virginia stone crop, which 
is a priceless drug in intestinal catarrh. Nothing in the materia 
medica which can be compared with it. 



Repeated irritation of the lining mem- 
Catarrh Nasal brane of the nose, sinuses, posterior nares, 
(Chronic). larynx and bronchi, so devitahzes, modifies, 

changes and degrades normal living matter 
into a diseased germ ; the amoeba, which is simply a degradation 
of the normal bioplasm that nourishes the lining membrane of 
the respiratory mucous membrane, that gives us rather a compli- 
cated disease, one both contagious and infectious. We also find 
the disease-germ in the mouth, urethra, vagina, but always more 
perfectly developed and in larger quantities in the air passages. 
Chronic catarrh, then, may be defined to be chronic inflam- 
mation of the Schneiderian membrane, with this change of its 
own living matter, or matter concerned in its nutrition, into the 
disease-germ, amoeba. It is most erroneous and unscientific to 



1 68 



DISEASE GERMS. 



assert that it is caused by syphilis or tubercle. Those disease- 
germs may impair the vital stamina of the patient, but cannot 
produce the amoeba. 

Our highly oxygenized atmosphere, our very variable climate, 
the extreme susceptibility of our people to climatic changes, with 
our violent winds and atmospheric currents, absence of trees, etc., 
render our people very liable to catarrhal affections. The most 
careful microscopical examinations of an immense number of 
cases fail to exhibit any germ but the amoeba. When it occurs 
in a young or tubercular subject, the tissues being soft and not 
very vital, the amoeba of catarrh eats up the structures rather 
voraciously, and as soon as they reach the cartilages of the nose, 
all their proper nutriment being gone (for they cannot live on 

cartilage), and the vital 
powers being very low, the 
oidium albicans makes its 
appearance ; then we have 
that pungent, indescribable, 
fetid odor characteristic of 
ozsena. When the Schnei- 
derian membrane and frontal 
sinus are alone implicated, 
wkh no appreciable odor, it 
is termed catarrh ; when the 
amoeba have crept up the 
eustachian tube, ^?/r^/; when 
they have penetrated down the fauces and larynx, laryngeal ; 
when they have moved still further downwards on the bronchi, 
bronchial; asthmatic when they gnaw the periphery of nerves in 
the circular muscular fibres of the rings of the bronchi. 

Aromas or parasitical states, such as the bacilli of hay, the 
mycelia of roses, ragweed, and other vegetable germs, are not 
capable of living in human blood; nevertheless, they can blight 
normal bioplasm of the respiratory mucous membrane, and thus 
cause the appearance of the amceba. Plence, catarrhal conditions 
are named after those special vegetable agents. Diseases of the 
respiratory mucous membrane are very prevalent, each capable 
of causing tubercuhi:^ : (i) by reflex action; (2) by the amoeba 
entering the blood. 

Catarrh is often the starting point, as it is the most common 
of the entire class. When it takes place, its offspring, the 
amoeba, begins to enter the blood and produce a special diathesis 
of its own. Its chief characteristics are languor, lassitude, 
debility ; a peculiar pasty or doughy appearance of the skin ; 
pains in the limbs; headache, with a sense of tightness across 




The amoeba — the germ of na^al catarrh 
diameters magnified. 



BACTERICIDES. 



69 



the forehead ; excessive muco-purulent discharge from the nos- 
trils, or trickling down the throat, (which creates hawking), 
loaded with amoeba ; or if there is much oxidation, the discharge 
may dry up and become impacted in the nostrils. If the 
amoeboid colony runs up the eustachian tube, it will cause deaf- 
ness : if it moves downwards (for it is a living mass), hoarseness 
and aphonia ; if still further down, on the bronchial tubes, in- 
creased hawking, cough, emaciation and discoloration of the skin 
due to imperfect oxygenization of blood ; if down the oesophagus, 
dyspepsia. As it is very liable to cause amyloid degeneration of 
liver and kidneys, there may be some swelling of cellular tissue 
and oedema of ankles. 

It is not only a contagious and infectious disease, but loath- 
some, and liable to give rise to so very many other affections, as 
epilepsy, consumption. It 
is nearly identical with gland- 
ers in the horse ; it is simply 
a difference in size and viru- 
lence of the germ. Inhuman 
catarrh the amoeba is a mi- 
croscopical dwarf; in gland- 
ers in the horse it is a giant. 

Of all the disease-germs 
the amoeba is the most in- 
teresting to study. It can 
be seen with a low power, 
its movements and habits 
can be seen so accurately; 
even its mode of nutrition, 
opening and closing them- 
selves to receive foreign par- 
ticles, inclosing and appropriating them and even imbedding 
them in its very substance. As they enter the blood they no 
doubt impair the red corpuscles, and cause a peculiar form of 
anaemia. 

To treat nasal catarrh with success, there must be an effort 
made to build up the general health of the patient, the secretions 
regulated, warm clothing; the very best of diet, an effort made 
to change the diathesis which the microbe creates ; alteratives and 
tonics should be given for two or three months to kill the germ 
in the blood; comp. saxifraga and phytolacca ; comp. tincture 
cinchona and mineral acids. Irritating plaster to the nape of 
the neck to stimulate the origin of the olfactory nerve in the 
medulla oblongata. Then a selection of a bactericide made to 
\vash out the germinal mass. This is best effected by the use of 




The pathological state of the lining membrane 
of the nose — showing the disease-germ amoeba 
in active work, eating up the tissue. 



I/O 



DISEASE GERMS. 



the ozone ct chlorine, which might be used every twenty-one 
days for a few times. In between the very severe detergent ac- 
tion of the ozone et chlorine, mild douches of boroglyceride, or 
gold seal and borax, should be used. 

Other methods of management should be resorted to, as 
douches of resorcin, creolin, naphthaline, boroglyceride, etc., are 
also effectual. 

Peroxide of hydrogen is of immense utility in catarrh, in the 
destruction of the germ, but best used in the form of glucozone 
in a cold atomizer, it should be used several times daily, it rarely 
fails to effect a radical cure. 

This ozonized distillation of witch hazel is fully as strong in 
germicidal action as the peroxide of hydrogen, and more easily^ 
managed. Being a remarkable solvent to lymph, it is of great 
utility in chronic cases ; and the results obtained from it in 
chronic cases of all catarrhal affections of the nares, eustachian 
tubes, middle ear, throat and lungs, have, in the fullest sense,, 
been most satisfactory. 

Many cases of eustachian deafness of long standing, due to 
the migration of the germs, have been effectually cured by this 
remedy. 

Excellent snuffs are the pulverized horse-chestnut, boracic 
acid pulverized, microbe powder. 

Ointments, jellies, nasal pastiles, or pencils, etc., are in some 
cases very successful. Incorporate in these such agents as resor- 
cin, iodol, thallin, etc. 

Various affections of this gland are fre- 
. Catarrh of the quently mistaken for spermatorrhoea. In 

Prostate Gland, catarrh proper, we find a clear, viscid, tena- 
cious fluid, like the white of an egg, eniirdyr 
destitute of spermatozoa, oozing or passing from the urethra. 

Such a condition is generally due to debility, relaxation, the 
sequel of a gonorrhea, or some perversion of the sexual act ; a 
damaged prostate is apt to be irritated by the lactic acid of rheu- 
matism, or the lithiate of soda of gout ; any irritation will excite 
an exudation. 

If the weakness or irritability of the prostate is great, the 
sphincter muscle at the neck of the bladder becomes implicated 
in the debility, then there is likely to be a stoppage in the act of 
urinating, or it may be passed drop by drop ; and if passed with 
difficulty, residual urine and fungus formation are like to occur. 

The presence of prostatic catarrh invariably gives rise. to sem- 
inal weakness, spermatorrhcea, an oozing away of semen, or 
the oozing of a ropy viscid fluid from the tubular glands of the 



BACTERICIDES. 



171 



prostate, after micturition or defecation, or a diurnal weeping, or 
nocturnal involuntary discharges ; in or among all there is usu- 
ally spermatozoa. 

The most common form is due to a relaxed condition of the 
spermatic vessels and ducts, caused by masturbation, excesses, or 
ill-treated gonorrhea, a difficult and troublesome affection, open- 
ing the door to impotency. 

Under the microscope this exudation, or leakage, has the ap- 
pearance represented by this wood-cut : mucus, shreds, floating 
spermatozoa. The spermatic fluid may be wasted in this way for 
weeks, months, years, without the individual being aware of the 
drain upon his vital forces. Large quantities are usually ejected 
if bowels are constipated, in the form of a tenacious fluid like the 
white of an egg. 

Whether this seminal debility be due to urethral or prostate 
hyperaesthenia, the best remedies are cocaine suppository, which 
is of great utility, very advantageous, 
in overcoming prostatic tenderness, 
and continence of urine. 

Ozonized urethral bougies, gelatin 
prepared from papoid, resorcin and 
cocaine, when introduced into the ure- 
thra, clear up to the prostate and into 
the bladder, exercise a most remark- 
able sedative influence on the motor 
and urinary centres in the cord, and a 
powerful absorbent, action on the 
lymph effused in the gland. They 
are worthy of daily insertion. 

That great sexual sedative, salix 
niger ozonized, which has effected so 
much in diurnal and nocturnal seminal 
emissions, can be administered with marked benefit in catarrh of 
the prostate, in doses of half a teaspoonful three times a day. 
I have in a few weeks cured cases of many years' standing. 
In eighty cases treated with this drug, I have done more real 
good in ten days than by years of the old methods. It is 
altogether different from other remedies ; it does not impair,, 
but rather augments virile power and passion ; in every case it 
has afforded great satisfaction ; in arresting the oozing, over- 
coming the hyperaesthenia. 

Nearly all cases are much benefited by the administration of the 
uric acid solvent, in very small doses ; the advantage of this com- 
bination in irritable prostate is often quite great, as it most effec- 
tually neutralizes the acid state of the urine, and acts as a genital 
sedative. 




Spermatozoa as seen in the urine of 
patients suffering from prostatic 
catarrh. 



1^2 DISEASE GERMS. 

I have made considerable use of the saw palmetto in different 
morbid states of the prostate ; its action is best suited to catarrh 
of that gland with atrophy, the drug being a great gland 
stimulant. 

The direct medication of the prostate is best effected by the 
soluble gelatinized bougies ; they afford immediate results, and 
patients are not discouraged by waiting. In some cases the catarrh 
is aggravated by seminal emissions, very frequent ; in other cases, 
almost complete impotency, yet, in most instances, a few bougies 
inserted make a great change. 



Catarrh is a chronic inflammation of a mu- 

Catarrh of the cous membrane, hence there may be a catarrh 
Rectum. of any mucous membrane; and incidental to 

this partial death, there is a degradation of 
the primary elements of nutrition into a disease germ ; hence all 
catarrhal affections are contagious and infectious. 
' The amoeba is the microbe we find present in the nose, larynx 
and bronchial tubes ; in the stomach the sarcinae ventriculi ; in 
the uterus and vagina the amoeba bacteria and sarcinae ; in catarrh 
of the rectum a whole category of germs are found, with their 
ptomaines. 

Rectal catarrh is the most common, more dangerous to the 
general health and longevity than catarrh of any other part. 

The sensibility of the rectum is so limited and obscure that the 
affected individual often does not suspect the real nature of the 
difficulty, but complains of general lassitude, and debility from the 
disease germs and ptomaines re-entering the blood. 

In cases of catarrh of the bowels, interspersed throughout the 
frothy, slimy discharges blended with the sarcinae are to be seen 
a bacterium which bears culture well in beef broth, rendered 
alkaline with bicarbonate of soda, pathogenic of rectal catarrh. 

Causes. — The principal causes of rectal catarrh are torpidity of 
the liver, brought about by irregular habits of life, alcoholic 
drinks, malaria, sedentary habits, certain drugs, cold, damp, ex- 
posure, tight lacing, pregnancy. 

Symptoms . — These are often obscure, a species of diarrhea or 
dysentery is most likely to exist, or if not that, constipation, with 
itching. In catarrh of the rectum the mucous membrane only is 
supposed to be affected, whereas in inflammation of the rectum 
proper all the coats of the bowel are affected ; still the symptoms 
of catarrh are almost identical with a general inflammation of the 
various structures ; there is apt to be heat, burning soreness, exces- 
sive tenderness, copious muco-purulent discharge, the rectum re- 



BACTERICIDES. ly^ 

laxed, slight protrusion, blood and nerve poisoning, due to the 
germs re-entering the blood. 

Treatment. — The causes which produced this affection must, if 
possible, be removed, and then the patient should be placed upon 
a general alterative and tonic course of treatment, embracing the 
following special remedies : saxifraga, Virginia stone crop, c.oUin- 
sonia, mineral acids and cinchona, and then the bowel should be 
specially attended to. 

Either of the following formulae is of great utility in all ca- 
tarrhal states of the rectum. They should be added to thin 
starch and injected into the bowel three times a day : 

^, Distillation of hamamelis 6 ounces. 

Fluid extract hydrastis .....*•• 2 ounces. 

Tincture calendula . 2 ounces. 

Mix. A tablespoon ful. 

Three times a week twenty drops of the following, added to 
thin starch : 

ij^. Oil eucalyptus 2 drams. 

Phenol sodique 4 drams. 

Glycerine 3 drams. 

Mix. 

The following is of great utility, nay, unsurpassed, as a vital 
restorative to the rectum. 

Ij',. Fluid extract juglans 2 ounces. 

Fluid extract Virginia stone crop ... 2 ounces. 
Fluid extract stone root 2 ounces. 

Mix. A teaspoonful added to half a teacupful of slippery-elm 
water every three hours. 

A catarrhal state of the entire alimentary canal is often present 
in pulmonary phthisis and insanity, and is often the cause of a fatal 
termination. The microbes of either affection along the entire 
tract, the exhausting discharge, soon reduce flesh and impover- 
ish the blood more than any other state. 

The real causes of this catarrhal state are the intense acidity, 
the presence of germs, ptomaines, lardaceous or phosphatic de- 
posits on the bowel. 

In nearly all these cases ulcers on the intestinal tract begin 
below the duodenum, but in the small intestines they are insigni- 
ficant compared to the worm-eaten appearance of the large bowel. 

The localizing of disease germs follows the line of the blood 
vessels, specks of congestion isolated, coalescing, broad or per- 



ly^ DISEASE GERMS. 



forating in the colon and sigmoid flexure, and as they reach the 
lower bowel it is not uncommon to find ulcers of great depth. 

Recognizing their microbe origin, there should be a persistent 
(use of stone crop, salol, naphthaline, peroxide of hydrogen. 



Numerous and varied are the causes 

Catarrh Uterine which excite catarrhal conditions of the 
(Endometritis), inner lining membrane of the uterus. The 
most common are, various forms of ova- 
rian disease ; frequent abortions ; the irritation produced by the 
retention of the placenta, or shreds of lochial discharge; the 
introduction of instruments. Some drugs are productive of it, 
as excessive doses of bromide of potassa, aloes, savin, sudden 
suppression of the menses from cold or damp, masturbation, men- 
tal excitement, torpid liver, tight lacing, gout, rheumatism, 
incompatibility in married life. 

As there are, so to speak, so many grades of irritation, we 
have an immense variety of symptoms. Take the acute variety, 
in which there is fever, high temperature, rapid pulse and respi- 
rations, general irritation, sallow complexion, loss of appetite, 
headache, pain in the loins and the lower part of the abdomen, 
sacrum, groin and inside of the thighs ; a sense of great heat and 
fulness about the pelvis, and bearing-down. Bladder very irrita- 
ble ; a desire to pass water every few minutes, which is loaded 
with uric acid. Diarrhea and tenesmus, and, subsequently, 
constipation. Tenderness on pressure over ovaries and uterus. 
After a day or two, thick, ropy, tenacious discharge, which, after 
a while, becomes muco-purulent, and is tinged with blood, and 
imparts a greenish-yellow or greenish-red stain to the chemise or 
other body linen. There is often piles. 

This acute form should be treated with rest ; warm hip-baths ; 
mucilaginous drinks; open bowels with cascara; ^administer 
either antipyrine or antifebrin for fever ; pastiles of cocaine both 
per vaginam and rectum every four hours. 

As soon as the acute stage has been overcome, three teaspoon- 
ful doses of the wine of aleteris farinosa should be administered 
every three hours, alternated with other uterine tonics. 

The chronic form is the most common, and runs a tedious 
course, with headache, languor, lassitude, debility, great mental 
depression, obstinate dyspepsia, flatulence and constipation. A 
sense of weariness, if not pain, about loins, sacrum, groin, inside 
of the thighs, and bearing-down. The discharge now is thick, 
ropy, tenacious, very abundant, glairy, like white of egg. Often, 
under the microscope, the sarcin?e and yeast-plant germs can be 



BACTERICIDES. 



75 




Bacteria of yeast plant. 



<ietected in it. The discharge is most abundant in the mornings, 
-accumulating in uterus over night, or after lying down awhile ; 
indeed, in bad cases, after being in the recumbent posture for 
some time, it will flow right out. The debility increases, and a 
train of other symptoms set in, as hysteria, convulsive affections, 
nausea, vomiting, tympanitis, tenderness of 
breasts, and menorrhagia, if the lining cover- 
ing the fundus is involved. 

In the chronic form a weak, relaxed state 
of the intra-uterine mucous membrane, in 
which the yeast-plant and sarcinas are 
evolved in the mucous secretion. One of 
the most common maladies of the modern 
female, brought about by numerous causes, 
as sexual incompatibility, metritis, miscar- 
riages, metastasis of disease germs, and the like, and reflexly 
gives rise to a feeling of goneness, hysteria so-called, headache, 
debility, dyspepsia, bloating, with an indescribable burning in 
the hands and feet; a leucorrhoeal discharge, most copious in 
the morning, in which those micro-organisms are invariably 
present. The germ-laden secretion, as it oozes from the uterine 
cavity, is intensely acid owing to the presence of the three germs. 
This bacteria or vinegar-forming plant is often present in 
intra-uterine catarrh. It is found in all the hollow organs of the 
body ; often grows to an immense size, alongside of the sarcinae 

and yeast-plant. It is completely 
sterilized in the presence of germi- 
cides. 

Dysmenorrhcea, sterility, and ulti- 
mately a cancerous germ is elabo- 
rated from the normal bioplasm. 
Such is the state of two-thirds of 
our married ladies. 

The most experienced physicians 
find this affection most difficult to 
manage ; indeed, by some incurable, 
simply because they have failed to 
realize that the cavity of the uterus, 
with its entire mucous covering, was 
a colony of a million microbes — factors of morbid action, often 
the precursor of cancerous infiltration. 

Authors recommend injecting the uterine cavity, in these cases 
with germicides ; this must not be done with American ladies, 
whose reflex centres are so impressible, such a procedure, if 
resorted to, is sure to give rise to great trouble, nervous and con- 




The yeast plant and sarcinie present 
all cases of intra-uterine catarrh. 



76 



DISEASE GERMS. 



vulsive affections. My method is to insert into the uterine 
cavity a soluble gelatinized bougie, composed of papoid, or tryp- 
sin, or iodol, a germicide of sufficient power to annihilate the 
yeast-plant and sarcinae. Use one about once a week three times 
during the month. One to three will cure ; but as the cavity of 
the uterus is considerably dilated, and its walls so much thick- 
ened, to be thoroughly certain of a cure it is better to resort ta 
this proceeding for three consecutive months. 

At the initial period of treatment the patient should in all 
cases be placed upon full doses of the distillation of the aleteris fari- 
nosa. This is a most efficacious remedy in those cases, being a 
uterine tonic and invigo.rator. In alternation, the fluid extract of 
the salix nigra is a decided sedative to the genito-urinary organs 
of both sexes. 






The cervix uteri is a large, open gland,. 

Catarrh Cervix extremely liable to suffer from very slight. 

Uteri. irritation which is constant, and on this 

account catarrh is the commonest of all 

diseases incidental to woman. 

The causes are most numerous— irritating bodies in the vagina,, 
childless marriage, abortions, tedious labor, suppression of the 
menses, gonorrhea. 

The general symptoms of an exhausting discharge are inva- 
riably present : debility, bear- 
ing down, aching in the 
thighs and hips. In parts of 
the cervix that can be seen 
through a speculum the mu- 
cous membrane of the neck 
is red, swollen, and will bleed 
easily, and secretes a specific 
muco-parulent matter ; in. 
other cases the mucous mem- 
brane has a granular or punc- 
tured appearance. 

Intercourse with a patient 
so affected (which passes by 
the name of leucorrhoea) is 
bound to give rise to all 
the symptoms of gonorrhea 
in the male. 

The mucus secreted by the glands of the cervix has the identi- 
cal appearance of the annexed diagram. It consists of cysts or 
vesicles, which never appear in healthy mucus. These cysts are 




■^t^) 






The microbe of chronic catarrli of the cervix uteri 



BACTERICIDES. ijj 

regular cocci, which breed freely and give rise to profuse leucor- 
rhceal discharge. As they have wonderful powers of reproduc- 
tion, they soon render the cervix loose, spongy, patulous, bur- 
rowing in its intestinal structure. This accounts for the greater 
frequency of cases in practice of men who have all the symptoms 
of gonorrhea after intercourse with women so affected. Avoid- 
ing the old caustic treatment for this malady, we have a most 
efficient one in boroglyceride ozonized, either in packing the 
vagina a few times with the paste, or using a saturated solution 
by means of a fountain syringe. In this way, with rest, removal 
of the causes, an easy and an effectual cure is established. 

More chronic still, these minute cysts become altogether inde- 
pendent, although merely obstructed follicles, are the regular 
breeding ponds, give rise to a crop of vesicles, the contents of 
which give rise to herpes preputialis, if applied to or coming in 
contact with the glans of the penis. The occurrence of these 
germinal eruptions calls for great care. 

If the above method fail, then make a pastile or pencil of the 
ozonized jequirity and insert it in the os ; allow it to remain. In 
a short time it will cause a peeling off of the old germ-eaten 
tissue. 

Leucorrhcea is a general term applied 

Catarrh of the indiscriminately to all discharges from the 
Vagina. vagina of a mucous or muco-purulent charac- 

ter, whatever may have been its origin or 
source. Either a weak, relaxed condition of the mucous mem- 
brane, or a catarrh of the os or cavity, to induration and ulcera- 
tion of the neck, to ovarian irritation ; all discharges from the 
vagina, when they exceed a slight moisture, are loaded with 
microbes, disease germs pathogenic respectively of each morbid 
condition. 

Therefore the treatment of all cases, irrespective of cause or 
condition, must be essentially germicidal, consisting internally of 
the wine of the aleteris farinosa, comp. syrup partridge berry, 
alternated with the peroxide of hydrogen; general tonics, rest and 
best of diet. 

Daily or more frequent vaginal injections with fountain syringe, 
holding from one to two quarts of tepid solutions of some effi- 
cient bactericide, such as boroglyceride, resorcin, iodine, creolin,. 
naphthaline, preparations of calcium, glucozone. 

The cause must be removed, and those injections or others 
continued. In some cases the jequirity uterine wafers are of 
utility ; pastiles of white pond lily ; packing the vagina with 
boroglyceride is one of the best of ail methods, as this germicide 



178 



DISEASE GERMS. 



exerts a chemical action upon the uterine secretions, restores the 
parts to their pristine vigor, obviates all conditions of blight or 
sterility, promotes fecundation. 



The degree of cold that can be borne by 
Chilblain the human body before freezing, depends a 
or good deal on the medium through which it is 

Frost Bite, applied (dry or moist), and the power of vital 
resistance in the individual. The exposed por- 
tions, as nose, ears, hands, feet, are most obnoxious to it, chiefly 
on account of their feeble circulation ; and the feet are peculiarly 
prone to frost-bite, if sweaty or damp. This is one reason v/hy 
it is so common in hired girls, who sleep in attics, and mostly 
sleep with their damp stockings on. A chilblain may be defined 
to be a subacute inflammatory swelling, due to cold, and the pre- 
mature restoration of the circulation by heat. 

In all chilblains, as well as in burns and scalds, there is a mi- 
crobe evolved from the damaged elements of nutrition of the part. 
Symptoms, — Burning, tingling, throbbing in the affected part, 
with swelling, redness, and itching. There may be vesication or 
ulceration and sloughing, in all respects similar to a burn. 

Treatment. — Frozen parts to be thawed gradually by rubbing 
with snow, or ice, in a cold room, without fire, and stimulants 
administered internally so as to get them to thaw from within 
outwards ; and for some time the parts should not be exposed to 
heat. The carbolic acid and olive oil, same as in burns, may be 
used here with good results ; or ozone oii'.tment, black salve, or 
lime liniment. 

Better still, ichthyol, creolin, naphthaline, resorcin, either one 
rubbed up in ozone ointment; if the feet, lotions of boroglyceride, 
iodoform, thymol ; in all cases treatment essentially germicidal. 
To prevent frost-bite, a high standard of health ; very nourish- 
ing food ; tonics ; fire in bed-rooms ; avoid wearing damp stock- 
ings, either during day or night ; tight shoes ; and proper pro- 
tection or covering for exposed parts. Our highly oxygenized, 
dry atmosphere, with its crispy feel, is not nearly so productive 
of frost-bite below zero as that which is humid and moist, with 
the oxygen greatly diminished. 



A peculiar form of aucemia, 0':curring in the 
Chlorosis, young of both sexes, in which there is a defi- 
ciency of the blood cells with a redundancy of 
the serous part of the blood. 

The defect is a genuine poverty of nerve force, generally most 
prominent about puberty, before the complete development of 



BACTERICIDES. I^tq 

the sexes is established ; owing to this neurasthenic condition, 
there is a defect in the evolution of red corpuscles of the blood ; 
they are small, dwarfed in size, diminished in number. 

The causes which induce this condition of nervous bankruptcy 
or deterioration are : in males, masturbation, a draining off of the 
iiervo-vital fluid, deleterious trades ; indoor life, solitary confine- 
ment ; in young ladies, the same causes may exist, as w-ell as un- 
due precocity brought about by erroneous modern education. 

Symptoms. — General symptoms of anaemia, with a wax-like 
hue of face, yellow pallor of skin, whence the name '^ green sick- 
ness.'^ Deficient or depressed appetite, fetor of breath, 
heavy coat on tongue, skin dry, constipation, abundant limpid 
urine ; weak, quick pulse ; hysteria. If a woman, pale, scanty 
menstrual discharge ; if a man, his semen entirely destitute of 
spermatozoa. Leucorrhoea in women ; often a thin gleety pros- 
tatic discharge in men. Languor, listlessness, head and back- 
ache, palpitations, cardiac and vascular murmurs. Occasionally 
enlargement of thyroid and protuberance of eye-balls. 

The treatment should be pre-eminently constructive ; fresh air, 
sun-light, daily bathing, followed with massage ; a most liberal 
and variated diet ; bowels regulated with either the kola nut 
paste or cascara sagrada lozenges. 

Our best drugs in all forms of chlorosis in either sex are 
either the peroxide of hydrogen, or glycerite of kephaline ; or 
avena sativa ; or nitro-glycerine, or pulsatilla et caulophyllin. 

This change in treatment operates speedily in a complete 
restoration to health. 

The living microbe of cholera, the comma-bacillus, 
Cholera, is undoubtedly derived from the degraded bioplasm 

of our own or others' bodies. 
The term cholera is applied to the presence or development of 
the cholera geriTi in the infant, middle-aged, and as an epidemic ; 
conditions of the human body in which this special degradation 
takes place, which are brought about by diminished vitality, a 
lowered electrical state, abnormal meteorological conditions, with 
an absence of ozone in our breathed atmosphere, and other 
insanitary conditions, for there is little doubt that imperfect 
drainage, improper food, impure water, fasting, fatigue, intemper- 
ance, uncleanliness, breathing vitiated air, all aid in the produc- 
tion of the germ. From the reckless condition of modern 
society, it is a wonder that we are so free from disease-germs. 
There ought to be more attention paid to sanitary science. Many 
of our modern buildings are but murderous sepulchres, being 
contaminated throughout. The very hair in some plaster is from 



l3o DISEASE GERMS. 

the hide of some animal that has died of anthrax. The atmos- 
phere of many houses is tainted with sewer gas ; neither ventila- 
tion, lighting nor heating has been attended to. Heated with 
dry air from cellars impregnated with disease-germs ; water- 
closets in houses, the reservoirs of contagion ; the very earth in 
our large cities is contaminated. . All sewers should empty at 
least five miles from human abode, and the water into which they 
empty should not be drunk by man or beast; all dwellings 
should have open fire-places, as they burn up many noxious 
poisons that would otherwise enter our bodies. 



This is -common among children of all large 

Cholera cities in tropical countries, between the ages of 

Infantum, four months and two years. Children of the poor 

suffer most, or those who are subjected to the 

direful influence of modern pestilence ; for it is really the case of 

the little god's kissing carrion — compelled to swelter in the hot, 

insalubrious, death-dealing atmospheres during the months of 

June, July and August, the temperature ranging from 90^ to 

100° Fahr. 

The degradation is brought about in one or other of two 
ways : 

1. By some shock, such as a fall, blow, rocking, concussion of 
brain, or by some reflex irritation, as teething, diarrhea, or 
the action of some cerebral stimulant, as opium in a soothing 
cordial. 

2. By irritation of the stomach and bowels, caused by indiges- 
tion of swill or diseased milk, giving rise to acidity, fermentation, 
vomiting, diarrhea. In the former case it is central ; in the lat- 
ter, peripheral. In whatever manner it originates, the two con- 
ditions quickly coalesce, and the disease manifests itself as a ner- 
vous affection, with an irritation or paralysis of the eighth pair of 
nerves that supply the liv^er, and a chemical change in the secre- 
tions of the bile, which is highly acid and irritating to the fine, 
delicate nerves that supply the m.uscular coat of the bowels, 
which causes contraction of the muscular coat, giving rise to 
severe pain, frequent evacuations, loaded with the cholera germ. 

Symptoms. — These are well defined — nausea, vomiting, diar- 
rhea, great nervous prostration or irritability; patient feverish, 
restless; heats and colds ; skin white; sleeps with eyes partially 
open ; rolls head ; grinds teeth ; wakes up with a scream ; rapid 
emaciation ; stools, at first greenish, become like chopped spinach ; 
and prior to each motion of the bowels, the child instinctively 
draws up its knees and cries with the excruciating spasmodic 



BACTERICIDES. 



I«I 



pain in the bowels, from the passage of the acid or acrid bile 
loaded with cholera germs, and their excretions, ptomaines, irri- 
tating the fine, delicate nerves of the bowels; the urine is very 
scanty and high-colored. As the case progresses there is more 
prostration ; the skin becomes whiter and colder, and, in bad 
cases, bluish ; the features shrunken and pinched ; greater emaci- 
ation ; breath cold, as the liver fails to secrete sugar for combus- 
tion ; the alkaloid ptomaines increase, and the case grows worse 
and worse. If the patient survives the first attack, the tubercular 
diathesis is created, and there is a complication in the deposit and 
growth of tubercle in or on membranes of brain, in or on the 
mesenteric gland. 

The duration of cholera infantum depends very much on the 
vitality of the child, its surroundings, the capabilities of the 
mother, and denseness of population. Some cases will commence 
in June, and struggle through to Septemb-er ; whereas others, 
under less favorable circumstances, ^ 

will be attacked and die in a few days. ^ ^^ fr 

Treatment. — Before considering the ^ r ^^\ Aj"^ 

treatment, it might be well to ask the i \^ ^T" ( f^'S 
question, what means have we to pre- '^'^'^"^ >V '^^-Nir"') 
vent this terrible scourge in all our I \ ^'p'^ I. -^ "^tZ^ 
large cities? The insanitary condi- i ^-^^ ^ ^^^ '^^^^ ^^ 
tion of cities during the heated term, /s^^ )j ^Z)^)^ 

and the condition of overcrowding, '^^Sc' S^-n 

does not admit of a remedy ; but the *^ c ^ O 

vitality of the child and welfare of the Dwarfformofthecomma-baciiius 

^1 1^1 r T^i found in the green stools of 

mother can be taken care of. Ihe cholera infantum ; magnified 700 

mother is of primary importance — her ^''"" 
health and comfort ; her food should be nutritious ; her mental 
and physical powers should not be taxed ; she should do 
everything possible to maintain a very high standard of health, 
and avoid work, anxiety, or any depressing influence. Men- 
struation and sexual congress should be prevented during 
nursing. The health of the little one should be promoted by 
fresh air, good milk, flannel clothing, and in an especial man- 
ner by wearing the flannel roller round the abdomen until they 
are two years of age. Daily bathing with cold water, followed 
by friction. Cradle-rocking to modern infants, whose parents' 
nervous system has been developed at the expense of the physi- 
cal, is very hurtful. Dandling, shaking or jolting is also very 
injurious. The little one should be kept quiet, cool, free from 
jolt or motion, and from the solar rays. Its diet, until teeth 
appear, should be the mother's milk ; and if that is not sufficient, 
cow's milk, very slightly diluted ; no starchy article of diet per- 
mitted to be used, nor sugar in anv form. 



1 82 DISEASE GERMS. 

As soon as the disease makes its appearance, vigorous means 
must be taken to arrest it ; an emetic of the wine of ipecac, fol- 
lowed with sufficient doses of the neutralizing mixture to open 
the bowels freely, followed with lime-water and milk, and a 
plaster consisting of equal parts of pulverized allspice, cloves, 
cinnamon, peruvian bark, and a very small amount of capsicum, 
wet with vinegar,. spread between fine book muslin, and applied 
over entire abdomen ; taken off every three hours, the caked mass 
broken up and remoistened with vinegar, or if not that, concen- 
trated ozone. An evening bath is also to be recommended ; well 
dried and rubbed, and followed by inunction of several ounces of 
warm olive oil. If case does not improve, then give liver a 
rousing up by administering one or two grains of leptandra in a 
little compound licorice powder, following it up with teaspoonful 
doses of the expressed juice of raw meat every three hours ; put- 
ting patient upon tincture of white hellebore, which has such an 
immense sphere of action on base of brain, eighth pair of nerves 
and liver — dose must be regulated by the physician in charge — 
and begin at once with bactericides. From among that class of 
drugs, the ozone-water, the sulphurous acid, or tincture of iodine 
and carbolic, or the solution of chloride of lime, sahcylate soda, 
salol, lactic acid, resorcin, creolin, are probably the best to destroy 
the germ. Alkaline antiseptics, however valuable they may be, 
act rather freely on the liver. We cannot doubt the efficacy of 
the chlorate or permanganate of potassa, or sulphate of soda, but 
in few cases dare we sanction their use ; so one of the above 
must be selected, and administered often and with regularity* 
The entire success or non-success in the treatment consists in 
the use of germicides and nourishments. Head to be kept cool ; 
socks, with dry mustard, to feet ; fever to be controlled with 
aconite; any brain symptoms, the bromide mixture; and, above 
all, keep up nutrition, confining diet to mother's milk, milk and 
lime-water, and juice of raw beef 

If the case recovers, and means are available, the child should 
be removed to the country, away from the pestilential influence 
of a large city; a tonic, antiseptic course of treatment carried out 
for some months, with such remedies as glycerite of ozone, 
ozone-water, cinchona, and aromatic sulphuric acid. 

Prof James M. Bunn, M.D., of Altoona, Pa., the most brilliant 
bacteriologist in that State, says : The comma-bacillus is the 
cause of the green stools of cholera infantum. This can readily 
be ascertained by a microscopical examination of the discharges^ 
when there will be found an innumerable number of the patho- 
genic bacilli ; the coloration is not due to the bile pigments, 
which are entirely absent, but to a peculiar pigment secreted by 



I 



BACTERICIDES. 



183 



the bacilli themselves, and which can be reproduced by artificial 
cultivations of the microbes. Bile is entirely wanting in the 
rice-water discharges of epidemic cholera, as well as in the green 
stools of cholera infantum. The disease in all its forms is essen- 
tially contagious, although indigestion, mal-assimilation prepares 
the soil, favors the production of the bacillus. 

The greatest success in treatment is from the use of germicide 
remedies. Take either mucilage acacia or syrup of tolu, four 
ounces ; add to it three or four drachms of resorcin, thirty drops 
concentrated ozone. Mix well ; give half a teaspoonful every 
hour. Stop milk entirely; feed on barley water and port wine ; 
the bacilli lodges and breeds in the casein ; multiplies to an 
alarming extent in the casein clots. So starve and kill the germ. 
Paint abdomen with equal parts of con. ozone and chloroform — 
a powerful stimulant and germicide — arrests germ evolution. 

Care should be taken to employ disinfection of the stools to 
prevent the spread of the disease, and, with proper care, we claim 
that this microbic form of diarrhea may be reduced to a minimum. 



This term is applied to a condition of extreme 
Cholera nervous prostration, with cold skin, feeble pulse, in- 
Morbus. terrupted respiration, cold breath, a cadaverous ap- 
pearance of face, blue feet, hands, nose, ears, with 
nausea, vomiting, frequent motions of the bowels, with cramp or 
knotting of the intestines, and the cholera-germ in stools. 

In our climate, with its inhabitants suffering from an incessant 
nervous strain or worry or struggle, we meet with cases of 
cholera morbus in all seasons of the year, chiefly among our 
adult males, although it is more prevalent when the system is 
enervated by heat, or when there are violent transitions from heat 
to cold. Chmatic changes affect those who have their nervous 
systems prostrated by overwork or anxiety ; and especially so if 
the stomach is irritated by offending material, as green or unripe 
fruit, some acid or acrid cond tion, acting on the stomach and 
liver as an irritant, or upon the brain, involving its base and 
eighth pair that supply the liver. The disease may be traced to 
other causes, but the true cause is to be found in a depression of the 
great sympathetic, eighth pair, and brain, the spinal cord being 
involved in the first dorsal vertebrae. 

Bacteriology teaches us that in whatever way the microbe is 
evolved, either by nervous depression, aided by the irritating ac- 
tion of green fruit or vegetable, or some indigestible compound 
as clams, or some other irritant, the comma-bacillus is present in 
the bowels, actively, energetically excreting ptomaines, that deadly 
alkaloid which produces all the alarming symptoms of the disease. 



i84 



J)ISEASE CiERMS. 



Syuiptoms. — It usually comes on with nauseau, soreness, pain 
in stomach, vomiting, purging, which rapidly exhaust the patient ; 
when, by and by, those terrible cramps or knotting of the intes- 
tines by spasm, the features becoming cadaverous ; breath cold ; 
skin cold and clammy ; hurried or short respiration ; cramps in 
the legs ; coldness of extremities ; intermitting pulse. 

Treatment. — This must be pursued with great energy. Ad- 
minister at once thirty grains of bicarbonate of potassa in tepid 
water ; follow quickly with an emetic of a mixture of equal parts 
of lobelia, capsicum and valerian. Repeat dose after dose, until 
emesis is very thorough. Use the same as an enema. After the 

stomach is thoroughly evacuated, con- 
tinue with same remedy in small doses 
sufficient to keep down spasm of the 
bowels. Apply artificial heat to stom- 
ach, feet, limbs. Open bowels either 
with neutralizing mixture or com- 
pound licorice powder. Commence, 
as soon as the stomach will retain 
anything, with either the tincture ot 
white hellebore and antiseptics, as 
ozone-water, or tincture iodine, and 
carbolic or sulphurous acid, per- 
oxide of hydrogen or salol, or creo- 
lin, or naphthaline, or resorcin ; or 
if these are not handy, then use eu- 
calyptol. 

The lobelia compound is invaluable for relaxing of spasm and 
overcoming the prostration. If, after the bowels have been freely 
moved, the stomach is still irritable from the presence of the 
germs, and will retain nothing, administer the following : cam- 
phor, thirty grains ; capsicum, ten grains ; sulphate of morphia, 
one grain. Mix, and make ten powders ; and, while triturating, 
add five or ten drops of oil of peppermint. Give one powder 
every half hour. 

After the stomach has been quieted, continue with antiseptics 
and tonics until recovery is complete. 




The comma''bacUlus al work in the 
tubuhir glands of the bowels vieor- 
oiisly excreting ptomaines, the deadly 
alkaloid oi rigor mortis, immediate- 
ly sterilized on the administrat on of 
ozonized creolin. 



Human beings, whose nervous systems aie 
Epidemic devitelized by overwork, exhaustion, privation. 
Cholera. anxiety, struggle for existence, and subjected to 
depressed electrical states of the atmosphere, ex- 
traordinary meterological conditions, and the absence of ozone, 
have within their bodies certain living elements altered or de- 
i^raded bv those adverse conditions into the cholera-germ. There 



BACTERICIDES. 



185 








The microbe of cholera (the comma-bacillus), the different forms 
it presents in its various stages of growth. 



can be little doubt that this germ is the modified Hving mat- 
ter, either of the base of the brain, the spinal cord down to the 
last cervical verte- 
brae, whence eman- 
ates the sympathetic, 
or else the eighth 
pair that supplies the 
liver. In proof of 
this, we often find 
cholera-germs, the 
comma-bacillus, in 
those whose nervous 
systems are shatter- 
ed, and who suffer 
from diarrhea. Be- 
sides, the appearance after death points to those parts as being at 
the origin of the trouble. When once developed, it is capable, 
like all other contagious diseases, of being propagated by con- 
tagion and infection. It is not, however, contagious in a high 
•degree, but can be carried by human intercourse, by clothing, 
merchandise, ships ; undoubtedly often spread by water, milk. 

Symptoms. — The symptoms of this disease are divided into 
three stages, which may be classed as follows : 

1. Irritability, languor, lassitude, sleepiness, confusion of head, 
pale countenance with nausea, vomiting and diarrhea. 

2. In addition to the above aggravated symptoms, the dis- 
charges become light-colored and serous; white flakes and rice- 
water discharges appear; the 
pupils become contracted, 
spasms, cramps, coldness of 
body, with intermittent pulse. 

3. Blueness, with rigid spasm, 
suppression of urine, collapse. 

The general symptoms of those 
three stages in detail are as fol- 
lows : copious vomiting and 
diarrhea; stools are entirely des- 
titute of bile, and consist mostly 
of water, containing large quanti- 
ties of epithelium and albumen, 
resembling rice-water ; they con- 
tain also a large quantity of 
chloride of sodium ; cramps in 

muscles, causing them to contract into cord-like masses or knots ; 

spasm; the pulse is soft and easily compressed ; varies from ninety 






'(^;.^^x 









4 




From the rice-water stools of a case of cholera. 
Masses of single comma-bacilli ; circular 
farms; semi-circular forms; magnifying 
power about 1400. 



1 86 diseasp: germs. 

to one hundred and ten; general temperature 65° to 70° F. ; the- 
expression of the features is ghastly or cadaverous ; eyeballs 
sunken, glassy ; cold, clammy sweat ; breath cold ; so is the 
tongue and mucous membrane of mouth ; distress at pit of 
stomach, with burning; albuminuria, suppression of urine; great 
thirst; circulation gradually diminished; respiration impeded; 
hence great prostration. 

The heart now becomes affected ; so do the blood vessels, by a 
spasm of their muscular coats. The sugar-generating faculty of 
the liver is suspended, so that there is an icy coldness of the skin 
and breath, and blueness of the lips and skin generally. The 
force of the germ-disease and its ptomaine is on the nervous sys- - 
tem, which becomes early and decidedly affected; hence the un- 
natural and whispering voice, shrinkage of the entire body,, 
pinched features, and contracted pupils ; muddy-looking com- 
plexion ; sinking of the eyes, pupil immovable, cornea flattened. 
If symptoms are not relieved, the breathing becomes less frequent,, 
the whispering voice spasmodic, and if the pulse is at all percep- 
tible, thread-like and intermitting ; circulation arrested from para- 
lysis of the heart; intellect clear; evacuations involuntary, and 
not a trace of bile in the stools. If the patient survive forty-eight 
hours, and exhibit signs of improvement, he may recover rapidly 
if the pulse rises and the stools become bilious, and respiration, 
and circulation be restored. 

But very frequently improvement is only temporary, headache, 
drowsiness, tonic or clonic spasm, vomiting, stertor, coma, usher-- 
ing in death. 

All those symptoms are due to the lightning-speed evolution, 
of ptomaines by the microbe ; so rapid that the bacilli have not 
time to elaborate in the blood, the ptomaine of the comma- 
bacillus, is like alkaloid strychnine, chemically, for if it be injected' 
into any animal it at once produces diarrhea, vomiting, spasms,., 
torpor, collapse, and finally death. 

7'he appearance after death, aside from the rigid contraction- 
and stony feel of the muscles are a white liver, effusion in the 
ventricles of the brain and spinal, the latter being congested and 
compressed by a serous exudation, in which ptomaines are abun- 
dant. Death is so rapid from the excretions of ptomaines that 
the comma-bacilli are not to be found in the blood, but only in the- 
tubular glands of the intestines. 

Treatmc7it. — If an epidemic prevail, the most careful sanitary 
and hygienic measures should be observed, and the very highest 
possible standard of health maintained ; the very best of food 
used ; no green fruit ; no alcoholic drink ; no late hours ; no-- 
mental or physical overwork ; no overcrowding. The best pre- 



BACTERICIDES. 



187- 



ventive is small doses of sulphate quinine, and abundance of 
good food. On the very slightest derangement of the bowels, 
that is, nausea, vomiting, or diarrhea, give small doses of the 
neutralizing cordial, with tincture of opium, until it is relieved. 
At the same time, apply sinapisms of capsicum and vinegar over 
the bowels and down the spine ; and, as a drink, give sulphurous 
acid in water. Any other symptoms should be promptly re- 
lieved, the patient kept in the recumbent position for a few days,, 
and plain, nutritious food given. 

If the disease has set in, and is seen first in its premonitory or 
first stage, the patient should be put to bed in the best ventilated 
apartment in the dwelling ; its temperature kept about 80° Fahr., 
and arrangements at once made to have him surrounded with 
dry heat, heated sand in bags. The diarrhea and vomiting are 
evidently efforts of nature to get rid of the germ, and it is often a 
good plan right here to administer an emetic of equal pares of 
lobelia, bayberry, and capsicum. Afcer it has acted, try some 
one of the following remedies in solution, so as to get the liver 
to secrete and discharge the bile : rub abdomen and spine with 
oil of capsicum cut with alcohol, and apply artificial heat, and 
let the drink be sulphurous acid and water. 

Opium in every form is contra-indicated, because it increases 
the congestion of the cord. Large doses of bromide of potassa, 
ranging from fifteen to thirty grains, with ten of carbonate of 
ammonia, and twenty drops of tincture of calabar bean should be 
given frequently. 

If the case is more advanced, pupi's contracted, spasms, cramps,, 
coldness, biueness, intermitting pulse, these symptoms are 
promptly met with the following : 

Tincture of lobelia, capsicum, and American valerian, of each 
one ounce. Give a teaspoonful in water every half-hour, and 
occasionally a dose of the bromide, with tincture of white helle- 
bore. Cholera-germs are difficult to destroy, but with the lobelia 
compound we have had good success. Of all drugs in the ma- 
teria medica, it alone retrogrades the growth of the germ, and 
sterilizes it. Its properties are really incomprehensible ; it holds 
the position ; no more are developed under its influence; it gives 
nature a chance to rally to legitimate work ; every drop that is 
given benefits; the respirations becomes more frequent; heat in- 
creases ; breath becomes warm ; pulse, imperceptible at first, be- 
comes wiry and full ; blueness and contraction leaves the surface ; 
the paralysis of the eighth pair is relieved ; bile appears in the 
stools ; spasm and contraction are relieved, and the eye acquires 
its brilliancy. 

It must never be given to the point of vomiting ; its action- 



I 88 DISEASE GERMS. 

must be guarded, and held on to, and persevered with, so as to 
enable the vital forces to recover themselves. Its action is im- 
mense in cholera. If sinking is threatened, compound tincture 
of capsicum and quinine should be administered repeatedly. 
Juice of raw meat, well salted, should be given often. If thirst 
is intense, iced champagne or chloride of sodium, carbonate ot 
soda and chlorate of potassa in w^ater should be given. If vomit- 
ing is incessant, medicine and drink in small doses every few 
minutes, with capsicum over abdomen. Dry heat, in the shape 
of hot sand bags around the entire body of the patient, reaching 
from axillae to toes, and from the groin down the inner aspect of 
the thighs, and also along arms ; while being changed, friction 
with tincture of capsicum. Hold spasmodic action in abeyance. 
As soon as stomach settles, keep on with juice of raw meat, and 
give antiseptics, as ozone water, or sulphurous acid, or carbolic 
acid and tincture of iodine. 

In cholera the insulation of the patient is of great importance ; 
bed in middle of the room, head to north, glass under feet of the 
bed. 

The evacuations should be removed in a bed-pan, with a solu- 
tion of sulphate of iron, and the greatest of caution should be 
exercised in diet, allowing little but beef-extract, milk and bicar- 
bonate of soda, farinaceous substances, until bile appears in the 
stools. 

Convalescence should be established upon cinchona and min- 
eral acids, baths, irritating plaster the entire length of the spine, 
holding on to antiseptics for four or five weeks after recovery. 



A morbid condition of the nervous system, char- 
Chorea, acterized by a want of control of the motor nerves 
which supply the muscles in the waking state ; 
which gives rise to irregular, tremulous, and ludicrous movements 
of the voluntary motions, most common between the ages of five 
and fifteen, among those of a neurotic temperament and feeble 
constitution ; girls are more obnoxious to the affection than 
boys. 

Causes. — It is supposed to originate in a jar, or want of har- 
mony, between the gray and white matter of the spinal cord, 
probably brought about by falls, blows, shocks of various kinds 
acting upon a weakened cord and bulb. More active, exciting 
causes are anaemia and other blood diseases ; teething, worms, 
dyspepsia, skin eruptions, retarded catamenia, constipation, cold, 
insufficient food, excessive loss of blood, pregnancy, disease of 
bladder, rectum, mental emotion, passion, masturbation, and 



BACTERICIDES. I go 

o'her reflex conditions at the origin of all star\/ed cerebral 
areas. 

Nearly one-half of the cases of chorea that we meet with in 
city practice is due to defects in our high-pressure system of 
education. Over-schooling produces a nerve shock, peculiarly 
liable to affect the nervous system of children whose food is 
meagre or adulterated (their brain is under-fed), or who live in 
the midst of insanitary surroundings. A city child is more 
feeble, less able to cope with disease, than those in the country;, 
the law of reflex impressibility is keen in the former, and the 
daily endurance of mental toil, with its incidental shocks, produce 
a jar, a want of equilibrium, between the gray and white matter of 
the spinal cord, hence the chorea, the penalty. With a different 
system of education, a vast amount of child-suffering might be 
prevented. 

Symptoms. — The commencement of this disease is character- 
ized by nervous depression and debility. The involuntary mo- 
tions begin by slight twitching of the muscles of the face; then 
other muscles become affected, and one or more limbs ; features 
often curiously contorted and twisted ; vacancy of countenance ; 
articulation impeded; appetite irregular; often constipation ; gen- 
erally one-half of the body more affected than the other. Irre- 
gular action ceases during sleep. The disease may last for a life- 
time and produce no bad results, whereas in other cases the 
nervous system becomes impaired and there is a rapid breaking^ 
down. It produces difficulty of respiration and retards the 
functions of the heart. It is apt to be attended with danger. 

TreaUncnt. — In the treatment of all cases of chorea, a complete 
change of habits and occupation, and a resort to the fresh air of 
the country ; abundance of exercise, and a very generous diet, 
together with daily baths and friction to skin, are indispensable. 
The closest scrutiny of the case, as to whether there be any 
blood affection, or reflex irritation, especially of the genito-uri- 
nary organs. All causes must be removed, if possible, and a 
special treatment inculcated for each ; the secretions well stimu- 
lated. The great impressibility of the nerve-centres must be 
seen to by the daily application of stimulants to each side of the 
spinal cord, as friction with stimulating liniments, the irritating 
plaster, ice, or use of menthol ; some one of these selected, and,, 
internally, bromide, Scutellaria, calabar bean, sumbul. These 
latter not only relieve the impressibility of the cord to reflex 
action, but help to control the involuntary movements. 

Whatever treatment may be deemed best to control the move- 
ments, sumbul or scullcap, we must ever keep in mind that there 
exists starved cerebral areas, v/hich must be overcome by kepha- 



190 



DISEASE GERMS. 



line and avena sativa, and as the brain only picks up its pabu- 
lum from the blood during repose, sleep must be prolonged 
indefinitely. 

Our best curative drug in chorea is the ozonized extract of 
sumbul, being a powerful antiseptic. It reaches a class of cases, 
in which the malarial, rheumatic and other microbes play an im- 
portant part in the excretion of ptomaines. The remedy kills 
the microbes and neutralizes the poisonous alkaloid in the intes- 
tines, and thus diminishes reflex irritation. 

The jar or want of equilibrium between the gray and white 
matter of the cord is completely arrested during sleep. It is 
therefore, a good plan to prolong sleep and thus cut short the 
mischief which is being carried on in the nerve-cells by the in- 
cessant, unnatural activity. Prolonged rest affords an oppor- 
tunity, a restorative, to the discordant nerve-cells to be at rest. 

Massage is most effective, persistent for two hours, morning 
and night ; induces sleep. 

Sulphonal and paraldehyde are efficacious remedies, in alter- 
nation with the sumbul. 

The patient should be put upon an alterative and tonic course, 
and special remedies as to its cause. 

If retarded menstruation be a cause, in addition to the bromide, 
Pulsatilla and caulophyllin ; comp. betin pill and acetate of iron. 

If rhenmatisni be suspected, manaca, salicylate soda in liquor 
ammonia acetatis ; cascaradyne ; colchicumi, phosphate of qui- 
nine ; uric acid solvent ozonized. 

If it has appeared subsequent to the metastasis of a skin erjp- 
tion, ozonized sulphur water ; lycopodium, saxifraga. 

If uterine irritation is suspected, pulsatilla, aleteris farinosa 
wine, Indian hemp. 

If due to fright, mental distress, belladonna, stramonium, ma- 
crotys, nux. 

The usual remedies if worms are suspected. 

If due to disease germs in the blood, saxifraga, phytolacca. 

Other remedies sometimes successful are arsenic, bromide of 
gold, nitro-glycerine, avena ; this latter being a powerful nerve 
"tonic and food, is admirably adapted to imperfect development of 
the nervous system, whether partial or general, and is markedly 
suitable to children who are precocious, whose assimilative func- 
tions are not up to the task of supplying the waste consequent 
upon active brain expenditure ; such children while needing rest 
and restraint rather than encouragement in the development of 
their faculties, will be so greatly improved in physical strength 
by the use of the oats as soon to resume their intellectual 



trammg. 



BACTERICIDES. I pi 

Chylous urine, or the excretion of urine of a 
Chyluria. milky appearance from the presence of fatty mat- 
ter in a molecular state. In addition, there is gen- 
erally present liquor sanguinis, blood-corpuscles, fibrin, and albu- 
men. The urine, after standing a little while, coagulates into a 
trembling mass resembling common size or blanc-mange. Coin- 
tnon in tropical latitudes, and is associated, not always, but in 
many instances, with the filaria in the blood. 

Associated with this condition of the urine, there is great lassi- 
tude and debility; pains about loins and stomach; very great 
mental anxiety ; loss of flesh. It is usually intermittent in its 
nature ; chylous for months ; healthy for same space of time, 
and then recurs on and on. 

Treatmefit. — Sea air, salt-water baths, very nourishing diet ; 
flannel roller over abdomen ; tonics, such as Warburg's tincture ; 
-eucalyptol, kurchicine, cinchona, and mineral acids. 



According to the last census, there were 
Climacteric three millions of women in the United States 
Disorders, between the ages of forty-five and fifty, undergo- 
ing the change of life, and this number is annu- 
ally kept up by fresh recruits ; so that we have, at all times, about 
that number. The importance of the period, the history of suffer- 
ing endured, cannot be approximated; neither has its diseases 
been adequately investigated. 

The terms, change of life, turn of life, critical period, etc., are 
understood to mean a period of life beginning with those irregu- 
larities which precede the last appearance of the menstrual flow, 
and ending with the resettlement of health on a new basis. This 
is usually divided into a premonitory period, the actual stoppage 
or cessation of the flow, and the adaptation of the system to the 
change. The first indication of failure of ovarian energy is 
irregularity, when the failure is complete, perfect cessation. 

Although it is termed a critical period, it is not to be deemed 
fatal, if the patient's system is healthy. It is a gradual change, 
leading to better or worse ; to complete recovery more frequently 
than to death. 

The streams of life, instead of flowing on in a smooth, tranquil 
current from the cradle to the grave, are marked by rapids, or 
milestones, which are critical, metamorphic, or developing epochs. 
Seven, fourteen, twenty-one, are clearly and distinctly written on 
the first part of life ; forty-two, forty-nine, and sixty-three, are 
less deeply cut, but are distinctly visible in the latter period of 
life. Those periods are characterized by important changes. 



1^2 DISEASE GERMS. 

which give a peculiar aspect to the physiognomy of the humara 
body, and impart a family likness to the diseases of epochs justl}r 
deemed critical, in which one or several organs of the body 
undergo changes. The object of each critical change in our 
bodies is to insure the greatest amount of health for each subse- 
quent period of life. This object, if the vital forces are of 
average strength, is effected quickly; but if there be debility or 
disease, then there is more or less disturbance, according to the 
degree or intensity of that state. The critical changes of denti- 
tion and puberty are frequently brought about without any dis- 
turbance or ill health; nevertheless, they are often followed by 
debility. At critical periods the activity of important apparatus 
may be too powerful, and disturb other organs, or too feeble to 
react on others. When the energy of the preponderance-seeking 
organ is above or below par, health may be impaired. With 
regard to the influence of critical periods of life, first and second, 
dentition influence both sexes alike and in the same way. 
Puberty is common to both ; but the impulse given to the con- 
stitution of man, by the perfect development of the sexual appa- 
ratus, is, in genet-al, fully effective and all-sufficient to insure its 
permanent activity until extreme old age ; whereas, in women the 
crisis is very liable to be delayed or perverted ; and even when 
puberty has been fully and effectively established, the health of 
woman is dependent on those oscillations of vital force, which 
render it most uncertain. The chemical activities of a woman 
cause her to mature early ; the inertia of man's nature renders 
him slow, late in maturing. The same inherent qualities of sex 
give woman an early change ; whereas, man's change is delayed 
(if not too early precocious) till a good old age, he being capable 
of begetting children to seventy or eighty; whereas, the moment 
a woman changes, fecundity ceases. It is true that children 
begot by very old men are of very feeble vitality. Although' 
most women change at forty-five or forty-seven years of age, it 
does not follow that sexual appetite is extinct. Sexual congress 
may not be enjoyed by some, whereas others never have a 
warmth of feeling until the change of Ijfe takes place. The large 
proportion of women, oh cessation taking place, become callous,, 
indifferent, lose their sexual vivacity and vigor. 

Menstruation, healthy or morbid, marriage, pregnancy, partu- 
rition and lactation, are critical eventualities in a woman's life, 
curing some complaints, giving greater activity to others ; and 
when, after having lasted thirty years, the action of the reproduc- 
tive organs is being withdrawn from the system, then there arises a 
series of beautifully adapted critical movements, the object of 
which is to endow a .healthy woman with a greater degree of 



BACTERICIDES. ig^ 

strength than that which she had previously enjoyed. But this 
will not occur if there are disease-germs lurking in her system, 
such as cancer, tubercular, syphilis ; then the seeds of those 
germs, when vital force is low, are liable to become active and 
destructive ; because the very essential of the change, debility, 
brings them into active growth, and causes them to locate and 
grow in the very organs in which the change is progressing. 
The change stimulates their growth ; imparts to them fresh 
activity. So, as a rule, it is at this period we meet with the 
greatest proportion of cases of cancer of the womb, and breast, 
adenoma, and other tumors. The change of life is only critical 
to the diseased. It is only they who need fear the crisis. To 
the healthy^ to those who live according to natural laws, eat 
healthy food, avoid balls, tight lacing, bad literature, and seden- 
tary occupations, nothing is to be feared. It is well to make no 
hap-hazard prediction, but if there is no disease, the process will 
not be critical. True, the disease may be got rid of; if so, it 
will mitigate the condition. The change does not cause disease ; 
it detects it, brings it into active existence, and causes an aggra- 
vation of it. Thus congestion of the womb, chronic inflamma- 
tion of the ovary, etc., existing at the change, become excessive. 
Disease has little tendency to leave or become inactive or quies- 
cent during the change. 

The critical nature of a period is shown by its effects on the 
health in ensuing years. Thus puberty is not only a crisis of 
most of the complaints of the preceding years, but it determines 
the health of the subsequent thirty-two years, for good or evil. 
In like manner, the change of life, if it can be consummated in a 
salutary manner, will influence the succeeding period ; nay, it will 
govern the whole subsequent period of life. So we can prognos- 
ticate, from the manner of the crisis, whether the after-life shall 
be good or bad. Five years after a woman ceases tells its own 
tale in the great additional strength of constitution. The greater 
sanative change, the greater longevity of woman after the period, 
her less liability to disease and death, her very remarkable good 
health, and almost total immunity from the general run of 
ailments render her last stage of existence a comfort and a 
blessing. 

From forty to fifty-five is a general period of invigoration for 
both sexes — a period in which the daily work of nutrition is very 
actively carried on in our bodies, rendering them stronger, more 
vital, healthier, and thereby insuring a more perfect performance 
of all the functions. The change in man is carried on insensibly, 
and worked out without disturbance. In woman the passage is 
often full of danger, if natural laws have been violated; but the 

13 



ig^ DISEASE GERMS. 

very great improv^ement that follows the change is so salutary 
as to compensate for all the suffering. 

Although the phenomena of change of life are principally due 
to withering of the ovaries and suspension of their functions, it is 
aided by and associated with other structural changes, which 
take place in both sexes, due to coming age, such as the ossifica- 
tion of the cranial bones ; atrophy of spleen, and lymphatics ; 
changes in bone, marrow ; degeneration of some form ; a smooth- 
ing down of Peyer's patches in the bowels, and some shrinkage 
of the brain proper. But after cessation a woman's constitution 
is entirely remodelled ; she takes a new lease of life ; decay and 
suffering have then less hold on her, and she begins life anew. 
The importance of the change cannot be too highly rated, espe- 
cially if easily passed; for if it is accomplished without much dis- 
turbance, so will the future period be healthy ; but if gone 
through with great suffering, then we may expect the subsequent 
time to be one of long-continued misery. It is a final settlement 
for good or evil, and it may be reasonably entertained that if it 
does not excite the activity of some disease-germ in the body 
which previously existed there in a quiescent state, and the vio- 
lence of the change be not excessive, it is reasonable to conclude 
from thousands of pre-existing cases that the rest of life will be 
passed in uninterrupted good health, and unusual longevity 
attained. The invigoration of the health which follows is often 
accompanied with a great improvement in personal appearance — 
where the thin and emaciated become fat and comely, where the 
timid become bold and daring ; while another class become mas- 
culine, and lose their feminine appearance ; their cheek bones 
project, the skin loses its velvety feel, creases show themselves, 
and stray hairs start on the upper lip or face. 

The effects of a suspension of ovarian action has a marked in- 
fluence on all the emotions, desires, affections, passions, as well as 
on the brain proper, giving rise to debility, prostration, nervous 
irritability and confusion. 

Puberty and change of life are caused by physiological and 
anatomical changes in the same organs : puberty is ovarian evo- 
lution ; the change of life, involution or stoppage. The true seat 
of both is in the reproductive centre in the brain ; the one growth, 
the other death to that special centre; the ovaries being merely 
the organs to perform the work. 

When, with proper age and perfect blood development, this co- 
ordinating reproductive centre in the brain matures (puberty) the 
seed or egg organs, the ovaries, increase in size, become v^ery vas- 
cular, and begin to let fall ovula or eggs every twenty- eight days, 
and cause in modern civilized women menstruation. When the 



BACTERICIDES. 



195 



reproductive centre in the brain dries up, which it usually does 
after thirty-two years of activity, the change has come ; the ovary 
or egg-bed, which, during the active period was smooth and tur- 
gid, becomes dried up, shrunken into a knot like a peach-stone, 
and it becomes difficult to trace the cavities of the Graafian vesi- 
cles, for their walls are pressed together. A few years later they 
shrink ; wither still more ; become atrophied, so much as to be 
no larger than a bean, and latterly completely obliterated, being 
marked by fibro-cellular tissue. This ovarian atrophy, or shrink- 
age, or wasting, or withering, comes from a want of germinal 
influence from the brain ; there being no use for the organs, they 
wither and die. This change is accompanied with corresponding 
changes in the fallopian tubes, determined by the same cause; 
these tubes contract, wither, become impervious and perfectly 
obliterated. The same condition of non-use, want of stimulus, 
or enfeebling energy causes the womb to contract, become small, 
round like an orange ; its neck becomes thinner, and shorter, and 
obliterated, and in some cases an obliteration of its mouth takes 
place. The vagina becomes very narrow, short, and there is a 
shrivelling up of the pampiniform plexus of vessels which pre- 
viously supplied the organs with blood, which accounts for the 
remarkable coldness of the parts. Incidental to this general col- 
lapse, the broad ligaments that retain the womb in its position 
also shrink and disappear. The breasts, which are a part of the 
reproductive system, also become cold, small and wasted. During 
the change they are often seriously affected, being painful and 
congested, if not otherwise diseased. It would be a matter of 
infinite surprise how so many phenomena of health and symp- 
toms of disease could be determined by two little bodies whose 
structure does not appear complicated, but the fact is unquestiona- 
ble that not the bodies, but the brain, is the source or seat of 
change. The ovaries are energized by that nervous centre of 
sexual power located in the spinal cord, opposite the fourth lum- 
bar vertebrae, and supplied from the cerebral centre ; but although 
a central act in the brain through the cord, there can be no per- 
fect exercise of sexual power without well formed and healthy 
ovaries. The ovaries influence all parts of the body (directly the 
cord and brain) through the medium of their nerves, for as they 
have both ganglionic and cerebro-spinal nerves, they can react 
on both the ganglionic nerves and their centres, and the cerebro- 
spinal and their central organs. 

Whether the ganglionic be an independent system of nerves, 
or an offshoot of the cerebro-spinal nervous system, it is not 
necessary here to discuss. All are agreed that vaso-motor nerves 
follow every capillary to their minutest ramification and govern 



196 



DISEASE GERMS. 



the nutrition of every part of the body. All organs of nutritive 
Hfe are supplied with ganglia and a plexus of ganglionic nerves ; 
but they all communicate together, and with a larger plexus and 
more voluminous ganglia, situated in the viscera of the abdomen. 
And before those foci of nervous matter were discovered, this 
region, that is the ganglia on the bowels, liver, spleen, bladder, 
kidney and reproductive organs, was called the lever of forces by 
which the body is moved. Sensation and motion are dependent 
on the cerebro-spinal nerves, nutrition on the ganglionic ; but 
there is a concentration of ganglionic nervous power in the cen- 
tral ganglia which gives and receives from each viscus a variable 
impetus. The ganglionic is a centre of nerve force, capable of 
controlling and disturbing the various parts of the body by its 
nervous fluid or soul. 

The human body is so constructed that the various component 
organs act upon each other in the way most conducive to health, 
until the age of puberty. At that time health may fail and the 
whole system languish, unless the reproductive organs come into 
full activity. From puberty to the change of life, the health of 
woman cannot be maintained without an energizing influence 
from the reproductive centre in brain and cord, so as to impart an 
appropriate amount of ovarian influence. If the ovarian energy 
reacts under proper nerve stimulus in a healthy way, it will aug- 
ment, vitalize, energize the visceral centre, or brain, and cause 
the function of nutrition to be performed with increased energy ; 
give vigor, instinctive consciousness of strength. If the ovarian 
energy be insufficient, the abdominal brain, the visceral centre of 
ganglionic action, is half or partially paralyzed, and uneasy sensa- 
tions are felt at the pit of the stomach, a feeling of sinking, of 
faintness, goneness, or even actual fainting is sometimes induced ; 
defective nutrition follows, with anaemia of the cord and brain, 
vulgarly termed hysteria, met with at puberty, during preg- 
nancy, lactation and change of life. If the brain does not furnish 
the necessary amount of ovarian stimulus, so that evolution is in- 
efficient, the menses will come on in an irregular way, off and 
on and likely scanty ; if it be too strong, as under emotion, pas- 
sion, it will react upon the adjacent viscera and cause violent dis- 
turbance. 

All the organs in the chest and abdomen are, on their front 
part, covered over with the cervical sympathetic, similarly en- 
dowed wath ganglia or little brains. They are knit together by a 
mysterious net-work of nerves ; they sympathize with each other 
at puberty, menstrual period and change of life, and in this way 
any disturbance of the ovaries, irrespective of reflex states, will 
give rise to nausea, sickness, depraved appetite and deranged 



BACTERICIDES. 



197 



bowels and kidneys. If the ovarian stimulus be too great for the 
allied abdominal organs, there may be pain in the ovaries them- 
selves ; pain, disturbing sensations, irritation which may be trans- 
mitted to a weakened cord and bulb, then hysteria, tetanus, nervous 
irritability, restlessness, hysterical convulsions, or there may be a 
numbness in skin and other parts. 

The strength or relative weakness of the nervous system may 
be inferred from the condition of anaemia of brain and cord that 
is present. The solar ganglia in both sexes form an important 
centre of nerve force. Insufficient ovarian influence having 
reached the solar plexus affects the brain chiefly by means of the 
pneumogastric nerve, so any disturbing influence at puberty, preg- 
nancy, parturition, change of life, may be shown by the distress- 
ing headaches, fretfulness, peevishness, irritability, capriciousness, 
perversion of the moral nature, moral insanity. In other cases, 
excessive or disturbed ovarian action is manifest by high spirits, 
or depression, a cloud or a weight on the mental faculties, hazi- 
ness of mind, brain muddled, memory faithless and an unquenchable 
desire to sleep during the day, remaining awake all night, almost 
amounting to coma, or lethargy. 

From puberty to the change, healthy women, when not preg- 
nant or nursing, drop ovules every twenty-eight days, and, as a 
rule, modern civilized women lose about four ounces of blood. 
But there are women in perfect health, who live according to 
nature's laws, eat healthy food, avoid modern literature as a 
destructive ovarian poison, that have perfect ovulation, are easily 
impregnated, and whose womb does not bleed on the shedding of 
the Qgg in the ovary and dropping within its cavity. Those 
women enjoy the highest possible standard of health. Indian 
women, in their aboriginal state, seldom lose blood at the monthly 
period ; nothing but a white, glairy discharge. 

Sexual involution has an ill-defined beginning and end, and 
only one fixed date, cessation. The activity of the menstrual 
period is usually thirty-two years, between fourteen and forty- 
six ; but there are cases, once in a while met with, where the' men- 
ses stop as early as twenty-one, twenty-eight, thirty-five, and at 
all periods up to sixty-one. The average, however, is forty-six 
in healthy women, and more cease to menstruate at forty-five 
than any other period in life. It depends greatly on accidental 
conditions of life. Blows on the head or back, frights, and other 
nervous states may prevent its appearance, and arrest it at any 
time, either when the discharge is on or off, and if the shock is 
grave, forever. Its continuance depends greatly on the state of 
the health, the richness and purity of the blood, the freedom 
from worry, struggle, shocks, jars, and uterine and nervous 



igS DISEASE GERMS. 

disease ; but taking all these into account, the average among 
our ladies is forty-six. Races, being essentially distinct, have 
each their pecuharities in menstruation. It is said that the Hin- 
doo women run from twelve to sixty, when free from disease ; 
and the Laplanders and other races have different peculiarities 
and eccentricities. 

Ovulation and menstruation stand together, very nearly as 
cause and effect. Periodicity is an element in woman's nature. 
Vaginal blood, even if it occurs with periodicity, when late in 
life may not be menstrual, but may come from congestion, ulcera- 
tion at the neck, polypi, and other morbid states. Still there are^ 
as we know, rare cases of cessation at sixty-two, or later, in 
strong constitutions ; so it is well to be guarded. Cases at sixty 
and seventy menstruating are mostly due to some disease. Out 
of one-half million women who become mothers from under 
twenty to above fifty, seven thousand bore children from forty- 
five to fifty years of age, and one hundred and sixty-seven were 
mothers after they passed their fiftieth year. Cases of menstrua- 
tion admit of great variation. Isolated cases are met with at six; 
more numerous at eight to eleven. Still there are a greater 
number late, from eighteen to twenty-two ; while the general 
average does not vary from fourteen to forty-six. 

The Irish, at home in their salubrious atmosphere, with a fish 
diet, are remarkable for their fecundity. Their nervous systems 
and their ovaries are endowed with wonderful activity. The 
fish-eating and oat-meal-consuming races, as the Scotch, Swedes^ 
Danes, Canadians, have strong procreative powers, and reproduce 
themselves speedily. 

Ovarian activity, then, is commensurate with constitutional 
vigor. An unusual prolongation of ovarian life and longevity 
indicates a healthy condition of the functions of vegetative life,, 
and when prolonged, it implies great vigor, strength, and endu- 
rance, and means a good old age. 

During the wear and tear, struggles, hopes, cares, sorrows, 
vicissitudes of life, the ovaries are often simply paralyzed, and 
their action suspended ; when the difficulty is removed their 
function will be resumed. Visceral disease has the same effect ; 
when the disease is cured, and better health brought about, their 
activity is restored. There may be a stoppage for a long time,, 
and then a recurrence. 

A woman past the age of fifty-three may be regarded beyond 
the age of child-bearing, except in very rare and exceptional 
cases. Pregnancy late in life is often mistaken for other diseases ; 
and late labor is dangerous to the mother ; indeed, it may be 
regarded as an extraordinary risk. 



BACTERICIDES. 



199 



Cessation is often delayed by morbid blood and affections of 
the womb and nerves, ulceration of the os. We will again repeat 
that there may be uterine bleeding without menstruation. It 
should not be called menstrual unless it occurs between fourteen 
and 'forty-six ; comes periodically, or with periodical paroxysms, 
and the blood has the characteristics subsequently described. 
On the approach of a fever, or pneumonia, or intense worry, or 
excitement, the womb of an elderly lady may bleed. 

Early cessation is very common, and consists in a premature 
paralysis of the ovaries ; and this extinguishment of the repro- 
ductive force m.ay be caused by hard work, worry; miscarriage, 
or induced abortions, falls on back, cold, fright, wet, purging, 
cholera, fever, long trouble, drugs, occupations — all paralyzing 
influences. It is called early any time before forty-six, whether 
it be at twenty-one, twenty-eight, thirty-five, or forty-two. This 
condition runs in families ; mothers and daughters resemble 
each other in this special department only. Women of the same 
family usually begin to menstruate at the same date ; have the 
same kind of trouble, same eccentricities, same complications ; 
cease at the same time, with the same peculiarities ; and even die 
under the same conditions. In this alone they resemble the 
mother; in their mental characteristics and conformation, they 
are specially the same as the father. 

Prostitution has a fearfully deteriorating influence on both 
brain and ovaries, and causes a loss of reproductive power. The 
vagina of a woman whose sexual act is loose and varied is cold ; 
it has lost its vital vigor and contractility ; it has no vivifying 
influence on the male. Its mucous membrane is purple or livid ; 
it has none of the cherry redness of the virgin, and it is even in 
a more dilapidated condition than that of the woman after the 
change. As a consequence, if they live over the three years 
allotted to their abnormal existence, they change, irrespective of 
age. Even the conditions of life have a modifying influence 
on menstruation and change ; the former comes on late in the 
poor and ceases early ; whereas in the rich, it is early and holds 
on longer. 

Menstruation usually takes place about the period of full moon 
in about two-thirds of all cases ; the other one-third, in the 
middle of the month. In spite of this disparity, there can be no 
doubt but that ovulation is regular, inevitable, uninterrupted ; 
but the menstrual function shifts, owing to some special attribute 
of the nervous system, and this fact shows that it is governed by 
nervous influence, and explains how strong emotion may repel or 
alter the time of its appearance. 

Menstruation is the effect of ovarian action, the shedding of an 



200 



DISEASE GERMS. 



ovule; but the menstrual flow, or a discharge of blood can occur 
without ovulation, just as ovulation may occur without menstru- 
tion. Nervous emotion, over-exertion, reading sexually exciting 
literature, passion, hearing disagreeable news, fatigue, quarrel, 
and jars, will bring on menstruation in some ladies without an 
ovule being shed. That sudden passion should cause the uterine 
surface to perspire blood is a well-known effect. 

Taking all the facts into consideration, it is more than prob- 
able that the recurring monthly discharge in the human female 
is a secretion, or rather excretion, from the lining membrane ot 
the uterus and fallopian tubes, without degenerative change 
other than that commonly associated with augmented functional 
activity, and comparable with that occurring in any other organ 
of the body under similar circumstances. 

The average duration of the menstrual function is thirty-two 
years, which is the possible duration of female fecundity, and 
that of each successive generation. The mode of stoppage in 
the largest percentage of women is by gradual diminution of the 
flow ; by a sudden stoppage of the usual flow, or by a flooding 
or successive floodings, or by alternate copious or scanty flow, 
or at irregular intervals longer or shorter than twenty-one days. 
The greatest number exhibit a diminution, a gradual decrease in 
quantity, and also in the time of its duration ; the other class, 
where it is erratic and the duration irregular; the next class, 
where there is flooding, the flow growing less and less, and at 
long intervals apart, till it becomes a mere show. The discharge, 
at first like blood, becomes blacker and blacker, clotty, then like 
cinder-dust or dirty-green water; in other cases like a lochial 
discharge, in smell. The menses, in health, are not to be re- 
garded as pure blood ; there are certain chemical elements in 
them induced by the brain, ovarian act, the presence of the ovule, 
that renders this blood totally different from the blood circulat- 
ing through the lady's body ; so much so if it is absorbed, owing 
to sudden suppression, it will not mix, but is thrown off at some 
weak point in the skin, lungs, nose, bowels ; it is sweet, not salt- 
ish like pure blood, but prior to and during the change it is still 
further altered in quality, whether it be scanty or profuse, at first 
paler in color, or later, brown or simply green water. As a rule 
ovarian influence begins to fail before menstruation becomes ir- 
regular, because when the sexual organs are healthy their loss of 
power is gradual, the ovarian forces become feebler and feebler 
until they can no longer determine any influence over the uterus, 
and the discharge subsides. 

The Period Before and After Stoppage. — The date of the last 
regular menstruation is to be taken, and the time calculated dur- 



BACTERICIDES. 201 

ing which the flow became irregular, scanty and the health unset- 
tled. The length of the premonitory stage of irregularity, off 
-and on, varies from a few months to six or seven years ; the aver- 
age time being two years and a half before, and two years and a 
half after. This divides it into two periods of pretty nearly equal 
length ; the period before, with its varied symptoms, is followed 
by a period after, in which every twenty-eight days there are sen- 
sations of a peculiar kind, which continue along growing less and 
less. These monthly occurrences are very varied, embracing 
lumbar and abdominal pain, leucorrhcea, headache, diarrhea, 
bleeding piles, hysteria, asthma, debility, sweats, dyspepsia, stoma- 
titis, swollen gums, legs ; usually lasting four or five days. 

When all is over, the perfect recovery of health, and its re-set- 
tlement on a new plan takes two or three years, after which women 
are not liable to debility, floodings, sweats, heats and other un- 
pleasant symptoms of the change. 

Diseases, with which a woman may be accidentally affected at 
the change, may bar the progress of involution, and protract it 
indefinitely. Fibroid infiltrations in the uterus have been known 
to delay the change for many years. The ovaries may be shriv- 
elled and shrunk ; reduced to an amorphous mass of fibrous 
tissue, while the womb is still large, and bleeds promptly every 
twenty-eight days. These events are of vital importance, espe- 
pecially when disease -germs have been lurking in the system for 
years, as it brings them into active existence. 

The great quicksands and precipices which a woman should 
avoid during ovarian activity are sexual excesses ; the use of 
drugs ; abortions, or miscarriages ; and our modern demoralizing 
literature ; these, if indulged in, shipwreck her existence at the 
change. 

The removal of the ovaries during the thirty-two years of ac- 
tivity, induces an artificial, but genuine change. This proceeding 
is sometimes necessary ; this castration of the ovaries is performed 
when menstruation causes very serious and grave disturbance of 
the nervous system, as mania, epilepsy, or when they are affected 
by disease, as interstitial fibroid infiltrations, or tumor, that give 
rise to flooding, or other very fatal condition. Castration is a 
grave proceeding ; dangerous to life, by inducing peritonitis, and 
forever renders sterile the woman, and never should be done 
without the consent of the patient and her friends, and after con- 
sultation with several other physicians. 

The question is frequently asked, " Is fecundity possible during 
the change of life ?" Yes, if there are properly matured eggs 
<evolved ; but after the forty-sixth year the chances of fecundity 
diminishes, becoming less and less every year; but it is possible 



202 DISEASE GERMS. 

just SO long as eggs mature and the menstrual flow appears, how- 
ever irregular the latter may be ; cases have occurred under my 
own observation. 

Is fecundity possible after cessation ? Most assuredly, no. If 
the ovaries have ceased to evolve eggs, if they are withered and 
wasted, shrivelled up and inert, the woman is as barren as a stone. 
We have already stated that evolution is not indispensable to 
menstruation ; that with very high vital force, ladies may pass 
eggs or shed ovules without discharging blood, and become 
pregnant without ever having the menses. Healthy women never 
menstruate either during pregnancy or nursing, but there are 
many nowadays who do. Conception has taken place before 
menstruation, so it is only possible when the ovaries and brain 
are healthy, and when ovules are thrown off, irrespective of the 
numerous eccentricities of the generative function. 

There is a perfect remodelling of the system at the change of 
Hfe. For thirty- two years, every twenty-eight days it has been 
habitual for a healthy, unmarried woman to lose an ovum, and 
with it four ounces of blood, so that when the great crisis in life, 
the change comes, there will be numerous efforts on the part of 
nature to get up various contrivances, compensating discharges 
and drains, which act as waste-gates, until health is restored or 
permanently re-established on a new basis. Those compensating 
agencies are varied and numerous, and embrace the various 
natural outlets, as the skin, lungs, urine, stool, hemorrhages and 
obesity. 

Women at and after the change exhale a much larger quan- 
tity of carbon than before ; their urine is loaded with brain waste 
in the form of phosphates and chlorides, which indicates a great 
revolution in the nerve centres ; the lithates are abundant also, 
which shows that nitrogenized elements are undergoing chemical 
change. The secretion from the skin is very great ; there is 
great heat, intense radiation, exhalation, evaporation, dry flushes ; 
so much so that the caloric of the elements of chemical change 
bursts in flushes from the face, neck, chest and other parts of the 
body. The pulse is not accelerated, nevertheless the generation 
of heat is indescribable ; the patient requiring little clothing, and 
during the intense cold of winter will have doors and windows 
open. Those heats are independent of another class, namely, the 
heats and colds of nervous depression. The heats or flushes oi 
the change are like hot waves, frequently wafted from the surface 
of the body eight or more times per hour, decreasing after the 
change has taken place, and disappearing in two or three years. 
It is rare for them to continue long, unless the patient is subject 
to worry or some form of nervous irritation. The face, neck. 



BACTERICIDES. 203. 

breast, hands, feet, nails, feel like fire. Florid, sanguine women 
have a greater power of generating heat than the thin and 
nervous ; in the sanguine temperament there is greater buoyancy, 
more hopefulness ; molecular change is greater than in the dark 
or bilious ; there is less resistarce to change ; consequently the 
heat generated is greater, and they suffer terribly from a variety 
of conditions from which a woman with black hair and eyes is al- 
most exempt. Sweats, copious and persistent, are also present. 
Vicarious discharges are very common if there be weakened 
patches anywhere, as bloody discharges from the nose, mouth,, 
lungs, skin, etc., if these parts are feeble. 

The effect of the change on all women is to cause a perfect 
remodelling of their physical and mental traits : the lean become 
stout ; they experience a great improvernent in health. The 
robust or fat do not fight the battle of the change so well ; they 
cannot convert their superabundant blood to other uses rapidly 
enough ; they drag along very slowly ; are more liable to hemor- 
rhages. The breasts in all atrophy, but if women gain flesh 
or get stout, they usually become quite heavily loaded with fat 
and become pendulous. Once the change is consummated there 
is often a grand remodelling of the intellectual faculties, and it is 
satisfactory to know that the highest grade of intellectual cul- 
ture, the most profound studies, can now do no harm ; so it is at 
this period of life only that woman should engage in literary and 
scientific pursuits. 

Its Cause and Treatment. — Before considering 

Change this subject in a practical light, it is necessary 

of Life. to have a proper knowledge of the generative 
organs of woman : they must be looked at in 
an anatomical, physiological and pathological condition as 
the great motive power, the potential lever of the world. 
It is the nervous system of the female reproductive organs that 
specially solicits our attention, as it is there, in its deep abyss,, 
in its incomprehensible structure of animated tissue^ that the 
ovum or ^^^ is evolved, before any microscope can detect its 
organization. 

In another part of this work, we divided the nervous system 
into three parts, although essentially one, a unit — the brain proper ; 
the cerebellum and spinal cord, with the reflex centre, the medulla 
oblongata ; and the great sympathetic or ganglionic nerve centre 
in the chest and abdomen ; those three points, essentially one, 
work for each other; any damage done to the one injures the 
other two. The three persons in this trinity are co-equal, but 
as the uterus, ovaries, etc., are covered on their front part with 
the sympathetic or ganglionic nerves, we speak of it more 



204 DISEASE GERMS. 

frequently, and as it is the potent instrument of life, a wondrous 
power, the citadel of the soul, we may have to recur to it again 
and again. 

Definition. — Change of life may be defined to be that state in 
which the brain and cord fail to impart the necessary stimulus to 
the ovary, so as to enable it to secrete ova. It is a change, a 
crisis, a critical period, a failure to elaborate ova, and cessation 
of the menses. 

Causes. — Although there is but one cause — a failure of the 
ovaries to shed ovules — still to be more explicit, we will arrange 
the causes into exciting and real. It is to be understood that it 
is just as natural for a healthy woman to shed ovules every 
twenty-eight days for thirty-two years, as for a tree to bear fruit. 
The exciting causes that bring about a sudden or early change 
may be any disturbance of the abdominal brain, as violent 
emotions, intense or unhealthy desires, grovelling affections, 
degrading passions ; hence, fright, grief, worry, struggle, emo- 
tional or sensational reading, masturbation, promiscuous sexual 
intercourse, predispose to a change. Deleterious trades, or 
occupations, in drug or chemical laboratories are productive of 
ovarian change. The use of such drugs as bromide of potass, 
belladonna, ergot, opium, chloral, mercury, iodide potass, all acro- 
narcotics, will in time produce effects analogous to castration — 
dry, wither, choke the springs of life. Blows on the head or 
back, poor or diseased blood, disease-germs of typhoid, of syphilis, 
cancer, tuberculae, etc., are exciting causes. 

The true exciting cause is when the brain and cord fail to 
send the stimulus to the ovaries, and as a result they are sterile, 
barren ; then, as there is no further use for the organs, they 
shrivel up, waste, and disappear. The uterus also becomes inert, 
its normal waves are gone, even the source of their nutrition ; 
their special plexus of vessels, not being needed, wither and be- 
come obliterated. 

Symptoms. — In enumerating the symptoms, it is not our pur- 
pose to describe the changes that take place in the skin and 
bones, the vertical wrinkles and hair on the lip, or stray hairs ; 
nor the atrophy of the ovaries ; the changes of the womb, the 
obliteration of its neck and vessels ; nor other changes. What 
we are desirous of doing more especially is to describe a train 
of symptoms, several of which are present in every case, and 
imperatively demand medical assistance. We shall begin with 
those of most frequent occurrence. We have already stated that 
there are at all times three millions of women between forty-five 
and fifty years of age, in the United States, undergoing the change 
of life. Now, it is fair to presume that one-half have lived in a 



BACTERICIDES. 



205 



natural way, in conformity to natural laws, and pass over the 
change so easily as to seldom require any medical aid. The 
other half are those that suffer from one or more of the following: 
symptoms : 

Nervous Debility, with great languor and lassitude, is present 
in every case to a greater or less degree. It begins with the first 
indication of a change, grows worse and worse till final cessation ; 
when that takes place it grows less and less till health is re- 
established. This is an essential symptom of the critical period^ 
and usually begins to affect most women about forty. Some of 
the phases of nervous debility may be due to the ordinary wear 
and tear of life, and are common to both sexes ; but at or about 
the change they form a special group by themselves, occurring^ 
with greater or less aggravation in different ladies, variable in 
each individual, never two alike, and most marked about three 
years before the complete stoppage, and continuing three years 
after the change has been completed and a new basis of life 
established. 

Nervous depression, debility, weakness, or some form of nerve 
tire or trouble, is present in all cases. It is a marked character- 
istic symptom either in the brain, cerebro-spinal system, or 
ganglionic. The nerve prostration never slackens its pace, but 
persists till the change is accomplished, simply modified by 
location of weakness. It is a perfect revolution ; when the stop- 
page or dropping of eggs ceases every organ supplied with the 
sympathetic is affected ; the spleen, kidneys, liver, larynx, face, 
bowels, womb. The three brains have worked harmoniously for 
thirty-two years, and now there is a disturbance. This disturbing 
influence generally shows itself in a diminution of the flow ; in a 
weariness, a torpor, a lethargy, headaches, and an indescribable 
feeling of goneness ; the brain and cord fail to give an adequate 
stimulus to the ovaries, and energy is impaired ; the ovarian loss 
itself gives rise to mild or severe nervous disturbance. If there 
be disease of the sexual organs the symptoms of ovarian dis- 
turbance will be more severe, and prolonged beyond their 
natural termination. If there be something in the nervous system 
eccentric, the reaction on the ovaries may be analogous to shock 
or paralysis. 

We cannot be surprised at the immense train of nervous 
symptoms so common at the change, when we reflect on the great 
volume of brain concerned in the evolution of the eggs, and its 
complicated and artistic structure, rich in gray or intellectual 
matter; and when we turn to the visceral brain, — the ganglionic 
nervous system, — that incomprehensible seat of life, of vital force,, 
of good and evil, located, centralized, and congregated into little 



2o6 DISEASE GERMS. 

lumps of nervous matter, bound together by tangled skeins of 
nerves, reflected over the viscera, not only the seat of power, but 
guides nutrition, healthy and morbid, and controls the action of 
iblood-vessels, heart, and lungs. 

The third brain, the ganglionic system, and great sympathetic, 
is an offshoot from the cerebro-spinal at the junction of the last 
cervical with the first dorsal. The ganglia are scattered every- 
where over the viscera, uterus, ovaries, and contain every kind of 
nerve matter, but are extremely rich in gray or sentient cells. 
These ganglia must be considered as little brains, each having its 
own range of power ; being very sensitive, through them the 
brain becomes cognizant of ganglionic impressions. The ganglia 
serve for a storage of power, of vital force — a source of energy 
for the sympathetic ; the fountain from which ganglionic nerves 
draw their supply ; by the currents of which the capillaries and 
nutrition is maintained. 

The centralization of vital force in the solar plexus and sym- 
pathetic renders the abdominal brain of immense importance at 
the change of life. To show its intrinsic value and its intensi- 
fication of power, a blow on the stomach will cause instant death, 
and yet leave no lesion or mark to explain the cause, not a trace. 
The ganglionic nervous system furnishes to the human frame a 
nervous influence, a reservoir of nerve-force, giving to the cerebro- 
spinal a power of which the human mind only recognizes the 
force when it fails. In the reproductive organs of v/omen, a 
prominent symptom, even in health, is occasional nerve prostra- 
tion at menstruation, or after connection, parturition, or nursing ; 
many women feel a great loss of energy. Woman cannot pass 
through any stage that communicates life without a momentary 
loss of a portion of her own vital energy. She reminds us of 
those animals that die when they have transmitted life to others. 
Nervous debility is so constant, and so intense in all women at 
the change, as to be fairly considered the primary symptom; 
and it is justly so; and her complicated mechanism readily 
explains it. Her nerve exhaustion fairly causes her to lose her 
equilibrium, and some special nervous disease is like to supervene. 

Flushes of Heat are present in about eighty cases out of one 
hundred, and slight heats and colds in the balance. This symp- 
tom is present to some extent in all cases of nervous depression, 
but the intense heat prior to, during, and subsequent to change, 
must be explained by the great chemical change going on in the 
body. The heat is due to molecular action ; and the intensity 
of the heat, as well as its quality, is due to the pathological 
conditions present, so that women at the change generate more 
caloric, because there is more change going on. In most cases 



BACTERICIDES. • 20/ 

it is a dry heat, a dry exhalation. If perspiration be present, it 
is Hkely cold or clammy. It is to be regarded as a salutary 
effort at elimination. It usually has an irregular area of dis- 
tribution, as flushes of the face, breast, body, hands, and feet, and 
if not diverted off by the safety-valve, the skin, may manifest 
itself internally in a burning in some organ. As a general rule, 
the heat starts from the solar plexus in abdomen, then the chest, 
and face ; the parts are suffused, hot, like a burning stream. 
They are not preceded with a chill unless there is great nerve- 
shock. The flushes occupy from a minute to a quarter of an 
hour or longer in duration, and are repeated six or eight times 
an hour ; usually begin three years before, and continue three 
years after cessation ; face and neck are most obnoxious to them, 
but they affect any part of the body, even the nails, which often 
feel like fire. Stout or plethoric women suffer most intensely in 
their severity as well as long duration. These heats never affect 
the pulse, which is usually slowed. These heats must never be 
confounded with blushing, which is an act of the sympathetic ; 
our w^omen still blush, even at sixty, seventy, and upwards ; and 
blushing will arouse them afresh. In blushing, heat is also 
evolved by the shock or emotion of the sympathetic. What this 
nerve does under emotion, it does also, to a certain extent, on 
the subsidence of ovarian stimulus, and aids, to an infinitesimal 
degree, in the production of heat. The heat flushes of the 
change are like tornadoes of heat, heated waves, which cause 
patient to discard some of her clothing and keep windows and 
doors open. 

Perspirations are the next symptom in the frequency of its 
occurrence. It may follow the heats, if nerve debility is very 
great, but it very frequently exists by itself It is often very 
great, amounting to twenty or thirty ounces in the twenty-four 
hours, independent of the insensible perspiration, which is in- 
creased. The skin is the most easily moved of all the safety- 
valves of the body, and is much influenced at the change of life. 
It is of great service in drawing off waste and solid elements not 
needed, and its active function is desirable. The critical nature 
of the sweats at this period is of much importance ; they are 
often heavy, saturating body-linen and bed-clothes. As a general 
rule, these perspirations do not come from the entire body, but 
are generally restricted to portions, as the brows, face, breast, 
hands, feet, and pit of stomach. Like the heats, they begin early 
and continue on to cessation, and subsequently dimimsh in 
intensity and duration, and gradually disappear. 

Leucorrlicca, or the Whites. — Next in frequency, we find this 
discharge from the vagina, beginning two or three years before 



2o8 DISEASE GERMS. 

cessation, and continuing the same length of time after. It ma>'- 
occur all the time, or at irregular intervals, or periodic monthly. 
They are so common at the monthly period at this time that the>r 
may be considered as its legacy ; especially so, when they come 
periodically. The critical nature of such discharges shows that 
they should not be stopped, although it may be proper to restrain 
them. When it occurs periodically, it usually continues several 
years after cessation. 

Hemorrhage occurs in about sixty cases out of every one 
hundred; two-thirds of all cases from the uterus ; the other third 
from nose, mouth, lungs, nipple, kidneys, rectum, pubes; skin, in 
blotches or excoriations. They are all critical, and are to be 
regarded as the harbingers of serious trouble. Flooding at the 
change, in some cases, prevents complications, and relieves 
nature, and affords time for the readjustment of the system to 
the new order of things. Successive floodings are very common 
in the robust; but may occur in any temperament as often as 
there is an overload of blood. The sanguine, with the florid 
features, are specially prone to it ; blondes more obnoxious to it 
than the dark. A continual dribbling from the womb, at the 
change, is very undermining to the strength. It does not weaken 
down so much as when occurring at the regular periods. The 
best mode of stoppage is one gradual and progressive. Flooding 
is not always to be laid down to premonitory or existing cancer 
without the pain in front and back opposite, nor to ulceration of 
neck or womb. The whole net-work of uterine nerves are con- 
fused, upset, and a fright, emotion, passion, excitement, bad news, 
a fit of sneezing, a connection, may bring on a flooding. When 
floodings occur a few months after cessation, it is dangerous, 
because the system cannot repair itself fast, and the patient 
becomes much weakened thereby. 

Next in the order of frequency of occurrence of symptoms are 
Headaches. We have no words to describe the dreadful headaches 
of the change of life. It is a frequent, and often a ruling symptom. 
The pain, and its location, is very variable ; sometimes a dull, 
heavy pain, with drowsiness ; at other times it is frontal, sharp, 
excruciating ; in other cases it is in the temple, or top of the 
head, or at the occiput ; most frequently behind. The nature of 
the pain may be described as shooting, throbbing, gnawing, 
boring, or like a nail driven in, or as if the head was in a vise. 
It varies in intensity from a mere inconvenience, to the most 
agonizing ; sufficient to prostrate the most vigorous. It is often 
accompanied with nausea, or sickness in the stomach ; in some 
cases there is vomiting. It is purely nervous, and is present in 
both plethoric and ana:mic. It may be associated with pains 



BACTERICIDES. 20O 

elsewhere. It is usually off and on, or periodic ; and in some 
cases it is a true neuralgia of the brain, with flushes, per- 
spirations, hemorrhages, etc. 

Next in succession comes Drowsiness^ Giddiness^ like being tipsy^ 
so that when she walks she likes to have something to hold by, 
or feels like a top. The drowsiness is peculiar ; sleeps all night 
unrefreshed, and falls asleep during the day ; sometimes feels 
stunned and lost for an hour, with hot pain at pit of the stomach. 
Before the change she was all life and animation; clever, 
sprightly; but now, stupid; lets things fall out of her hands, 
and falls down in attempting to pick them up. Such a condition 
is often present at puberty, and is often bad when the flow is 
scanty, painful, or absent. The tendency to sleep is great, and 
often accompanied with an uneasy sensation of weight in the 
head, a feeling as if there was a cloud or cobweb on the brain 
that required removal ; loss of memory, power of exertion ; 
heaviness of head ; dulness of intellect. This drowsiness, stupor, 
is often a precursor of insanity. Mental stupor is often present 
during pregnancy, but passes off. 

Catalepsy, Melancholia^ Nervous Stupor are due to, and caused 
by a morbid action of the ganglionic system on the brain, 
brought about by the disturbed performance of the reproduc- 
tive organs. It is a kind of spontaneous narcotism. 

Hysterical Symptoms are quite common ; but they are always 
associated with nervous debility, flushes of heat, sweats, ab- 
dominal pain, piles, or hemorrhages, such as a gush of blood 
from mouth or nose. 

Epilepsy is very common at puberty ; disappears when the 
menses are established, and is very liable to reappear at the 
change. Very frequently the attacks are periodic, corresponding 
to the flow; usually go away when the change is well over. 
Minor symptoms of epilepsy are very common, as vertigo, sensa- 
tions, or aurcB, temporary loss of speech and consciousness, 
twitching of the facial muscles. 

Aphonia^ or loss of voice at puberty, is very likely to recur at 
change, and then disappear finally ; so with stammering or stut- 
tering, fear or dread. 

Chorea is very rare at change. 

Insanity, from the best statistics, is more frequent among 
women from twenty to forty, while the reproductive organs are 
endowed with their greatest activity, than between forty and 
sixty. This latter time, when hope is fading, and physical 
strength giving out, is the period when men die insane, and when 
women are most exempt. From sixty to eighty, when the sexes 
most resemble each other, insanity affects them equally. The 

14 



2IO DISEASE GERMS. 

change of life is not prone to insanity ; the puerperal state and 
nursing more frequently give rise to it, which explains the reason 
of its prevalence between twenty and forty. 

Dcliriiuii, Mania, at puberty, may be expected at change. 

The tzuo mental states known as Melancholia and Hypochondriasis 
are very common at the change, particularly the latter, which 
may be regarded as an exaggeration of other symptoms. There 
is often blended with it haziness of intellect, self-absorplion. love 
of solitude, distrust of friends, and exaggeration of trifles. There 
is often associated with those mental states neuralgia and hys- 
teria. They are most frequently periodic, corresponding to the 
monthly flow ; at which period she becomes very gloomy, indo- 
lent ; scarcely speaks, and imagines a fancied evil is about to 
befall her. This condition generally continues for three or more 
years after the change. This symptom is a most common one, 
often well masked and hidden by the lady ; her sensitive and 
loving nature is disturbed when all is changing around her, and 
she feels cord after cord snap that anchored her to life ; and she, 
if she has sufficient strength of mind, will conceal her condition. 
The flame of vitality cannot die without forebodings of decay, and 
there may spring up doubts about faded charms, failing energy, 
changed aspect she never before harbored, whether now she may 
be able to retain the affection of husband, the sympathy of friends, 
the admiration of the world. Because the strength, the vigor, 
the vivacity of youth is gone, some women try to convince them- 
selves that they are useless, and make themselves miserable. If 
unmarried, this change tells her to put aside long-entertained 
visions of future bliss. 

Apathy and sudden change of habits ; dislike to exertion, 
mental or physical, with want of sleep ; melancholy and suicidal 
tendency. 

There is often a remarkable perversio?i of the moral nature; un- 
controllable impulses to do things which they know to be wrong; 
often ungovernable, eccentric, reckless, extravagant, and in other 
cases avaricous. 

The temper is strange, peevish, snappish, quarrelsome, invari- 
ably uneven. 

The nervous system at the change is in a state of pertur- 
bation ; there is an insatiable desire for alcoholic drinks ; a true 
dipsomania. 

An hnpidse to Deceive, — Women always surpass men in their 
stupendous powers of deception. When a man has an object to 
gain he may deceive; but he does not, like a woman, find a 
pleasure in deceiving for deception's sake. Untruthfulness is 
very common, and it is not to be wondered at, under the mental 



BACTERICIDES. 211 

perturbation present. Delirium, vertigo, distorted ideas and false 
notions are crystallized with deception. 

Kleptomania, or a desire to steal, is very common at puberty, 
during disordered menstruation, pregnancy, puerperal conditions, 
and at the change. It is most unaccountable, this impulse to 
steal, at all risks, at the critical period. 

Homicidal Mania. — A tendency to kill is a lamentable conse- 
quence of the change. 

Suicidal Mania is common at puberty, and recurs at the critical 
period ; less common in women than in men ; one woman to 
three men being affected. In women it is associated with the 
notion that they are possessed with the devil. 

Eromania, or inordinate desire for sexual gratification, is sug- 
gested, promoted, and intensified by morbid ovarian influences, 
uterine affections, and brain irritation. Woman, at the change, 
is an irresponsible being, being afflicted with some form of in- 
sanity ; the disturbance of the abdominal brain reacts upon the 
brain proper. 

Apoplexy, Paralysis, in all their forms, are common at this 
period. In apoplexy, there is the vertigo, the specks and spots 
before the eyes, the noises in the ears, the choking. In paraly- 
sis, the numbness, the feeling of pins and needles, the loss of sen- 
sation and motion, coming and going in a part, or the whole of 
the body. 

Nearly all women suffer from iieuralgia, as well as paralytic 
symptoms, most common about the small of the back ; lumbago 
in the abdomen all the time, or it may be simply monthly ; 
ovarian pain, colic, numbness, paralysis, sciatica; numbness in 
the hands, arms, feet and other parts ; neuralgia of the face, loss 
of voice, deafness, toothache. Nearly every woman, at the 
change, suffers from one or more of the above symptoms, and 
an endless variety not enumerated. 

The pains in the back, or loins, and legs, are the most common, 
and are generally described as radiating from the back, and an 
aching, numbing, gnawing, dragging, burning, or grinding. Often 
a sensation as if the back was broken through entirely. These 
backaches are often associated with pain in the ovary, or abdom- 
inal neuralgia ; numbness ; pricking sensation in feet and hands ; 
loss of power of parts are common ; burning sensations, with 
numbness in arms, back, and temporary loss of power; neuralgia 
of the eyes. 

There is a whole host of affections that attack the reproductive 
organs at the change, independent of flooding and leucorrhoea. 
There is a remittent form of menstruation ; vaginitis ; follicular 
inflammation of the vulva ; inflammation of the labia ; ulceration 



212 



DISEASE GERMS. 



of the neck of the womb ; induration and enlargement of the 
womb; faUing of the womb ; uterine polypus ; cancers; tumors f 
ovarian disease; irritation of the breasts; milk, or glutinous 
secretion from the breasts ; copious phosphatic deposits in the 
urine, with often inability to hold it; bloody urine; erectile 
tumor at the mouth of the urethra; rectal trouble; piles; abscess ; 
burning in womb and rectum. There is not much disposition to 
acute inflammation, as the general condition of degeneration 
going on protects the organs. 

Itching about the vulva, or pruritus, is very common, and i^ 
due to the sugar in the urine at this period of life, and to that 
coming in contact with the parts. 

Eczema on the lips makes the life of a woman unbearable. 
Prurigo and follicular inflammation begin at the change, and 
continue, in spite of the best treatment, for several years. Herpes,, 
or tetter is another annoyance. 

The great prevalence of vaginitis is to be explained by the 
continuance of sexual intercourse. Some cases are due to morbid 
states of the blood. A failure of health, gout, and extension of 
eczema up the vagina, or acrid discharges from the womb, which 
are muco-purulent, greenish, or yellow, or slightly tinged with 
blood, and more or less offensive and contagious. Vacrinitis 
gives rise to heat; bearing-down pains ; disturbance of bladder 
and ovaries. 

The symptoms of change in the reproductive organs are 
manifold. The ovaries rule supreme over menstruation; and if 
there is any disease lying quiescent, as a nucleus of a tumor, it 
will either retard, or give increased activity to the change. From 
thirty-five to forty-four years of age, when cessation begins to 
dawn in most women, sexual desire is less intense ; the married 
have fewer children, and the unmarried think less of marriage. 
This diminution of sexual energy accounts for a great decrease 
in the number and intensity of inflammatory uterine disease. 
Many women begin the change of life with uterine disease that 
has been undetected, or imperfectly cured, and all such conditions 
are likely to be intensified or aggravated by the change. Failing 
health gives rise to an exfoliation of the glands at the neck of the 
uterus at the change, so that the neck enlarges ; becomes soft, 
baggy. The change is often suspected by disease in the womb, 
or other parts; but after the change, the uterus is not liable to 
the old diseases of its active state. Disease is rare after, and 
when it does take place, it is a residuary legacy from old times. 

The obliteration of the neck of the womb, with the altered 
shape of the womb, vaginal prolapse, falling, uterine tumors, 
fibroid, fatty, and mineral degeneration, are quite common. 



BACTERICIDES. 



213 



Women, with cancerous germs lurking in the system, are 
extremely apt to have them grow between forty and fifty; 
although cancer, between thirty anH forty, is very common. 
The influence of the change on cancer is to give it an impetus, 
a start; to give it a rate of progression. The average duration 
of cancer here is sixteen months. 

Swelling and irritation of the breasts commence at the change ; 
they swell, become painful, nipples sore, ooze out serum or milk, 
or a gelatinous fluid, or a watery, bloody discharge. Tumors 
now put in an appearance ; cancer, if the germs are present in the 
blood. When the lacteal ducts and connective tissue are disap- 
pearing, fatty or adipose tissue becomes very abundant, and there 
are apt to be lobules of that tissue thrown out. Although disease 
of the kidneys is rare at the change, still there may be bloody 
urine, continence or incontinence of urine, and chronic inflamma- 
tion of bladder. 

Two-tJiirds of allivomen, at the change, suffer from some irritation 
of the stomach, liver, bowels, as dyspeptic symptoms, toothache, 
swollen gums, vomiting of mucus, blood ; biliousness, jaundice, 
constipation, diarrhea, inflammation of rectum, and enlarged 
abdomen. 

Biliary derangement at puberty, and its recurrence at the 
change, is the most common of all the disorders of the alimentary 
tract. A very large number complain of being bilious ; bitter, 
metallic taste in mouth, with headache, nausea, and vomiting ; 
bile in urine, and jaundice. This liver-irritation gives rise to the 
burning in the rectum, and piles, which are often so troublesome. 
That piles should be a common symptom is not to be wondered 
at, when we see the unrelieved plethora of the liver at the change, 
and when we bear in mind that the liver, intestines, and repro- 
ductive organs are covered by ganglionic nerves ; that the womb 
and all the viscera are supplied by nerves from the cord ; that 
the veins of the liver, uterus, and rectum are identical and con- 
tinuous ; it is not surprising that when the uterine discharge is 
arrested, that the nervous energy and sanguineous current should 
flow by the intestinal surface, and gives us bleeding piles. The 
swollen gums, dyspepsia, diarrhea, constipation, spitting of blood 
are generally periodic. 

A permanently enlarged abdomen is very common at the 
change, and is accounted for in two ways: (i.) by the increased 
deposit of fat in the omentum and in the abdominal walls ; (2.) to 
some extent, by an enlarged, inflated state of the bowels, without 
either diarrhea or constipation being present. 

The Skill gives decided, infallible indications of the change in 
every woman ; it loses its softness, its elasticity, its fulness, and 



214 



DISEASE GERMS. 



shrinks, and becomes withered and wrinkled ; then there are the 
heats, the sweats, the local burnings in hands, feet, legs, painfully 
hot; aching in the finger-ilails, just as if they were being pried 
off, a peeling, a rotting of the nails. Besides these, there are 
various eruptions often present on the skin, as nettle-rash, ery- 
sipelas, eczema, blood-spots, tetter, prurigo ; swelling of face and 
legs, either monthly or all the time ; varicose veins ; ulcers on 
leg ; boils everywhere, but especially about the seat ; abscess in 
the fingers, armpits, neck, groin ; sensation of insects in skin are 
very common ; peculiar exhalations from the skin are not un- 
common ; chronic rheumatism and gout, enlargement of the 
heart, chronic peritonitis, dropsy, are common at the change ; 
ulcers, goitre, discharges from the ears, nose, mouth, and nip- 
ples are very often present; swollen gums^ sore mouth, saliva- 
tion, periostitis of the small bones, and other chronic affections 
more rare. 

There is a long list of other symptoms : the long-continued, 
persistent debility, with regular monthly pain in ovary or womb, 
with laughing and crying fits, and intense burnings, to which so 
little attention is paid ; the irritable rectum, with tenesmus ; 
habitual oozing of mucus, or pus, or blood, is too often not at- 
tended to. 

The most common cause of delay of change, and consequently, 
prolongation of symptoms, is to be found in congestion and en- 
largement of the body of the womb, and this uterine enlargement, 
which delays cessation, is generally the result of sexual excesses, 
or frequent abortions. This very state, irrespective of hysteria, 
may give rise to spurious pregnancy at the change. 

If the patient is free from disease, and has led a temperate life, 
the rule, " like puberty, like change," will hold good, not other- 
wise. 

The change is greatly modified by temperament, by constitu- 
tional peculiarities or eccentricities, social position ; and. these 
modify all symptoms, from the debility and heats, to the pricking 
sensations in feet, numbness of extremities, trembling of the 
limbs. Some imagine that the unmarried are more liable to 
flooding, cancer, ovarian tumors, at the change, but this is not 
true ; the single pass over this critical time with much less trouble 
than the married, and suffer less. Women of loose habits, given 
to promiscuous sexual indulgence, prostitutes, those who resort 
to abortions, suffer immensely — words are inadequate to describe 
their sufferings. Such states keep up more or less inflammation 
through life, and predispose to much trouble at .the change. 
Marrying late in life is also bad ; those sexual states maintain 
congestion of the sexual organs, and are eminently calculated to 



BACTERICIDES. 



215 



aggravate all the symptoms enumerated, as congestion and ul- 
ceration of the womb, if it exist. 

Terminations. — Change of life in woman, at whatever age it 
occurs, is a final settlement, and exercises its sanative influence on 
the rest of her life. When it is effected, her mind emerges from 
a cloud, in which it has for some years been lost. All ladies, 
while avoiding causes that would be likely to give rise to conges- 
tion of the womb, should sustain their intellectual faculties well, 
read history, train their minds to take comfort from the fact that 
the period is past, which gives them an immunity from the perils 
of child-bearing, and the tedious annoyance of monthly restraint, 
thankful to have escaped real suffering. Women should not 
torture themselves into imaginary woes, but they should feel the 
ground steadier under them; they are now less dependent on 
others, and their mental faculties assume a more vigorous and 
masculme form. 

The change of life does not bring talent, but it imparts the 
power to bring out latent faculties that have been for years in 
abeyance. The subsidence of ovarian action depresses one form 
of love, — those emotional impulses which give passion energy ; 
but at last, when the heart becomes capable of listening to reason, 
love still rules paramount in the breast of woman, and whether it 
is called charity, friendship, affection, conjugal or maternal, it is 
still there. Sound religious ideas often becoitie engrafted, and 
take a sure hold, covering the evening of life with unanticipated 
happiness. When once over, and anchored in this new haven, a 
woman looks back on the time when her health was disturbed by 
ever- recurring monthly trouble, and her mind distressed by de- 
lusion and passion. The importance to a woman of the change 
is great ; she is healthier, lives longer, less risks to life, becomes 
stronger, and enjoys a great freedom from disease. It is said that 
a woman at the change loses all her personal attractions ; but this 
is not so. The beauty of childhood appeals for a fostering care ; 
the beauty of youth fascinates ; that of mature age excites ad- 
miration ; but in most women, after the change, there is an 
autumnal majesty, so blended with amiability, that it charms all 
who approach within its magic circle. Her sphere is wider, her 
social influence greater, her field of usefulness extended, and now 
is her time for intellectual pursuits and efforts. The cultivation 
of the mind, and its endowment with scientific lore, usurp the 
place of faded charms. Now woman becomes the guide, the 
mainstay, the pillar of strength to man in the difficulties and 
struggles of life ; 'she harmonizes society, unites its discordant 
elements, and stimulates the race to great, noble, and laudable 
ambition. 



2i6 DISEASE GERMS. 

Time may dull the eye, rob the cheek of its bloom, indent far- 
rows on the brow, but it cannot smother the seraphic fire burning 
in the hearts of women, prompting them to console, . heal the 
deep and ever-festering wounds that afflict society. Those who 
have attained their sunset without havinj^ been granted the 
anxious thougrh desirable vicissitudes of wedded life, destitute of 
relatives and friends, may find in the philanthropic efforts of allevi- 
ating suffering humanity a grateful channel for their affection. 
Some women at the change are perfectly unstrung, unnerved, find 
themselves solitary and alone in the world, bereft of the sympathy 
of friends. Travel, occupation, history, religious duties capable 
of engaging her attention, should be inculcated. The continued 
friction of sound duties restores peace and harmony, prevents 
brooding, self-absorption. 

Isolation causes everything to lose its natural and real appear- 
ance and to shine with morbid tints, and should be sedulously 
avoided. 

Social Position. — The position in life exercises a special influ- 
ence at the change of life. Women who live in a natural way, 
keep regular hours, avoid reading trashy or fictitious literature, 
exercise moderately, do not tight lace, and keep their health good, 
suffer comparatively little, except it be from the flushes and minor 
symptoms. Women in moderate circumstances get along the 
best ; they are much freer from the symptoms than the spoiled 
and petulant daughters of the wealthy lords of civilization. The 
necessity for working hard, the struggle, the anxieties of poverty, 
the impossibility of escaping these, in our abnormal condition of 
society, together with insufficient food, insanitary states, increase 
the sufferings of the poor at the change. 

Certain occupations have a good or bad effect : thus, sewing- 
machine operators and washerwomen suffer most; the movement 
of the leg, in the one, keeps up ovarian irritation ; in the other, 
the changes of temperature to which they are exposed are highly 
deleterious. The close, damp, heated rooms in which mill-opera- 
tives, book-folders, catgut-workers, etc., work, increase their suf- 
ferings at the change. Hard work has its merits, it cures the 
nervous affections which assail the rich at this period of life ; for 
luxury, ease, lounging on sofas, in shut-up rooms, is the hot-bed 
of nervous affections ; there they grow in profusion and run into 
extravagant eccentricities. Few ladies are compelled to work in 
a heated atmosphere so injurious as the heated ball-rooms of the 
aristocrat. We would say to the rich and poor alike, that the 
best way to approach the change, is to get right down to a natural 
base in all things, and thus approach the critical period with a 
sound constitution. A condition of debilitv, which is the result 



BACTERICIDES. 



217 



•of all excess, prevents the regular succession of vital phenomena, 
hy v^hich the critical period is carried out ; and as the change is 
marked by debility, when this is grafted on constitutional weak- 
ness, loss of power, ill health will be of long continuance with a 
train of nervous disorders. With those states of urgent debility 
present, there is not stamina enough left to carry them through 
the changes successfully. All constitutional affections, all forms 
of diseased blood, are increased by the change. 

Prognosis. — Menstruation is a useful guide for the changes ; as 
it is ushered in, so the change ; storms at puberty will realize a 
stormy change. Diseases that preceded menstruation are likely 
to attend the change. Skin affections, as eruptions of all kinds ; 
hysteria, epilepsy, bleeding at nose, discharges from the ear, boils, 
diarrhea; erratic pains before puberty, same condition before 
change ; faintings, want of strength, precede the succession of 
vital phenomena and are likely to re-appear. 

Puberty does not always bring health ; there may be a lack of 
development, which may produce conditions that incapacitate 
for exertion; her mental faculties may be lost in dreamy forget- 
fulness ; nervous irritability may give rise to fretfulness of temper, 
waywardness of disposition, mischievousness. The conduct of 
some girls at puberty ofcen betrays a dereliction of all principle. 
There may be some jar or want of harmony between the action 
of the reproductive organs and the nervous system, so that the 
flow may come on on the fifteenth or twenty-first, instead of the 
twenty-eighth; same troubles at change. 

Sisters are a fac-simile of each other as a rule ; observe the 
same date, have the same peculiarities, same crisis, same com- 
plaints ; as biliousness, headaches, mental condition, everything 
the same at puberty; same at change. 

The plethoric and sanguine suffer most; very much more than 
the bihous and nervous, and chiefly from flooding and heats, and 
have a hard road to travel. A girl at ten, without any sign of 
cerebral or gastric disease, may manifest either a sleeplessness, or 
drowsiness, the result of the premature action of the ovaries on 
"the nervous system ; the precocity of the ovaries are very pro- 
ductive of nerve affections several years before menstruation takes 
place. Great irregularities and suffering at any period are warn- 
ing symptoms of a change at any age. If the ovaries work well 
and smoothly at puberty, and the patient lives naturally, follows 
physiological laws, the change will be unembarrassing, irre- 
spective of age. It must ever be borne in mind that it is only 
the minority of women who suffer those innumerable difficulties 
and obstacles at the change; the large proportion pass the ordeal 
with little or no suffering. Well-regulated habits, healthy ex- 



2i8 - DISEASE GERMS. 

ercise, good moral and religious surroundings, and avoidance of 
tight lacing, of balls, late hours, unhealthy society and literature. 
Women, from want of instruction suffer much ; they are ignorant 
of what should occur, or form exaggerated notions of the perils 
that await them, and receive no help from their medical attendant,, 
because he is ignorant of their suffering. 

Let it, therefore, be clearly understood, that, if in tolerable 
health, and with ordinary care, they have only blessings to 
expect from the change of life. We say that the critical period 
is very dangerous to the tight-lacer, the dime novel reader, to 
the ailing, to the dancer, to the lazy, to the habitual sufferer at 
the menstrual period, to those suffering from uteriae disease, to 
epicures, for ices, improper food, sitting on door-steps, sewing- 
machine operators, and sexual excesses. Very great difficulties 
are likely to arise from marriages at the change, especially if for 
the first time. Such a state at the change causes the womb to 
become congested, and it increases in size four or five times. If" 
marriage is desirable, postpone it, hold it off till after the change 
has been consummated. 

Diagnosis. — Have we the means of foretelling the change, and 
recognizing it when completed ? Assuredly we have. The change 
can be predicted after forty, if there is a gradual diminution m 
the quantity of the menstrual flow, a gradual prolongation of the 
inter-menstrual periods, an occasional flooding, with heats and 
other symptoms ; but the grand landmarks are not this gradual 
cessation, or at once, but in the organic changes that take place.. 
The uterine wave disappears ; the ovaries are shrivelled, withered, 
crumpled up in a peach-stone shape ; obliteration of fallopian 
tubes ; atrophy of the womb, becomes round, its neck grows 
shorter, and thinner, and disappears; vagina becomes narrow and 
short ; coldness of the parts, from a shrivelling up of the pampi- 
niform plexus ; atrophy of the breasts; hairs on the upper lip, 
with vertical creases; stray hairs on the face and chin; and a. 
peculiar, masculine physiognomy. There is a prevailing, all- 
pervading debility, which cannot be accounted for by disease ; 
the complexion is pale, or sallow, a drowsy look, a sort of stupid 
astonishment, as of one seeking to raise herself to answer a 
question ; always some irritation of the brain, which shows itself 
in a knitting of the brows : the disappearance of the menstrual 
flow, or its irregularity, or scantiness, or its too great abundance. 
Cessation is to be looked upon as positive, whatever be the age, 
when the above conditions .are present, unless accounted for by 
nursing, pregnancy, or uterine disease. At forty-five it is a 
settled fact ; but, in order to complete the diagnosis, it is well to 
add, the debility, the unusual heats, the sweats, the appearance of 



BACTERICIDES. 



219 



discharge dirty brown, its total disappearance, and the other 
symptoms already enumerated. 

The sanp-uine or olethoric exhibit unmistakable indications of 

O J. 

a great aggravation of all the leading symptoms ; whereas, the 
nervous, with their white faces, ever-anxious, nervous look, suffer 
least. 

Cessation should never be mistaken for chlorosis, inflamma- 
tion of the womb, uterine polypi, uterine tumors, uterine cancer,, 
pregnancy, either spurious or real, or other eccentricities of the 
uterus. 

Some diseases induce early changes in a woman's nervous 
system, and render her barren or sterile, such as the cholera 
germ, typhoid germ, the germs of pernicious, malarial, or yellow 
fever, the germs of diphtheria ; under these the ovaries wither,, 
and change takes place. Blows on head and back, fright, etc., 
we have already alluded to, and they should be weighed in the 
diagnosis of some cases. 

Treatment. — As ladies approach the change, it behooves them 
to prepare for the crisis — to get rid of all little ailments or disease; 
to observe and carry out a special regimen, and, as far as possible, 
to so arrange themselves as to be ready for emergencies; eat the 
best of food, observe hygienic laws, and place themselves upon a 
course of alteratives and tonics, such as we will subsequently lay 
down. Those two kinds of remedies are specially useful at the 
change. Alteratives are particularly indicated, to aid the change, 
to rouse up all the glands, to relieve the system of all waste, or 
effete, or waste matter; and tonics, to aid in bracing up. In pre- 
scribing alteratives, it is necessary to guard against the prejudice, 
firmly rooted in the minds of many, that the change of life is 
synonymous with old age, which is not so ; for the very prime 
part of a woman's life is before her, and at the change all ladies 
are benefited by alteratives which are not suitable for advanced 
. years. Both at puberty and change, which are periods of a new 
birth, there is strong vital energy; it may be latent, but it is 
there, and the use of alteratives, which cleanses the blood, de- 
velops unexpected strength and great vigor, and is strictly in 
accordance with natural laws and the phenomena of the change. 
But before calling attention to those, we will lay down, briefly, 
the essential elements, in a dietetic, hygienic, and medicinal view, 
that should, as far as possible, be observed at the change in all 
cases, and then briefly allude to remedies for the predominant 
symptoms. 

Diet, — Women, at the change, should eat plain food, as milk, 
eggs, boiled white-fish, broiled beef-steak or chops, chicken, 
game, bread, butter, oatmeal porridge and cream, vegetables of all 



2 20 DISEASE GERMS. 

kinds, and an abundmc^ of rips fruit; the latter to be used freely, 
and to an extent not interfering with digestion. All farinaceous, 
or starchy food, or sweets, as puddings, tapioca, rice, pies, cakes, 
pastry, tend to load the system with carbon, and thus generate 
heat ; prolong sleep ; cause distaste for exercise, and a tendency 
to stoutness. Forbid, in all cases, the use of sugar, tea, spices, 
pepper; all stimulants, together with shellfish, salted fish, or 
bacon, ham, corned-beef; malt and alcoholic stimulants. Coffee 
to be used with moderation. 

Women who have a tendency to become stout, require less 
food and more exercise than the lean. If there is great languor, 
weakness, nervousness, the diet should be made very generous, 
and the tonics increased. With the above diet, women will tide 
over the change well and have no further unsettlement of health 
to bear. If, however, women go in for eating heavy meals, stimu- 
lants, and excess, they will become like men, and have another 
change to meet after sixty-five. High living and stimulants at 
the change, give rise to early degeneration, which begins first in 
the capillaries, and steadily progresses to the larger vessels ; then 
to the heart, spleen, liver, kidneys ; and this degeneration is 
characterized by an increase of fat ; a non-vital substance in the 
omentum, in the abdominal walls ; and, as a result, the belly be- 
comes large, protuberant, pendulous. 

Clothing and Bathing. — Whatever the season of the year may 
be, or locality, or condition in life, flannel should be worn next 
the skin, at all times, to protect the surface from changes, to ab- 
sorb perspiration, so as to prevent being chilled. Bathing the 
entire surface daily cannot be omitted, as it is a great safeguard ; 
its neglect gives rise to great suffering. We might say it is im- 
perative, for the skin is heavily loaded with waste matter. Warm 
baths are the best, as they remove from the skin copious saline 
deposits, and other secretions left there by the heats, or the per- 
spirations ; besides, being in a warm bath for three-quarters of an 
hour enables the skin to absorb moisture or water, which allays 
the cutaneous irritation and dilutes the blood. The warm alka- 
line bath is like a gigantic poultice, applying its warmth to all 
the peripheral expansion of nerves, so that it becomes a splendid 
sedative of nervous irritability. It is perfectly manageable in all 
cases ; temperature increased or lowered at pleasure ; and even 
while in the warm bath cold can be applied to the head, or a cold 
shower bath to the abdomen ; or by a long-tubed syringe cold 
water can be thrown up the vagina or rectum to relieve uterine con- 
gestion. The alcoholic vapor-bath about twice a week ; on other 
days the hot, or warm bath for over half an hour, followed by 
brisk friction, is always of utility, and, and in some cases, it is 
well to follow up with massage. 



BACTERICIDES. 22 r 

In a small number of cases cold bathing is useful, provided 
there is vitality enough for reaction. The mineral water baths, 
whether of the sulphurous or alkaline kind, are always of the 
most efficacious character. Sea- water is not of so much benefit 
unless warm. 

Exercise of the muscular system relieves the congestion of the 
internal organs ; it depletes, causes the skin to 'perspire, the 
kidneys to work acpvely and eliminate uric acid freely ; it rouses 
the liver to action. It should be taken in the mornings ; should 
be moderate, not continued to exhaustion ; long walks are objec- 
tionable, it should just be enough to carry off the redundant 
energy, which, when unemployed, or not wrought off, gives rise 
to fidgets, nervousness, temper. Driving is excellent; but horse- 
back exercise should never be indulged in at this period. 

Change is most beneficial in all things. There is nothing that 
conduces so much to mental and physical vigor as change. It 
is a great strengthener of the nervous system in particular. 
Travelling places the patient in a new sphere ; new scenes ; 
new ideas, every one of which makes a call on her attention, 
solicits her interest, captivates her faculties, completely leads her 
away into new fields of thought ; away from old habits and asso- 
ciations to which she. had been long and painfully chained. 
Change has a most salutary effect on the brain ; under it the 
mind is consoled, and resumes peace and tranquillity. Nothing 
so vitalizing ; nothing so serviceable for the cure and prevention 
of disease at this critical period. 

Fresh air is indispensable here ; there must be an avoidance of 
close rooms, badly ventilated apartments, insanitary surround- 
ings ; the bedroom windows open at top and bottom. 

Amusements. — The ordinary cares of the household are at this 
period a burden ; there should be, if possible, a general easing- 
up, a lay-off, or rest. The mind could be occupied with reading 
history, because exciting stories, which are present in novels, 
induce nervousness of some shade or type ; besides, excitement 
is injurious. For this reason, balls, parties, concerts, operas, 
theatres, are excitants, and the impure air breathed in those 
places, in addition to their moral effect, causes them to shock the 
impressible, susceptible nervous system, and renders the patient 
sleepless and irritable. All exciting agents are deleterious, 
being productive of continued irritation and want of sleep, and 
it must ever be borne in mind that continued sleeplessness is the 
precursor of insanity. Night after night at theatres habitually 
subjects the mind to an increased intensity of feeling, which in 
the silence, solitude, and darkness of the night that follows,, 
destroys its sensibility, and eradicates its typical fissures. All 
amusements should be of the most stable and healthy kind. 



222 



DISEASE GERMS. 



Hygiene of the Reproductive Organs. — This is a most import- 
ant consideration at the change, when those organs become atro- 
phied and shrivelled up. Nature emphatically points, by this 
very condition, that their appropriate stimulus should be 
avoided, and it is neither wise to marry nor to have congress at 
this unsettled period of life. Connection at the change brings 
about uterine disorders and grave complications. Some assert 
that the sexual appetite is strongest at the change ; that the 
flickering flame of sexual desire gives rise to a final blaze ; that 
there is increased ardency. This no doubt occurs once in a 
while, but it is rare ; the opposite condition is the natural one, 
merely a distaste for connection at that period. A marked in- 
crease of sexual impulse or ardency at the change is a morbid 
desire, depending on a condition of congestion of the ovaries, 
spinal cord, or brain. The sexual act aggravates the trouble, 
and leads to serious complications. No woman should marry at 
that crisis ; defer it till it is over ; because if performed it will 
result in flooding, uterine disease, the development of uterine 
cancer, etc. 

Having regulated the general condition of the patient, she 
should be placed upon a general alterative and tonic course of 
remedies for at least five or six years ; she does not want many 
remedies, only a few, but they should be good ones ; but in all 
cases she should persevere with them faithfully, changing them 
at regular intervals of every seven days ; and with those breaks 
the same remedies can be resumed again and again with great 
efficacy. 

The best alteratives at this period are the saxifraga ozonized 
compound, the mother's cordial, the wine of aleteris farinosa, 
and the ozonized phytolacca. Select two out of the above list 
and give in the usual dose about two hours after meals, and 
change weekly. If the patient is in very straightened circum- 
stances, so that she is unable to procure those invaluable aUer- 
atives, let her do the next best thing, make infusions of blue flag, 
tag alder, yellow dock, and take them instead, so as to aid the 
elimination of waste-matter from the body. 

The best tonics at the change are the Peruvian bark, white 
mustard seed, the glycerite of ozone, kurchicine, golden seal, 
eentian, etc. Of these the Peruvian bark and white mustard seed 
are the most efficacious ; the crude bark is better than its finer 
preparations : one ounce of the bark to one pint of good port 
wine, to which add one ounce of elixir of vitriol ; allow the whole 
to settle. Dose, one tablespoonful three times a day one hour 
before meals. In some cases leave the elixir of vitriol out, then 
it can be given in wineglassfuls three times a day before meals. 



BACTERICIDES. 



223 



The compound tincture cinchona and mineral acids is excellent 
At all events, don't deceive the patient by worthless and ineffi- 
cient preparations of the bark, nor delude her with tasteless in- 
finitesimal sugar globules. There is a gigantic, a grave change to 
be aided, shattered vital force to be restored, and it must be 
effected on the principles of common sense. 

Next in efficacy, as a tonic, is the peroxide of hydrogen. This 
is one of the valuable remedies at the change. It is particularly 
useful to meet the symptoms of debility in a worn-out constitu- 
tion ; invaluable if there be indigestion, or liver trouble, with 
heartburn, pain or cramp, or a numbness, or a failure to sleep, 
nerve-tire, prostration. The cinchona stimulates the brain; 
favors the making of red blood, and is slightly astringent ; 
whereas the peroxide of hydrogen operates in a most extraor- 
dinary manner in disorders of the organs of digestion and assimi- 
lation ; on the stomach and liver especially ; stimulates the gan- 
glionic nerves lying over the womb and ovaries ; corrects all 
irregularities, and improves the general health. It is a valuable 
tonic, stimulant and aperient ; strengthens all the organs in the 
abdomen ; imparts activity. The efficacy of the peroxide of 
hydrogen does not depend on any specific power, but from the 
vitalizing energy which it imparts. There is no better remedy at 
the change — not one that can excel it. It relieves that indescribable 
feeling of debility and languor ; overcomes drowsiness ; soothes 
the irritable ; strengthens ; invigorates ; increases assimilation 
one hundred per cent., and aids the vital forces under the terrible 
prostration, enabling them to hold their own by its effect on the 
nervous system. To ladies who need constant help it affords 
great relief; inestimable benefit. It should be taken one hour 
before meals, three times a day, in 10 to 20 drop doses, always 
exercising care not to give an overdose. It never fails to afford 
great amelioration. Its gentle action on the bowels is very salu- 
tary, as it is always important that bowels and skin should be 
stimulated. One or two teaspoonfuls of the aleteris farinosa wine 
should be administered every three hours for five days out of every 
seven, then on those two days, she should take the comp. syr. 
partridge berry. Those two remedies should be taken steady 
for a period of four years, embracing, some time before, during 
and after that period. The aleteris is a powerful uterine tonic 
and restorative of the greatest efficacy, in tiding ladies over this, 
the critical point of Hfe. The glycerite of ozone operates well 
in all cases, and combines the action of both tonic and alterative. 
The extract of kurchicine is also a very valuable tonic. Infu- 
sions of golden seal, gentian, collinsonia, wine bitters are good 
tonics, but not of much utility at the change. Next to the 



224 



DISEASE GERMS. 



Peruvian bark and white mustard seed may be placed the kurchi- 
cine. All tonics are best given one hour before meals. In or- 
dinary cases the above simple alteratives and tonics are all that 
the great proportion of cases require, and can be readily carried 
out by the patient herself. 

But in addition to these there are often met a train of symp- 
toms some of which are present, and require special remedies 
and management. To these we will now solicit attention. 

Nervous Debility. — This debility at the change is peculiar ; 
sometimes it depends on an excess of blood, and in other cases 
upon too little blood. If it depends on an excess, for which there 
is no drain, it is a good plan on the first appearance of irregular- 
ities which characterize this period, to curtail rather than augment 
food. Debility, when in the family way, or nursing, is benefited 
and often overcome by a very liberal and generous diet ; but at 
the change this surplus blood cannot be utilized. In some cases 
it is advisable to establish a drain by applying two small blisters^ 
about two inches square, on each side of the nape of the neck for 
six hours, every second or third day, so as to keep up a slight 
discharge. These off and on periodic blisters to the nape of the 
neck are of great utility when disease-germs are suspected to exist 
in the blood. 

In debility, Vv'ith anaemia or poor blood, these must be more 
and better food, with rest, and a free use of the tonics already 
laid down. It is almost useless to experiment with others. 
Preparations of phosphorus, although very strengthening, im- 
parting keenness and vivacity to the mind, are contra-indicated,, 
because they predispose to fatty degeneration of tissue; of the 
heart, liver, spleen, kidneys. The same objection is to be urged 
against malt and spirituous liquors. Iron is not a good tonic at 
the change, as it increases the heats by retarding the action 
of the liver. If it is tried, the acetated tincture is to be pre- 
ferred. 

Flushes of Heat. — The skin at the change suffers from flushes,, 
heats, sweats, eruptions. They all pass off, as a rule, after the 
change. The flushes are the most tenacious, often holding on 
for years. Prurigo, itching, and eczema are the most trouble- 
some, and are blended with the hot flushes ; have their origin in 
the latter. In the treatment of them, it should be borne in mind 
that they are increased by emotion, nerve-shock, external heat, as 
in cooking, washing, ironing-, baking, hot rooms, hot drinks, 
over-feeding. In arresting diarrhea, leucorrhcea, flooding, over- 
clothing, all these, as far as possible, should be avoided ; the 
Peruvian bark mixture, the white mustard seed, are to be in- 
creased in dose ; the bowels to be kept rather open, and the usual 



BACTERICIDES. 



225 



daily warm baths scrupulously carried out. Various local appli- 
cations, "cooling," should be applied, as bay-rum and borax, 
borax water, and the face, cheeks, neck, breasts, or other parts 
can be dusted occasionally with puff powders, which are very 
cooling, and contain no deleterious agent. 

In some cases the flushes are preceded by a chilly sensation, or 
coldness ; some even tremble with cold before the heats come on ; 
others have associated with it aching in the nails. When sweats 
follow, it denotes great debility and congestion of internal organs. 
Sometimes the flushes are anomalous, preceded by strange sensa- 
tions in the skin, which in numerous cases resemble a beating, 
like an animal throbbing in the stomach, or the fluttering of a 
bird, sensations that disappear when the perspiration comes. 
Some women are living furnaces, and insist upon the doors and 
windows being left open in winter time, and woe betide delicate 
women compelled to live with them. 

In such cases good results follow the use of salines in alterna- 
tion with preparations of sulphur, as the tincture, in twenty or 
sixty-drop doses three times a day ; or glycerite of sulphur, or 
sulphur and cream of tartar; or sulphur, fine flour-sugar, and 
white resin. In other cases infusions of sassafras or yellow dock 
are of efficacy. 

Sweats.— These are simply evidences of great brain prostration, 
sweat running off the forehead or the entire body, obliging the 
patient to change linen several times a day, and when in bed liter- 
ally soaking the bedclothes. 

To a certain extent sweats are beneficial, they clear the body 
of superfluous material ; but when they are excessive they hinder 
the insensible perspiration — that exhalation so necessary to health. 
Besides, when they are excessive they denote a passive permea- 
bility of the skin, caused by a loss of nerve power. It is not well 
to check them entirely, as such a proceeding will cause internal 
congestion. 

Try such simple remedies as aromatic sulphuric acid and 
quinine, tincture of sulphur, or in some case a tea of pleurisy 
root. 

Leucorr/icea. — This should not be stopped, although it is well to 
syringe out the vagina three times daily with infusions of white 
pond-lily, or witch-hazel, or strawberry leaves, and if there is any 
itching or burning, boroglyceride should be added. As a general 
rule, the injection should be tepid or cold. All these remedies 
failing, occasionally packing the vagina with boroglyceride is of 
immense utility. 

Hemorrhages from nose, mouth, ears, nipple, navel, ulcers, 
vagina, are common. If they are not excessive, mitigate them, 

15 



2 26 DISEASE GERMS. 

but do not check altogether, as they are often salutary. The 
regular treatment by alteratives and tonics should be adhered to, 
but if they are violent or excessive try ergot, gallic acid, and port 
wine, digitalis, or the alcohol, turpentine, and sulphuric acid mix- 
ture. At the same time, if from the vagina, enjoin rest in the 
recumbent posture, head low, foot of bed elevated, cold drinks or 
ice in mouth, small sponges, saturated with vinegar, inserted up 
vagina, and changed every three hours. Great care and good judg- 
ment should be exercised in its arrest. 

Headaches are often promptly relieved by guarana, four tea- 
spoonfuls of the fluid extract every few minutes, or two or three 
grains of caffeine, or, that failing, a four-drop capsule or pearl of 
nitrate of amyl inhaled ; these failing, treat it under the following- 
head : 

Sleeplessness, Giddiness, Drowsiness, with Headache, or Cerebral 
Neuralgia, — In those depressing states, hyoscyamus is of great 
utility ; repeat till it affords relief. Hyoscyamus suits the nervous 
disturbance of the change in a most excellent manner. The dose 
and its frequency of administration will depend on the condition. 
When the pain is very great try either croton chloral, bromo-caf- 
feine, or guarana If these fail, then bromide of potassa and brom- 
ide of ammonium are of utility, either alone or combined with 
chloral hydrate, as follows: Take one ounce of camphor-water, 
three drachms of bromide of potassa, one drachm of bromide of 
ammonium, and two drachms of chloral hydrate. Mix. Dose, 
one teaspoonful every two or three hours till relief is obtained. 
But if that fail, and nothing will allay the intolerable pain and 
giddiness, which render existence unbearable, give morphia suf- 
ficient for the purpose rather than let the patient suffer. Sleep- 
lessness, with cerebral neuralgia, at the change, often resists our 
best remedies, and it is necessary to tack around considerably, 
and only in the event of all remedies failing should the morphia 
be given, as at no period of life is a habit so easily acquired as at 
the change, so that with alcohol and opium we should exercise 
great care. Camphor is a valuable remedy in those cases; it 
stimulates the nervous system to increased action ; it corrects the 
toxic influence which the reproductive organs have upon the brain 
of some women ; it abates the sexual sting by acting on the 
cerebro-spinal nerves of the internal organs of generation, not on 
the ovary or testicle. Large doses of camphor to child-bearing 
women do not prevent conception, like bromide of potass, nor 
induce impotence, but simply appeases the excitement of the 
generative organs at the change. It may be given alone, or with 
lupuline from the hops. Sambul or musk- root, tincture of green 
root of gelsemium, operate beneficially. The inhalation of the 



BACTERICIDES. 227 

nitrate of amyl moderates cerebral irritability ; sulphonal or ure- 
than both extremely efficacious. Topical applications to the 
head are often of great value ; as, for instance, take two pints of 
water, to which add two ounces of liquor ammonia, one ounce of 
spirits of camphor ; mix, and apply to the head for fifteen or 
thirty minutes, or longer, and then remove and apply vaseline 
ointment. Or, another good remedy is to take two ounces of 
olive oil, the same of chloroform, and half an ounce of menthol; 
mix, and rub into the painful part. The irritability of the brain 
at the change is caused by and aggravated with ovarian disturb- 
ance, and it is a good plan to use both rectal and vaginal sup- 
positories of belladonna and opium. Veratrum viride, and aconite 
or antipyrine may be given with benefit if there is plethora. The 
same characteristic symptoms, as headache, giddinesss, drowsiness, 
are present at puberty, and at that period bromide of potass is 
inadmissible, and never should be given. 

During the change the brain is often unhinged, so that cata- 
lepsy, epilepsy, melancholia, hypochondriasis, insanity, apathy 
are present, for the management of which see those different 
heads. 

Clever women often lose confidence in themselves at the chancfe. 
and are unable to manage their own affairs, and their moral treat- 
ment, for a few years, requires great care. The disturbance of 
this crisis tells heavily upon her. Very frequently her mode of 
dealing with everyday occurrences of life betrays a want of prin- 
ciple, strongly contrasting with her previous rectitude, and a 
return to that untruthfulness that may have existed at puberty. 
There may also exist every idiosyncrasy — peevishness, irritability, 
ill-temper, ingratitude, passion, eccentricity. It is no uncommon 
thing for a high toned Christian lady all through life up to the 
change to desert her husband and children for a scamp, while 
others make life intolerable by their tyranny and hate the long- 
cherished object of their affections. Some become moody, silent, 
gloomy ; neither loving nor hating. Others again, in the midst 
of wealth talk poverty and indulge in a propensity to steal, while 
another class feel like committing grave crimes. The nervous 
system is unhinged, still it will pass away and must not be re- 
garded and treated as insanity, for all the strangeness of temper, 
the fitfulness of spirits, the perversion of character will abate and 
disappear under proper care. But the patient requires judicious 
care, removal from home excitement, new scenes, the intelligent 
sympathy of friends, and the support of strong minds. The most 
amiable at this time become annoyed with trifles, and are often 
passionate, quarrelsome, fretful, by the slightest worry or excite- 
ment. Derangements of the stomach and liver are very common. 



228 DISEASE GERMS. 

This disturbance shows itsejf in every imaginable form of dys- 
pepsia and biliousness ; the kidneys also suffer. The general 
treatment as laid down for those affections should be carried out, 
and nitro-muriatic acid and phosphate of soda given. Diuretics 
are very valuable and deserve attention. 

Diarrhea is salutary and must not be hastily checked. Some- 
times useful to encourage by giving small doses of either of the 
following mixtures, say about ten or twenty grains thrice daily : 
sulphur, one ounce ; calcined magnesia, half an ounce ; mix ; or 
equal parts of borax and sulphur. In some cases of diarrhea 
great benefit accrues from the use of the liquor ammonia acetatis 
in teaspoonful doses as above. 



A most painful affection, caused by violent contrac- 

Colic. tion of the muscular fibres of some portion of the in- 
testinal tract, generally near the umbilicus, occurring 
in paroxysms. Pain almost invariably relieved by pressure, never 
aggravated by it ; there may be vomiting, and generally constipa- 
tion ; an entire absence of either fever or inflammation. During 
its occurrence pulse is lowered ; surface of the body cold ; face 
white and anxious. 

There are numerous varieties, as microbial, bilious, nervous, 
brass, lead, tin and other mineral varieties. 

Microbial Colic, formerly known as flatulent, due to the pres- 
ence of bacteria, the degraded bioplasm of mal-nutrition, induced 
by excess, indigestion, perverted nutrition, improper or deleteri- 
ous articles of diet, the delicate nerves of the intestine are 
affected toxically by the ptomaines of the microbe. 

Best relieved by the administration of an active germicide ; if 
an adult, a teaspoonful of either eucalyptol, or kurchicine, or 
Warburg's tincture ; if a child, some aromatic, as menthol ; con- 
centrated ozone ; peroxide of hydrogen ; resorcin, etc. These 
means failing, an emetic of lobelia combined with bicarbonate 
soda, copious draughts of tepid water. 

Bilious Colic. — The irritation of acid or acrid bile, or other 
morbid secretions, often irritates the nerves of the bowels, and 
causes contraction of the muscular coats. 

In those cases there are usually the dulness, the brown coat 
on tongue, the yellow tinge on the white of the eye, fetor of 
breath, etc. 

This is best relieved by the administration of small doses of 
the anti-spasmodic tincture, or a warm infusion of the wild yam 
or dioscorea, followed up with the compound licorice powder, or 
neutralizing mixture, with leptandra, oil of peppermint and anise. 



BACTERICIDES. 



229 



or with more active remedies to stimulate the Hver, as phosphate 
of soda or nitro-muriatic acid. 

Nervous Colic comes on from fright, cold, hysteria, gout, rheu- 
matism, or from irritation of adjacent organs, as the bladder, 
uterus, or morbid conditions of the alimentary canal. 

This must be promptly relieved by the administration of chlo- 
roform in sweetened water internally, or belladonna or anti- 
spasmodic tincture, phosphate of quinine, colchicum, and the 
cause removed. 

Tin Colic. — This form of mineral colic has become very com- 
mon since the introduction of canned vegetables, fruit, beef, fish ; 
and also caused by cooking soup in tin culinary vessels on petro- 
leum cook stoves. 

Relieve the pain and spasm by the usual means, and put pa- 
tient on the iodide of potassa and carbonate of ammonia. 

Copper Colic. — A most severe form of twisting or griping ; 
comes on suddenly ; pain is intense ; nausea, vomiting ; bowels 
generally loose. The countenance is anxious, of a peculiar sal- 
low hue ; eyes sunken and lips livid ; a purple line around gums. 
Common among copper-plate printers, brass founders, and from 
copper cooking vessels. Treatment same as lead colic. 

Bismuth Colic. — Bismuth introduced into the stomach blunts 
the sensibility of the gastric nerves, but when extensively used, 
as it often is by ladies in face powders and cosmetics, gives rise 
to colic, with a peculiar bluish, shrivelled, or wrinkled appearance 
of the skin, and after death, the duodenum is black with the debris 
of the metal. Same treatment as lead colic. 

Lead Colic. — Due to the absorption of lead ; hence, it is com- 
mon among operatives in lead works, oil-cloth factories, painters, 
plumbers ; drinking from lead pipes, soda water from lead taps, 
snuff adulterated with lead, claret drinkers, as sugar of lead is 
often added to wines to render them cooling ; and wine casks 
absorb the lead, and if ever used for carrying water in ship, they 
re-impregnate the water, and the sailors, or those drinking the 
water, become affected. Lead, whether inhaled by the skin or 
b-onchial mucous membrane, or absorbed by the glands of the 
mouth, or swallowed in water or food, or breathed from a newly 
painted room, diffuses itself through the body, but seems to 
spend the force of its poisonous effects on the fine, delicate nerves 
of the duodenum, giving rise to an irritation which speedily 
terminates in a spasm or contraction of the muscular coat of the 
bowel, so that it is usually ushered in by a grinding or twisting 
near the umbilicus, with retraction of the abdominal muscles to 
the spine, and pain in the back, vomiting, constipation, metallic 
aspect of countenance, a blue or slate-gray line round edges of 
the gums, with general languor and debility. 



230 



DISEASE GERMS. 



Treatment. — To prevent absorption of this metal, workmen 
employed in or about it should exercise great care, resorting 
to daily baths, wear flannel clothing, keep bowels regular, eat 
the most nutritious diet and spend a good portion of time in 
open air. 

Aromatic sulphuric acid, fifteen drops thrice daily in water, pre- 
vents absorption, and is undoubtedly the best prophylactic. Alum 
is not a preventive, but, if given after the lead is in the fluids and 
solids of the body, it will unite with the metal and form an inno- 
cent sulphate. Although alum has this remarkable chemical 
property of changing the lead, it does not prevent its ingress into 
the body, like the aromatic sulphuric acid. 

In suffering from an attack, the first thing to be done is to relax 
the spasm and relieve the patient from pain. The compound 
lobelia, with capsicum and valerian, should be administered by 
mouth and rectum in small doses, often repeated, so as not to 
excite emesis ; and if the spasm does not yield, administer thirty 
drops of chloroform with it for several times. Relieve pain by 
hypodermic injection of morphia. 

As soon as the spasm is relaxed and a free motion of the 
bowels brought about by oil, begin with iodide of potassa. This 
drug unites with the lead, sets it free, and also eliminates it by 
the skin, kidneys and bowels. The dose of the iodide should 
not be less than five grains, three times daily ; but it is often 
beneficial to give it in ten-grain doses, and combine it with either 
bicarbonate of potassa or carbonate of ammonia ; the whole to be 
given in syrup of stillingia compound. While pursuing this 
treatment with iodide, an everyday bath of the sulphuret of po- 
tassium. This should be done in a wooden bath-tub, with tepid 
water enough to cover the body, to which one pound of carbon- 
ate of soda and sulphuret of potassium should be added. The 
patient should remain in bath not less than half an hour, even 
a little longer. 

The diet should, while pursuing this treatment, be generous to 
a fault. 

Shock, prostration, extremely great depression 
Collapse, of the vital forces, such as may follow any acci- 
dent, injury, concussion ; inhalation or absorption 
of any poison ; or even from some depressing passion. 

The symptoms are very variable, most commonly, however, we 
find the patient lying on the back, with a cold skin, feeble pulse, 
sighing respiration, half unconscious. If the force of the shock, 
or injury, or poison, has fallen upon the vascular system, there 
will be syncope or fainting, pulse and respiration imperceptible ; 



BACTERICIDES. 23 1 

if upon the nervous system, patient bewildered, incoherent, 
vomiting, coma, convulsions, paralysis of sphincters. 

The duration of the stage of prostration is variable, depending 
on the power of vital resistance inherent in the patient and the 
amount of violence inflicted, or poison absorbed, or degradation 
of Hving matter, commonly from a few to forty-eight hours. 

The mode or manner of recovery from shock or collapse is 
termed reaction — everything depending on the nature, degree, or 
quality of that reaction. If, aided by proper means, it is perfect, 
we have recovery ; if in spite of our best efforts it is altogether 
wanting, we have death ; if it is imperfect, then it is followed by. 
fever, a salutary effort of vital force for recovery. 

The indications in treatment are to stimulate vital forces to 
healthy reaction. If the patient is cold, shivering, respiration 
and pulse feeble, diffusible stimulants should be administered, 
such as brandy and water, or capsicum, or some preparation of 
ammonia ; if incapable of swallowing, the same remedies should 
be administered by the rectum in an emulsion of slippery elm, 
and spirits of turpentine added. The patient should be bathed 
all over with ammonia and warm water, after which he should 
be well dried and rubbed with dry mustard. If no reaction is 
perceptible, dry cups or scorching hot pillows should be applied 
to both sides of the spine, and mustard plasters with heat to the 
feet. Rubbing the skin is of the greatest importance, as we 
thereby stimulate the periphery of nerves, which stimulus is 
carried to the brain. Artificial heat by means of bricks wrapped 
in flannel, or bottles of hot water, should be applied all around 
the patient's body, especially inside of arms and thighs. Stim- 
ulation must be persevered with, and other remedies, such as 
nitro-glycerine in drop doses, or quinine, resorted to, the object 
being to establish an equilibrium in the body, and the greatest 
care should be observed not to over-stimulate, as we thereby 
produce exhaustion with cerebral excitement. What is desired is 
perfect reaction, so that fever, the condition of imperfect reaction, 
may be obviated. 

Insensibility from various causes is worthy of the 

Coma, most earnest consideration. 

When an individual has been picked up on the 
road or street insensible, irrational, or inarticulate, and his ante- 
cedents unknown, what is the matter? Is he ill, drunk, drugged, 
or suffering from some brain concussion, or from coma after an 
epileptic fit, or otherwise ? 

Syncope, trance, catalepsy, coma, are names used by medical 
writers to designate states of insensibility, which the public call 
fits. 



232 



DISEASE GERMS. 



Syncope is fainting, a condition of the body in which there is a 
death-like pallor, with loss of muscular power and consciousness; 
a faint is usually transitory, due to shock. In it the person 
collapses, rather than falls to the ground ; his knees are bent 
under him, he subsides into the sitting posture, his head drops 
forward, and by the time his head has thus sunk to the level of 
the heart, or below it, the circulation of the brain becomes suffi- 
ciently restored for consciousness to return. In a faint, a person 
seldom bruises his face. Upon waking, he may feel sick, giddy, 
or alarmed, but his brain resumes its thinking functions at once, 
and entirely. 

Recumbent posture on right side, articles of dress loosened, 
dashing cold water on face and front of chest, cautious inhalation 
of ammonia, diffusible stimulants. 

Trance is a state of death-like faintness, in which some con- 
sciousness is retained, but inability to speak. In trance, the body 
appears inanimate, there is no power to move a muscle, the 
limbs are flexible ; he may hear, see, and remember all that goes 
on around him. There is no perceptible pulse or respiration ; 
hence trance has been, and often is, mistaken for death, as the 
temperature is lowered ; muscles re-act to galvanic stimulus. 
There should be no hurried burial alive, or post-mortem unless 
rigor mortis or signs of putrefaction be present. 

Treat same as Collapse — artificial heat, enemata of turpentine, 
cups to both sides of entire spine, over abdomen ; and as soon as 
he can swallow, diffusible stimulants. 

Catalepsy^ a rare inanimate condition ; insensible, stiff, unable 
to move, or articulate ; pulse slow, respirations diminished ; ex- 
tremities cold and flabby. He or she may be pinched, pricked, 
beat without flinching — statue-like, but perfect muteness. There 
is neither the lividity of asphyxia, nor the pallor and general 
flexibility of syncope, nor the stertor of coma, nor the paralysis 
of epilepsy, nor the movements and dreamy mental automatism 
of somnambulism. 

Treat same as neurasthenia. 

Coma^ or deep sleep, may be due to very many causes as 
pressure exercised upon the brain from effusion within the 
ventricles, and outside of the membranes ; to alteration in the 
molecular state of brain from concussion, contusion, apoplectic 
extravasation ; to brain-poisoning by insufficiently oxidized blood; 
to disease germs, to uraemic blood, narcotics, anesthetics, 
inebriants. 

It is impossible to give accurately positive landmarks for 
diagnosing each kind of coma. 

Profound Coma is present in serous effusion into the ventricles 



BACTERICIDES. 



233 



of the brain, such as arises from extensive burns, or from tuber- 
cular meningitis in later stages. Patient is first sleepy, then 
drowsy, then stupid, slow of comprehension, difficult to wake, 
and finally, incapable of being roused at all. The breathing is 
stertorous ; at first he can swallow, then he fails to do so ; pupils 
are not characteristic, most frequently contracted, and then 
dilated. 

Coma, due to fracture or effusion of blood, as in sanguineous 
apoplexy, is sudden in its advent. The breathing is stertorous, 
pupils contracted, heat may be normal, skin perspires freely. In 
fracture of the skull there is oozing of blood or serum from ear 
and nose; or there may be blueness, humidity, ecchymosis of the 
eye, neck. In apoplectic cases, face often turgid with blood. 

Coma, due to molecular death of a portion of the brain, the 
face is pale, heat lowered, pupils unequal, evidence of hemiplegia, 
or some form of paralysis. 

Coma, due to some brain-poisoning, as deficiency of oxygen 
in pneumonia; nitrous oxide gas; the nose, lips, neck, face, and 
other parts are livid, often black. 

If patient has breathed carbonic acid gas, say from a lime- 
kiln, or sulphuretted hydrogen from some source, those two 
gases arrest the oxygen- carrying properties of the blood, and 
this blood-change, or damage, is not recoverable from brain- 
poisoning ; and coma by anesthetics and inebriants is usually 
detectable by the breath of the comatose person. Apoplexy and 
dead-drunkenness are often mixed. 

In Brain- Poisoning try artificial respiration, abundance of 
fresh air, cloths out of boiling water over heart ; enemata, say 
one and a quarter pints of cold or warm water, with a table- 
spoonful of salt ; caps to nape of neck ; mustard to feet and 
hands ; free purgation, if he can swallow. 

Fever Cojna, due to the presence of disease germs, spores, and 
ptomaines in blood and brain, loxically affecting the functions of 
life. 

Easily recognized by the history of the case, and febrile state. 
It is an imperative call to push bactericides to destroy the factor 
of the fever. 

Urcemic Coma is recognized by cedema of eyelids, or extrem- 
ities ; wax-like pallor, uriniferous odor of breath and skin, furred 
tongue, pearly conjunctiva, dilated pupils. 

Try warm bath^ free purgation with salines, and hypodermic 
injections of pilocarpine. 

Coma of an epileptic fit is usually recognized by the bruises, 
torn or soiled clothes ; indications as if the tongue were bitten. 

Patient to be placed on right side, clothes loosened or re- 



234 



DISEASE GERMS. 



moved ; enemata of lobelia, capsicum, and valerian ; or hypo- 
dermic injection of one-fourth of a grain of sulphate of morphia, 
if over seventeen years of age ; dashing cold water on the patient, 
of little service. 

Alcoholic Coma. — Alcohol, a toxical agent, an arrester of gen- 
eral metamorphosis, has a special action upon the brain and 
liver. In large doses it produces insensibility, partial or com- 
plete. Symptoms vary according to the amount of poison 
imbibed. There may or may not be stertor ; slow or fre- 
quent pulse,- temperature lowered two or three degrees ; pupils 
contracted, more frequently dilated. The odor of the breath 
chloroform, chromatic spirits of ammonia or liquor ammonia 
acetatis is the best agent to clear the poisoned brain. 

Opium, Coma. — Profound stupor, closed eyelids, contracted 
pupils, upturned eyeballs, pale face, cool, clammy skin, forehead 
beaded with heavy perspiration, limbs lax; breathing slackens, 
reaching as low an ebb as six per minute; coma profound; no 
responsive movement to pricking, pinching, or other stimulation. 
The body will not walk, it is only dragged; lips become livid, 
surface colder, breathing, at long intervals, and pulse, nearly im- 
perceptible. This coma may be mistaken for effusion into the 
pons; so it is well, in all cases of profound coma, with contracted 
pupil, to exercise care, unless there be collateral evidence, as a 
laudanum or -morpiiine bottle about, or marks of a hypodermic 
syringe, lest the case be apoplexy into the pons — a kind of coma 
that is not benefited by bastinado, beating with wet towels or 
willow rods, walking about, or all the caffeine, or coffee pumped 
into the body. In all cases of effusions, fracture, apoplexy, ad- 
here to cups to nape of neck, stimulants to extremities, open 
bowels. (See Opium.) 

A formation of solid, unorganized masses 
Concretions, within the body, either by chemical prepara- 
tions from the fluids, or by the accidental 
aggregation of solids introduced from without; in the former 
case it is termed a calculus, in the latter concretion. 

A concretion may be wholly composed of solids foreign to the 
body, or there may be a mingling with the elements of secretion, 
as with mucus or calculous matter. Beans, peas, noodles, and 
other foreign bodies, introduced into the cavities of the body, 
often become the nuclei of concretions, by attracting around 
them mucus, or crystalline deposits. The most remarkable forms 
of concretions are those found in the stomach and intestines of 
man, from the more solid and indigestible parts of food or o{ 
substances improperly swallowed. 



BACTERICIDES. 



235 



Remarkable concretions are formed in the stomach and intes- 
tines of man and the lower animals, from the solid, undigested 
part of the food, or of substances imperfectly cooked and 
swallowed without proper mastication. The swallowing of hair, 
the use of raw oatmeal, the continual use of animal food, the use 
of carbonate of magnesia as a laxative, insoluble carbonate of 
iron, phosphate of lime, pulverized bone are apt, if continued 
steadily, to give rise to solid concretions, varying in size from a 
walnut up to that of an orange. They invariably give rise to pain, 
constipation and obstruction of the bowels, as they are pushed 
along. They are very apt to lodge above the sigmoid flexure, 
and thus give rise to backache, derangement of the kidneys and 
bladder, a wearied sensation or 
rather neurosis of the sacral nerves, 
numbness on the posterior part of 
the limbs, general prostration. 

The annexed wood-cut gives a 
beautiful illustration of one of 
those concretions that were passed 
from the bowels, under the influ- 
ence of copious enemata of warm 
glycerine into the lower bowel 
daily, patient in the recumbent 
posture, enemata passed by a long 
tube above the flexure. 

The localizing of disease germs 
in different parts of the body is extremely liable to give rise to 
concretions. 

The tubercular bacilli is the most prone to effect this, especially 
if the deposit is made in the brain, parotid, lungs, stomach, intes- 
tines, ovaries, testes, pancreas, spleen, female breast, etc. 

There is an irritation somewhere in a tubercular patient, 
effusion takes place, the bacilli aggregate together, form a round 
mass, which by-and-by becomes milky, then cheesy, and 
latterly calcareous — phosphate of lime ; that is, the tubercle takes 
on the form of degeneration and death. 




Section of an alvine or intestinal con- 
cretion formed in su cessive layers 
upon a ra.sin seed. 



A shock or concussion is usually caused by a 

Concussion, jar, blow, fall, or some mechanical injury ; and 

it may also be the result of some depressing 

passion. No part of the body, no organ or tissue is exempt 

from a concussion. Thus we have concussion of the brain, 

stomach, bowels, etc. 

Concussion of vital organs is much more common in our 



236 DISEASE GERMS. 

highly civilized state, than is generally supposed. For example 
our improved means of railroad travel and electric lighting, are 
highly detrimental from the repeated jars and shocks produced 
thereby. The strain and struggle for existence are greater — the 
emotions, desires, affections are more intensified, and give rise to 
shock to vital organs. Certain drugs have a depressing, or jar- 
ring action, alcohol, opium, quinine, if in large doses, give rise to 
a cerebral shock — phosphorus, if large dose, irritates, jars the 
function of the stomach, etc. 

All concussions are spent upon the brain, whether the cause 
be direct or indirect. 

In the treatment of brain shock, or concussion, absolute, per- 
fect rest in the recumbent posture in bed, so as to enable the 
vital forces to rally. Sulphonal or hyoscyamus should be admin- 
istered in sufficient doses to procure sleep ; bowels opened, 
stimulants applied to the extremities, and if need be to the head. 
A skilled physician should be in immediate attendance, who will 
prescribe some cerebral sedative, as aconite, or belladonna, sam- 
bul, valerian, bromide of ammonia, so as to induce sedation, 
even an excess of sleep. 

If brain shocks or concussions were more actively treated, 
there would be fewer cases of cerebral disease. 

If any people in the world require great precaution against 
concussion of the brain it is our people, v/ith brains feverishly 
active and literally starved for a diet of phosphates. There 
should be an improvement here, better brain nourishment, which 
our people would find in boiled white fish, oat-meal, whole corn- 
bread. 

A retention of faeces beyond the usual 

Constipation, period, so that when they are passed, it is 
with difficulty, and in a comparativly hard 
or indurated state. 

A normal condition of the body demands a movement of the 
bowels following the morning meal ; if this does not follow there 
is inertia of the intestinal track. 

Constipation is a most troublesome and prevalent affection. 

Causes. — This may be due to some constitutional defect, in- 
herent weakness of organization, or inertia of the nerve centres, 
which gives rise to scanty mucous secretion, deficiency of bile, a 
defective nerve supply, as exists in neurasthenia. Add to these 
habitual inattention to nature's calls, sedentary habits, use of 
drastic cathartics, malaria, alcoholic drinks, erroneous drug treat- 
ment, adulterated food, hasty or insufificient mastication, dys- 
pepsia, anything which will arrest the peristaltic wave. 



BACTERICIDES. 



237 



Symptojns. — Looking at the rectum with its immense supply 
of spinal nerves, its mucous membrane studded over with the 
most active absorbents, any retention of the faeces over twenty- 
four hours will give rise to headache, fetid breath, drowsiness/ 
fever, due to the absorption of deleterious gases, poisons, and 
disease germs re-entering the circulation, such a state necessary 
gives rise to a morbid state of the kidneys, bladder, skin, lungs. 

The pressure of a loaded rectum gives rise to prostatorrhoea, 
and seminal emissions in the male ; ovarian, uterine, and vaginal 
disturbance in the female. 

Its reflex effect tells disastrously upon the brain, often giving 
rise to serious nervous disorder. 

Treatment. — In the treatment of constipation, the cause if 
possible should be ascertained, and removed. The patient should 
be instructed, that there is no rule of health of so much import- 
ance as a well regulated state of the bowels. 

It is a very common belief that the rectum is but a receptacle 
for the fasces, or the refuse matter of the intestinal canal, but this 
is a mistake. The rectum is not a storage for the faeces, as they 
are naturaUy stored in and above the sigmoid flexure, just above 
the rectum, but when habitual constipation is induced, it is often 
compelled to act that part. 

As the rectum has a greater supply of nerves, of blood vessels, 
and its mucous membrane literally studded over with absorbent 
follicles greater than any other part of the intestines, it clearly 
explains why persons who suffer from habitual constipation, have 
dry, hard stools, fetid breath, rough skin, febrile exacerbation. 

Every individual should be taught a regular habit, a daily 
evacuation from the rectum, of all matter that approaches it for 
exit from the body. The great trouble is that all disease germs 
and ptomaines contained in the faeces, on entering the rectum, if 
they are not promptly discharged, re-enter the circulation again, 
rendering the blood germ-laden, irritating, deranging, interfering 
with the healthful working of every organ. Let this continue 
from day to day, and it silently but surely produces disease of 
the rectum itself. 

The evil results of constipation are not limited to blood poison- 
ing and nerve irritations. The failure of the bowels to excrete, 
throws additional work upon the skin, lungs, kidneys ; deranges 
and produces disease of vital organs. Habitual constipation oc- 
casions great distress and produces grave pathological changes 
in the brain, heart, lungs, bowels, organs of assimilation, often 
gives rise to chorea and epilepsy. 

It is often difficult to ascertain the cause, but a careful exami- 
nation of the rectum should be made for chronic inflammation or 



238 



DISEASE GERMS. 



catarrh, for ulceration or other morbid states. Cathartics for the 
relief of this difficulty are worse than useless and invariably do 
more harm than good. 

Rational attention should be paid to diet, exercise, bathing, 
massage, accompanied by regularity in going to stool to solicit 
movements; if the condition does not yield, there is some trouble 
with the liver, mucous membrane, nervous system. We shall 
enumerate briefly a few of our best remedies for habitual con- 
stipation. 

Kolatina is the best remedy in the materia medica for all forms 
of constipation. This principle is isolated from the African kola 
nut by a peculiar process of maceration, and converted into a 
pleasing palatable paste, and this into a refreshing fruit lozenge. 

Kolatina has many properties : it rejuvenates the nervous sys- 
tem in all cases where a poverty of nerve force exists — by this 
action on the brain the liver is roused into activity, the peristaltic 
wave heightened, strength augmented. 

The dose is from a half to a whole lozenge and should be 
taken at bedtime. 

It is indicated in all cases of constipation, particularly those 
dependent on defective or perverted nutrition, combined with in- 
digestion. It has been used extensively, and all have been fully 
satisfied of its wonderful power as a therapeutic agent, and the 
very best remedy in constipation, producing full, easy stools, 
without nausea or tenesmus. 

Another very valuable formula in or among neurotic patients 
who suffer from constipation, caused by a want of nervous 
energy, is three drops of the tincture of belladonna and the same 
amount of the tincture of nux vomica, added to a little water, 
administered two hours after eating. Tincture of sulphur is also 
a most effective remedy, in doses ranging from five to fifteen 
drops added to water. 

Enemata of one or two ounces of glycerine either alone or 
medicated with tincture of belladonna or nux. This is a most 
efficient remedy in habitual constipation, and intestinal ob- 
struction. 

Cascara sagrada lozenges, two at bedtime, are most effectual in 
overcoming this difficulty. 

Ox-gall, charcoal pulverized, and extract of nux vomica is in- 
valuable ; thus, ox-gall, thirty grains ; willow charcoal, pulverized, 
sixty grains ; solid extract nux vomica, five grains. Mix. Make 
thirty-six pills. One at bedtime ; or the following : solid extract 
golden seal, sixty grains ; comp. solid extract of colocynth, thirty 
grains; extract hyoscyamus, five grains. Mix. Make thirty pills. 
One or two at bedtime, as the case may require. 



BACTERICIDES. 



239 



Injuries inflicted 

Contusions, with blunt or obtuse 

instruments are usually 

followed by an extravasation of blood 

either into the cellular tissue or skin. 

Treatfnent should be active, and 
should consist of such remedies as rest, 

the application of the tinctures ofmari- ^£'^/'$y&^'^^^^^%'f 
gold or arnica, so as to stimulate ab- ^irii^fhii^^^^^ >\VA.\H';f/ 
sorption of the effused blood. 

If these fail, then take half and half 
of peroxide of hydrogen and water and 
apply to the part, which will prevent the contusions, followed byecchy- 

1 .• r .• • mosis ; magnified 1000 diam. 

evolution of micrococci. ^ 




Chains of micrococci found in 



Inflammation of the mucous membrane lining the 

Coryza. nose, frontal sinuses, throat, accompanied with fever. 
The cause is usually exposure to cold or wet, or dis- 
ease germs. 

Symptoms. — Languor, lassitude, debility ; pain in head ; ach- 
ing in back and limbs ; fever, thirst, loss of appetite, rapid pulse, 
increased heat, coated tongue, discharge from nostrils ; profuse 
lachrymation, hoarseness, sore throat. 

In addition to those symptoms, the discharge from the nose is' 
liable to become acrid, and coming in contact with the lips causes 
an eruption of fever blisters or herpes. In a few days symptoms 
will subside and pass into a subacute form, and tonsilitis or bron- 
chitis may supervene, and the patient recover. If he happens to 
be feeble, or possess a tubercular habit, it may pass into ulcera- 
tion, and a chronic form be set up. In all cases there is a degra- 
dation of the living matter that supplies the mucous membrane 
of the nostrils, frontal sinuses, posterior nares and throat, into 
the disease-germ, amoeba, which, if not speedily relieved, will 
produce grave changes. 

The treatment to be promptly effectual must consist of bac- 
tericides. During the feverish stage jaborandi to diaphoresis, 
followed by antifebrine and tincture of belladonna till throat be- 
comes dry, or salicylate soda in liquor ammonia acetatis, alstonia, 
Pulsatilla, cimicifuga race., alternated with peroxide of hydro- 
gen, or else quinine ; chloride of ammonia. 

Inhalations of glucozone, benzoin, ammonia, camphor, menthol, 
nasal bougies, prepared from menthol ; benzoin, cocaine, applied 
locally, will often cut short an attack. 



240 



DISEASE GERMS. 



This is an indication of the presence of microbe 

Cough, in or on or near the larynx and bronchi, and is a 
symptom of various microbial diseases, as catarrh, 
laryngitis, asthma, croup, pleurisy, pneumonia. 

The act of coughing consists in first, irritation of these and 
other germs, and in a deep inspiration, closure of the glottis and 
violent expiratory effort by which the glottis is forcibly opened 
by the compressed air, which carries with it, in its exit, mucus or 
other matters which may have lodged in the lungs or respiratory 
passages. The nervous centre for this act lies in the medulla 
oblongata. It is bilateral, and situated on each side of the cen- 
tral raphe. It is excited into action reflexly by irritation of the 
respiratory branches of the vagus, distributed to the folds of the 
epiglottis, to the whole interior of the larynx, to the trachea, espe- 
cially at its bifurcation, to the bronchi, to the substance of the 
lung itself, as well as the pleura when it is inflamed. Irritation 
of the internal auditory canal at the point to which the auricular 
branches of the vagus are distributed, also causes coughing ; and 
so may irritation of stomach, liver, spleen. As coughing is a 
reflex act, excited by irritation applied to a sensory nerve, and 
reacting through a nerve-centre upon the respiratory muscles, it 
is obvious that it may be lessened either by removing the source 
of the irritation, that is, destroying the germ, or by diminish- 
ing the excitability of the nervous mechanism through which it 
•acts. Both methods are employed in practice ; one of the most 
common being to lessen irritation by the use of mucilaginous, or 
saccharine, or oleaginous substances which have no action upon 
the nerve-centres ; the other by acting on the nerve-centres. 

The action of germicides is ever for good ; the wonderful ac- 
tion of either the tar or creosote syrup ; the syrup toluentaine 
compound cannot be too highly extolled. 

The probable action of marshmallow, gum Hcorice, is to 
soothe irritation at the root of the tongue, around the fauces, as 
well as the trachea, bronchi or lungs. This probable action in 
relieving cough depends to a great extent on the mucilaginous 
coat. Sedatives relieve cough by entering the blood, and being 
carried to the medulla lessen the excitability of the nerve-centres, 
such as bromohydric acid with spirits of chloroform and syrup 
squills, or a mixture of solution of hydrochlorate of morphia ; 
dilute hydrocyanic acid, of each, twenty drops ; glycerine an infu- 
sion of gentian, of each, two ounces ; chloroform, three drachms. 
A teaspoonful, as indicated, every three hours. Muriate of am- 
monia, in five-grain doses in syrup is excellent. 

Cough, from teething, intestinal irritation, is best relieved in 
the former by lancing the gums ; in the latter by getting rid of 
the parasite. 



BACTERICIDES. 24 1 

Cough Irom relaxed, or elongated uvula ; hypertrophy of the 
tonsils requires first, a trial of astringent gargles ; that failing, 
alteratives, iodide and excision. 

Cough, due to disease of the ear, mullein oil. 

Nervous cough, avena, kephaHne, sambul, coca, pulsatilla, 
g^entle exercise, sea-bathing, shower baths, nutritious food. 



A devitalized condition of the brain, caused 
Coup de Soleil, by solar heat and evaporation of the serum 
or of the blood. 

Sun-stroke. It gives rise to faintness, a craving for 

water, heat and dryness of the skin, high 
temperature of coldness, great nervous depression, vertigo, tight- 
ness across the chest; pulse variable, often quick and full, at 
other times thin and feeble, so that it can scarcely be felt. As 
the case progresses heart's action becomes violent ; stupor, so 
that the patient cannot be roused; face becomes pallid ; vomiting, 
coma, great difficulty of breathing, contracted pupils. While in 
this state the conjunctiva may become congested, action of heart 
intermittent, and just prior to death dilatation of pupils, gasping 
respiration, and it may be vomiting. 

In some cases symptoms are very insidious : mere listlessness 
and stupidity, with languor and debility, head feeling strange, yet* 
in a few hours death. In other cases after exposure to the sun, 
the individual has suddenly fallen down insensible, made one or 
two gasps, and died in a state of syncope; the brain being 
enervated, the blood deficient of its serum (clotty), and the secre- 
tions deranged. If recovery does take place, convalescence is 
apt to be retarded by a slight fever, some complications of heart, 
lungs, liver, kidneys, or from paralysis or prostration. Patient 
not free from danger for some time. A great while after apparent 
recovery symptoms of paralysis and insanity may be developed. 
In every case, just like recovery from inflammation of the brain, 
the patient is easily affected, and never the individual he was 
before the attack. 

Treatment. — If one has to be exposed during the hot season 
to the sun's rays, quinine is our best drug as a prophylactic ; 
besides, proper care of the dress and an abundance of water not 
iced. On no account must alcohol be used, but there may be 
utility in coffee or malto cocoa. 

The greatest good is to be derived from the judicious use of 

tepid or even moderately warm water, wrapping the patient in 

a nude condition up in sheets or blankets saturated with or 

wrung out of warm water, keeping them moist by pouring it 

16 



242 DISEASE GERMS. 

freely over them, so that the skin may imbibe the water, an 
element essentially needed in the blood, besides the revulsive 
effects of the water on the periphery of the nerves on the skin. 
The head, also, should be encased in packs, and even copious 
enemas of tepid water. If the tongue is coated, an emetic of 
mustard and salt, allowing the patient to drink freely of tepid 
water and bicarbonate of soda. After it has acted gently, follow 
with half a teaspoonful of compound licorice powder, in which 
one drop of croton oil has been rubbed up, and repeat if bowels 
are not promptly opened. Allow the patient as much water as 
he may desire to drink, for water is the remedy. 

As soon as the patient can swallow, half teaspoonful doses of 
the sesquicarbonate of ammonia freely diluted with water, is a 
good remedy to liquefy the blood, given as often as indicated by 
the condition of the heart. If the patient does not react, no im- 
provement, then cup the nape of neck, shoulders, and apply 
mustard plasters to feet and hands, still holding on to the water, 
and an alkali internally. If a stimulant is necessary, carbonate 
of ammonia, liquor ammonia acetatis and artificial heat ; other- 
w^ise, the case should be managed like chronic inflammation of 
the brain. 

This is the utmost limit of deterioration which 
Cretinism, can be reached by a human being without death. 
It may be regarded as defective, or imperfect 
formation or development of the body, accompanied by a 
dwarfish stature, malformation of the head, which is usually flat 
on top and spread out laterally ; accompanied with mental im- 
becility ; vacant staring countenance ; devoid of intelligence; the 
physical deformity is variable in degree; in mild cases (sporadic) 
the shortness of the limbs is most remarkable. The tips of the 
fingers, instead of reaching well down to the middle of the thighs, 
only extend as far as the umbilicus in many instances. The arms 
and hands are very short, the fingers scarcely longer than the 
toes. The legs are as short in proportion as the arms ; in well 
marked cases (endemic) the mouth is gaping wide, tongue pro- 
truding, saliva flowing; goitre; brutalized habits; squinting 
blindness ; deaf-mutism. 

The endemic form is common in valleys, gorges, in which 
neither sunlight nor purified air enters, where the inhabitants are 
necessitated to drink ice or snow water deeply impregnated with 
silicious or calcareous deposits. In addition to impure air, there is 
usually associated with it bad or meagre diet, extreme poverty, 
insanitary conditions, sensuality, incompatibility consanguinity. 
Whenever either endemic or sporadic cretinism is developed, 



BACTERICIDES. 243 

and the cretin survives and reaches the age, say, of 15 or 20 
years, its condition is equally remarkable and characteristic. 
No signs of puberty make their appearance and the mental con- 
dition is that of iodiocy. Such being the case, cretinism never 
can be transmitted, an impure sustained breed cannot be pro- 
duced. A cretin never can beget a cretin, procreation ceases — 
there is no establishment of a morbid race. 

Probably a hundred years hence, when our population reaches 
two or three hundred millions, the population necessarily re- 
stricted to given areas, this disease may appear in our mountain 
gorges or valleys. 

The disease admits of no treatment. Its prevention is important ; 
this embraces legal enactments to restrain marriage among those 
closely related by blood or temperament, those affected with the 
tubercular bacilli, or crypta syphilitica — to restriction in the use of 
alcohol which atrophies and whittles down the brain of the 
modern Caucasian. 

Under this term there are usually, classed three 

Croup, distinct pathological states : (i) a spasmodic action 
of the larynx, usually caused by reflex irritation, as 
teething, worms and derangements of the digestive tract ; (2) a 
species of laryngitis, due to cold, wet, exposure, often accom- 
panied with oedema of the glottis ; and (3) true croup with 
the formation of a false membrane on tongue, tonsils, uvula, 
larynx and trachea. 

In true membraneous croup, we have a micrococcus very 
much resembling that of diphtheria and croupous pneumonia, 
and although not deemed contagious and infectious, nevertheless 
is so, the microbe being very heavy, the living germs of conta- 
gion are limited to the patient. 

The microbe is easily isolated, either from the false membrane 
or blood, bears cultivation well, the cultures injected into animals 
produce the identical pathological condition, to with a pale red 
gelatinous exudation on the mucous membrane of the air passage, 
giving rise to bronchitis, pneumonia. The bacillus indicum ap- 
pears, patient dies from exhaustion, suffocation, convulsions, 
thrombosis. 

The microbe is pathogenic of the disease, and is associated 
with a special diathesis. 

Symptoms in the early stage are very similar to catarrh : slight 
fever, cough, hoarseness, drowsiness, suffusion of eyes and run- 
ning at nose. In the course of a few hours wheezing respiration ; 
fits of hoarse coughing ; occasional spasm of laryngeal muscles. 
Then the characteristic symptoms, alteration in cough, which has 



244 DISEASE GERMS. 

now a peculiar ringing sound, rendering it brassy ; inspirations 
prolonged, accompanied with a crowing or piping noise ; redness 
and swelling of tonsils, uvula, but not so diffused as in tonsillitis ; 
increased fever ; breathing becomes more hurried and impeded ; 
cough frequent ; great prostration, with irregularity of pulse ; 
great thirst, irritability and restlessness ; patient's features ex- 
pressive of alarm and distress ; he grasps at his throat, thrusts 
his fingers into his mouth, as if to remove the cause of his 
suffering ; symptoms much worse towards afternoon and evening; 
a remission towards morning. If vital force properly aided with 
remedies overcomes the disease, cough loses its peculiar twang, 
becomes moist, crowing inspirations cease, expectoration takes 
place. But if all fail, and death is approaching, drowsiness 
becomes great, sleep is uneasy, child starts and wakes in terror, 
breathing becomes gasping and interrupted, suffocation seems 
impending, congestion of lungs, skin cold, covered with a clammy 
sweat, asphyxia, coma, convulsions or fatal thrombosis. 

Treatment. — There is much good to be derived from general 
management. Patient must be confined to bed in a room with a 
moist atmosphere, whose temperature is 75° Fahr.; steam atomi- 
zers kept running near the bed, with either resorcin, creolin, or 
distillation of jequirity, or iodine, or lime-water, alumina, or lactic 
acid ; or all failing glucozone. Calcium sulphide alternated with 
peroxide of hydrogen acts well in hoarseness. If symptoms 
resemble 'asthma, give quinine in from one to five grains every 
four hours ; and every half hour 30 drops of the acetic syrup of 
blood-root, and if there is any tendency to spasmodic action of 
the muscles, add lobelia. Hot fomentations to the throat, con- 
sisting of solutions of boroglyceride with cocaine act v/ell. 

Nasal bougies composed of resorcin, lactic acid, creohn, etc., 
pushed up the nostrils have an excellent effect. 

Case must be carefully watched, every point guarded, and 
germicides pushed. Diet very nourishing ; beef tea, cream, milk 
and lime-water, malted milk ; bowels kept open with enemata ; if 
there is fever give antifebrine, alternated with liquor ammonia 
acetatis and salicylate of soda. An energetic germicide treatment 
is essentially curative, prevents complications, as embolism. 



A term applied to a variety of morbid condi- 

Cyanosis. tions in which the microbe indicans appears in 

the blood and all vital organs, as the heart, brain, 

lungs, etc., its presence is indicated by a gasping, respiration, 

general coldness and blueness of the cutaneous surface; more 

especially the nose, lips, ears, fingers. It is a diagnostic symp- 



BACTERICIDES. 



245 



torn of asphyxia, pneumonia, Addison's disease, malarial poison- 
ing, purpura, organic disease of the heart, etc. 

In asphyxia and pneumonia, non-aeration, or non-oxygenization 
of the blood ; in disease of the suprarenal capsules, the excre- 
tion of indican is often so great as to stain the underclothing 
blue; the alkaloid ptomaine from the malarial germ in bad 
cases, evolves the indican microbe in immense quantities ; 
in purpura, the factor in the production of the germ is pov- 
erty of the nerve -force; in organic cardiac disease, the presence 
of this microbe is a precursor of an early termination in death. 
The presence of the microbe is invariably associated with embol- 
ism of the blood. 

Cyanosis at or subsequent to birth is dependent on some defi- 
ciency or defect in the construction of the heart, as the septum 
not arriving at its full development at birth ; or from permanence 
of the foramen ovales allowing a passage of blood from the au- 
ricles; or from the origin of aorta and pulmonary artery from a 
single ventricle, or from contraction of the pulmonary artery ; 
any state or condition which permits a mixture of venous and 
arterial blood. 

In the diagnosis, the history of the case, the blueness and cold- 
ness, the difficulty of breathing, fainting on movement or excite- 
ment, violent palpitation. In the congenital form, tips of fingers 
and toes become bulbous, nails incurvated ; imperfect develop- 
ment; dropsical effusions, mostly congenital ; if so, patient blue 
all over, often present at the termination of valvular disease. 

In the treatment, each individual case, dependent upon some 
special disease, must be managed according to its own pathology ; 
asphyxia and pneumonia, liquor ammonia acetatis and salicylate 
soda, alternated with peroxide of hydrogen and compound oxy- 
gen ; in purpura, malaria, disease of the suprarenal, eucalyptol 
is a priceless remedy. 

If it is a congenital, the best plan is to be very cautious in any 
opinions of the case, as in one-half the cases the organic mis- 
chief is irreparable, whilst in the other it is amenable to treat- 
ment. So it is well to keep the little patient warm by keeping 
it rolled up in blankets, with external artificial heat ; nourish 
carefully ; administer one or two drops of digitalis twice daily ; 
in a large proportion of such cases, the digitalis will contract the 
orifice and a cure be effected. 

When it appears as a symptom of other maladies, palliate 
the condition by the administration of bactericides; plaioa 
nourishing food, mild tonics, rest, freedom from mental care or 
worry. 



246 



DISEASE GERMS. 



Cysts. 



A species of degeneration which may have a con- 
genital origin, or may be acquired by some degenera- 
tive action. Properly speaking they are tumors 
consisting of a sac containing solid or liquid substances. They 
may arise by the formation of definite cavities in the meshes of 
the areolar tissue ; by the dilatation and growth of obstructed 
gland-duct or follicles ; by the erratic development of nucleated 
cells, which b-come exaggerated into cysts. Some contain 

serum, others a jelly-looking substance ; 
some blood, others solid matter. 

Cysts in the brain are usually either 
hydatids or cysticercus— both have been 
found, solitary or multiple, and may 
attain considerable size, and cause 
atrophy of the brain. 

Cysts in the kidneys are met with in 
four different forms of degeneration. 
Two of them follow as a natural sequel 
from Bright's disease: (i.) Cysts vary- 
ing in size from a pin's-head to a hazel- 
nut are common, as a result of inter- 
stitial breaking down and obstruction. 
(2.) General cystic degeneration from, 
atrophy and obstruction, and expan- 
cyst.m me kidney. ^-^^ ^^ dilatation of urinlfcrous tubes. 

(3.) Small cysts are often met with on the surface of the kidney, 
which do not interfere with its function in any way.- Sometimes 
they attain a great size, and form an appreciable abdominal 
tumor. (4.) Congenital cysts, complete or incomplete, or kid- 
neys made up of cysts without any trace of secreting tissue ; 
usually combined with other malformations. 

If the result of chronic desquamative nephritis, treatment same 
as for degeneration. In the other forms the 
.symptoms are often obscure. 

Cysts in the Liver are still more common. 
There is a variety of views as to their origin 
and nature ; some believe that they are 
formed by a degenerative process of the 
hepatic cells ; others that they are due to 
dilatation of the minute canals ; others that 
they are a new formation of vacuoles in the 
hepatic cells that these vacuoles are formed 
by obstruction and dilatation of the biliary 
of branches. 

Encysted, knotty tumors, containing a cheese-like substance 





Cysts in the liver. 

ducts, vacuolation 



BACTERICIDES. 



247 



are found in the glandular substance, varying in size from a pea 
to that of a hen's egg. They arise from irritation and inflamma- 
tion of the hepatic ducts ; steatomatous contents composed of 
irregular granules, free oil globules, and occasionally plates of 
cholesterin. 

Simple Serous Cysts, with clear watery contents, are sometimes 
found scattered over the liver, usually about the size of a small 
bean. 

Sacculated Cysts, containing a glairy fluid, are also met with. 
In some cases they resemble a honey-comb. The liver in some 
cases is crowded with such cavities. 

I can suggest no explanation of the fact that such changes in 
the liver should be so commonly associated with similar changes 
in the kidneys. We have no means of determining in which or- 
gan the change commences, though the destruction of the kidney 
and interference with its functions are the more marked. In some 
cases the increase in size of the liver is much more obvious 
than in the kidney, which from its position is accessible to 
examination. 

There seems to be no way in which the changes in the one 
could be secondary to the other. The connection between the 
organs is functional only ; neither anatomically nor by develop- 
ment are they at all related. Perhaps, to take a broad view, we 
may look on the changes in both organs as a constructive 
attempt, possibly making use of embryonic remnants, and in- 
tended to resist degenerative processes in 
the organism due to the strain of advancing 
years and failing powers of excretion and 
secretion. 

Cysts in the 
lungd^xe neither 
so common nor 








wm 

Cysts of the lung. 



so numerous as 

in other organs. 

They are alto- 
gether different in their origin and 
pathology from emphysema. 

Cysts in the mesentery are still 
less common ; when they do occur, 
they are found of very peculiar 
shapes and sizes. 

Cysts in the pancreas are due to 
the retention of the pancreatic secretion, from obstruction of the 
duct by calculi, or from the external pressure of tumors. 
Hemorrhagic cysts are rare ; when the duct is closed near its 




Cysts in the mesentery. 



248 DISEASE GERMS. 

mouth, there is apt to be hemorrhage ; atrophy and cirrhosis of 
the gland may result from these cysts. 

Cysts of the uterus, closed sacs, filled with serum or otherwise, 
are often found developed in the walls of the uterus, or beneath 
the internal lining membrane or serous covering. Sometimes 
one part of the uterine walls is invaded with c) sts, or small 
bladders, while another part is infiltrated with fibrous tissue, or 
the ordinary fibroid tumor. These cysts give rise to trouble and 
inconvenience when they attain any size, such as leucorrhoea and 
hemorrhage. If within reach, they may be punctured. They, 
like the others, are unaccompanied with pain ; not infrequently 
give rise to uneasiness. The best treatment is a general alterative 
and tonic course. 

In order to avoid those three common forms of uterine disease, 
there should be a rigid avoidance of irritation of the uterus, 
either by tight lacing, wearing sponges or pessaries, masturbation, 
abortions, irritating caustics of doctors, especially nitrate of silver ; 
even certain occupations, as the sewing machine, should be 
guarded against, or other forms that aid in the production of 



The ear with its appendages is a perfect instru- 

Deafness. ment'by which the brain receives the undulations 
of sound from the external world, through the 
medium of the auditory nerve reflected upon the membrana 
tympani. 

A normal state of the brain and ear is essential to perfect 
hearing. 

Loss of hearing may be the result of a great variety of states 
or conditions, and supervenes as a sequela of nearly all affections 
of the middle and inner ear. 

Every disease germ incidental to the human body, when 
present in the blood, finds the ear a favorite structure for deposit 
and growth ; the microbes of typhoid and typhus fevers often 
leave the ear in a state of dilapidation ; tubercle, syphilis, rheu- 
matism, gout, their spores, germs, and ptomaines are destructi\{e 
to the ear, and often cause irreparable deafness ; the migratory 
germs of scarlatina, mumps, diphtheria, measles, nasal catarrh, 
produce great havoc in the ear by giving rise to points of ulcera- 
tion (nests), and various inflammatory changes in the ear. 

Microbes in the nose, fauces, throat, often find their way up the 
eu-tachian to the inner ear and give rise to pathological changes 
an' I deafness. 

Besides these and other affections in which the hearing is 
i^iipaired or permanently lost, there 2lyq: five other states in which 
the hearing is either impaired or lost. 



BACTERICIDES. 



249 



1. A class of cases due to aiKEinia of the brain, in which the 
emotions, desires, affections, passions, play an important part ; 
among these emotional deafness, the death of a friend, fright, 
Hews of a painful character ; exhausted vital force, by sexual 
excesses ; shocks ; masturbation ; want of nutrition in the brain ; 
action of the sun ; railroad jars ; meagre brain food ; isolation ; 
monotony ; sameness ; obliterating the typical brain fissures. 

Best treatment for deafness due to anaemia, is avena sativa; 
glycerite of kephaline ; nitro-glycerine ; coca wine ; cerebrin ; 
peroxide of hydrogen; removal of cause ; nourishing brain food ; 
every thing possible to create richer blood. 

2. Deafness due to congestion, a determination of blood to the 
brain, as in apoplexy, etc. 

Best treatment, foot baths ; hot mustard water ; free purgations, 
stimulants to the nape of the neck and shoulders. 

3. Reflex, chiefly due to teething, worms ; irritation to 
stomach, liver, bowels, uterus, sexual organs. 

The chief point is to get rid of cause. 

4. Often due to the careless and indiscriminate use of such 
drugs as quinine, chloral hydrate, opium, belladonna, tobacco. 

Coca wine ; avena sativa ; glycerite of kephaline. 

5. ■ Organic, due to bankruptcy of the brain ; white softening ; 
:^trophy, obliteration of its convolutions ; very hopeless. 

In all the different varieties an effort at cure should be aimed 
at by placing the patient upon a general alterative and tonic 
course of treatment, as all affections of the ear are most amenable 
to constitutional treatment. 

The introduction of so many invaluable remedies of late have 
effected a complete revolution in aural diseases. For example, 
the internal use of nitro-glycerine alternate with avena sativa 
operates like a charm in some cases ; in others the glycerite of 
kephaline, in alternation with the peroxide of hydrogen, with 
the use of mullein oil dropped into the ear. Brain food is essen- 
tial in all cases, change of air, especially the mountains where the 
atmosphere is highly rarefied and ozone is abundant. 



Saccharine diabetes, a complicated chronic 
Diabetes, malady, characterized by the presence of glucose 
or or grape sugar in the urine, blood, and all the 

Mellituria. solids and fluids of the body. 

The liver is the great sugar-forming gland, and 
ft is to that organ we must look for the grand predisposing cause. 
Any irritation transmitted to it through the medium of the eighth 
pair of nerves from the brain, produces an exaggeration of the 



250 



DISEASE GERMS. 



hepatic secretion, and an augmentation in the flow of urine. 
Still, the liver may be irritated reflexly by a diseased stomach, 
pancreas, spleen, either by the presence of disease germs in the 
blood ; or the abdominal brain, the great sympathetic, may be 
damaged by worry, struggle, mental depression, depressing 
passions. 

This irritation, central in the brain, peripheral in the liver, 
may be directly due to shocks, falls, blows, concussions, over- 
work, exposure to the sun, drinking ice-water when heated, or 
vicissitudes of climate. 

As a rule it comes on slowly and insidiously, with great mus- 
cular and nervous debility ; greatly increased flow of saccharine 
urine, of an apple odor, of a high specific gravity of from 1035 
to 1060. Still, cases are often met with in which the specific 
gravity is lower ; skin invariably very dry and harsh ; obstinate 
constipation, gradual failure of health and strength, with loss of 
sexual power, pain in loins ; extreme prostration ; coldness of 
extremities, with sense of burning in hands and feet. Debility 

increases, weight diminishes, bod*y 

shrinks, withers ; oedema of feet ; some- 

^"^ a ^ \ JJ ^ times albuminuria ; breath has a chloro- 

^ Ji M o\k ff '^ form odor from imperfect combustion 

of sugar ; gums spongy ; teeth drop 
out ; mental depression and irritability ; 
constant sense of sinking at pit of 
stomach ; appetite for food voracious ; 
Thegiucosefungusof Diube-.es, or thirst cxtrcme ; strong tendency to 
^^^^'''""^- cataract. After it has lasted months or 

years, the lower lobe of the right lung, which is so fully covered 
by branches of the sympathetic, becomes literally invaded with 
tubercle, colonizing from below and proceeding upward. There 
may be boils, eczema, psoriasis, lichen, with pruritus of the genitals. 
The above are the common symptoms, when it originates in 
the brain, the great co-ordinating chemical centre ; but when it 
starts in gastric intestinal catarrh, from the presence of some 
poisonous substance, or microbes, with its ptomaines, or morbid 
material generated in the intestinal tract, there may be in the 
early stage localized or paroxysmal pain in the upper part of the 
abdomen, and vomiting of green-colored matter, exceedingly ob- 
stinate constipation, heart affection, cerebral irritation, somno- 
lence, great prostration, febrile spells, in which the pulse is fre- 
quent and small, with very rapid breathing, with remarkably deep 
inspirations, dry tongue, intense thirst, and no elevation of tem- 
perature. By-and-by the symptoms coalesce. 

The whole train of symptoms point to a nervous origin at the 




BACTERICIDES. 



251 



base of brain in the fourth ventricle ; even the eye-symptoms can 
.be partially explained. The spinal root of the optic blending- 
with the sympathetic and passing the origin of the eighth pair, 
in the base of the brain, may receive a pathological effect ; at all 
events, this root brings the retina into direct communication with 
the co-ordinating chemical centre and the medulla. The exist- 
ence of this branch is interesting, as it throws light on the 
physiological relation between the parts affected in diabetes, the 
medulla and retina, and it constitutes the undiscovered link be- 
tween certain diseases of the spinal cord and eye. There are 
often wandering, or aching pains in the bones ; hyperasthenia of 
the soles of the feet ; flesh is tender ; feel as if they were walk- 
ing on pebbles ; cannot maintain their balance ; sciatica is 
common. 

Besides, the very common termination ; tubercular consump- 
tion, bronchitis, pneumonia, peritonitis, gangrene, may take place, 
or the patient die from exhaustion. 

To constitute the morbid condition, there must be a persistency 
of sugar in the urine with the symptoms. This can be readily 
detected by the potash, copper, or fermientation tests. 

It is clearly to be understood that the liver, under this weak- 
ened or irritated nerve, can, will secrete, and continue to secrete, 
sugar, without either sugar or starch being introduced into the 
stomach. If sugar or starch is taken in, we then are feeding a 
poison the system cannot get away with. What becomes of the 
sugar that is taken in, in some cases, even in large quantities, see- 
ing none of it is ever found in the chyle or portal vein ? It must 
be transformed somewhere, and this transformation is, no doubt, 
effected in the duodenum by the agency of the pancreatic juice. 
If the digestion of sugar does take place in that way, and it 
should happen that the pancreatic secretion was insufficient, from 
disease of pancreas itself, from the disturbing and inhibitory in- 
fluence upon the nerves controlling the secreting function of pa- 
thological events, or from the constant ingesta of sugar in too 
large amount, a greater or less quantity of sugar which has 
escaped transformation must accumulate in the intestines. Of all 
tissues that keenly absorb sugar the intestinal tract is the most 
active, especially the small intestines. 

When the co-ordinating chemical centre in the brain is dam- 
aged, and the irritation is transmitted to the liver, grape sugar is 
elaborated in such quantities that the ozone-forming faculty of 
the lungs is incapable of burning it up, hence the presence of this 
agent in all the tissues of the body engenders the formation of a 
fungus in the blood, which is easily isolated, especially from the 
urine. 



252 DISEASE GERMS. 

This glucose fungus is pathogenic of diabetes, capable of cul- 
ture in any starchy or saccharine liquid at a temperature of be- 
tween 80 and 90° F. Cultures injected into animals give rise to 
precisely the same symptoms as in man. 

As a rule animals into which those cultures are injected die 
before the microbe of boils and bacilli of tubercle put in an ap- 
pearance. There is a pathological alteration of cell-life through- 
out the organism by virtue of which a greater or less part of the 
elements have lost the capacity of destroying the sugar secreted 
in excess. f, 

Treatment. — In the general management of the case, daily 
bathing, flannel clothing, bowels to be opened every morning, for 
great improvement follows the abundant evacuations of extremely 
offensive and almost black quantities of excremental matter 
loaded with ptomaines, so, as a rule, empty the bowels daily ; for 
it is not too far-fetched an idea that the sugar has undergone de- 
composition or some chemical change in the intestines, and aids 
in producing that terrible burning and thirst so common in 
diabetes. 

The diet is to be highly nutritious, and free from sugar and 
amylaceous ingredients, for then the pancreatic juice is sufficient 
to meet the trifling amount of sugar present. How far the pan- 
cn^atic juice suffices for the transformation of sugar in different 
cases, it is not easy to say. It is difficult to prepare a diet list 
entirely free from sugar, for even flesh, yolk of eggs and most 
acid wines contain sugar ; and with regard to vegetables, the 
stalks and ribs of salad and leafy herbs all contain sugar. In 
short, with the exception of cheese and sour milk, there is scarcely 
any edible to be found that does not contain sugar. If in spite 
of a diet of flesh, white-fish, grame, ^z?.^, beef-tea, cream, cheese, 
bran-loaf, gluten bread, herbaceous vegetables, the sugar does 
not disappear, we know that the case is beyond the reach of pan- 
creatic influence, or the patient may not have adhered strictly to 
the rules. Rigidly forbid cane sugar, but allow saccharine fruit, 
confectionery, potatoes, carrots, parsnips, beets, turnips, radishes, 
rice, sago, arrowroot, tapioca, liver, oysters, lobsters, crabs, beer, 
whisky, coffee. If able, gentle exercise in open air. Two small 
irritating plasters, an inch square, should be kept constantly ap- 
plied to the nape of the neck ; one on each side, and stimulation 
over the region of liver. A persistent alterative and tonic course 
commenced and persevered with ; vegetable extracts, with iodine 
and such tonics as cinchona. The appetite for food and drink is 
best appeased by the administration of the glycerite of kephaline 
or tincture of oats. 

After attending to the general management of the case, our 



BACTERICIDES. 253 

treatment becomes decidedly empirical, and is confined almost 
exclusively to the use of cerebral tonics and bactericides. 

These are a few remedies worthy of most serious consideration. 

Sambid seed finely pulverized, introduced into a capsule or 
pearl which will hold five grains, to be taken after every meal, 
has a magical effect in diabetes. The use of five grains of this 
drug after each meal, corrects the faulty condition of saccharine 
fungus evolution, and it disappears from the blood and urine 
while taking this remedy, and the patient may eat anything on 
the entire list of dietetics, and for years he may prolong his life in 
comfort, but let the remedy be discontinued, the fungus promptly 
re-appears in both blood and urine. Although not a curative 
drug, while taking it its action works wonders. 

Drugs of any utility in this disease must have a germicidal 
action. 

Salicylic acid, combined with the acetate of ammonia, and 
alternated with the glucoside of the poplar bark is most effectual 
in old, stubborn cases, and is worthy of a trial. 

The glycerite of ozone acts very energetically upon the glucose 
fungus in the blood, and destroys it at the same time ; appeases 
the appetite for drink and food, brings the specific gravity of the 
urine down to a normal condition ; patient improves under its use. 

Chlorate and permanganate of potass, comp. oxygen, ozone 
water, peroxide of hydrogen, glucozone, etc., all operate most 
efficaciously in sterilizing the fungus. 

All the vegetable balsams, such as copaiba, petroleum, oil of 
sandal wood, pine needles distillation, will, when administered, 
destroy the fungus, bring the urine to a normal standard. 

The sulphide and chloride of lime are essentially remedies of 
great value. 

Lactic acid, salol, resorcin, iodol, sulphonal, naphthaline and 
saccharine, with very little benefit except a slight amelioration of 
the symptoms. 

Saccharine has probably been more extensively used than any 
other of the phenol products, but its prolonged use gives rise to 
gastro-intestinal irritation and a sweet taste in the mouth, which 
is very disagreeable. 

Good results have been obtained from full doses of the citrate 
of lithia in alternation with boroglyceride in from ten to twenty 
grain doses. 

Where pains are prominent, either rheumatic or neuralgic, the 
salicylate soda and liquor ammonia acetatis, afford immediate 
relief. 

When the disease can be traced to chronic liver disease, the 
nitrate of uranium is invaluable. 



2 54 DISEASE GERMS. 

If the attending physician views the case as one of irritation 
of the visceral brain, he will use opium or codeia, in alternation 
with white hellebore and quinine, with most satisfactory results. 
Codeia is undoubtedly the best form, so long as it exercises a 
salutary effect over the disease ; narcotic symptoms early present 
themselves. 

Excellent results follow the exhibition of the cascara sagrada 
lozenge ; two following each meal often effects a perfect revolution 
upon the fungus. 

Exalgine is the most recent remedy, and there is no doubt that 
by its peculiar action on both liver and brain, it greatly dimin- 
ishes the amount of sugar in both blood and urine. The dose is 
from six to twelve grains in the twenty-four hours. 

Any cutaneous affection that may appear, is due to the sugar 
fungus, whatever it may be ; eczema, lichen, psoriasis, pruritus, 
must be treated by the application ol bactericides, as resorcin 
ointment, cerate of the pine needles, iodol ointment, ichthyol 
lotion, or essence of peppermint. 



This is usually defined as the discharge of fluid 
Diarrhea, or semi-fluid faeces from the bowels without pain 
or tenesmus. It is met with in an acute or 
chronic form. Both forms are characterized by frequent loose 
evacuations from the bowels, due to either functional or organic 
derangement of the small intestines, and produced by either local 
or constitutional causes. The evacuations vary in consistence 
and quality, as well as in quantity and frequency ; they may be 
fluid or semi-fluid ; sometimes they are watery and serous, at 
other times they are mixed with mucus and occasionally a little 
blood. In children diarrhea is readily produced and is often very 
troublesome to cure ; it may be acute or chronic, and in both 
forms is dangerous to life. Under five years of age the mortality 
from this cause is greater than at any other period of life, and the 
greatest liability is shown during the period of teething, from six 
months to eighteen months or two years of age. In hot climates 
diarrhea is more common than in cold. As regards the time of 
year, diarrhea is far more prevalent in the summer and autumn 
than in spring or winter. 

P [The causes of diarrhea are numerous and varied, and are 
divided into local and general; among the former are to be classed 
indigestible food, impure air and water. Amongst the latter may 
enumerated disease germs, which induce a diminution of vital 
power. It is often beneficial and due to an effort of the irritated 
bowel to throw off its noxious contents, as in cases where decay- 



BACTERICIDES. 255 

ing fruit or vegetables, or tainted meat or fish are taken ; in such 
cases a fatal result may follow from ptomaines being evolved ; 
hence in order to treat a patient with success, it is 
always important to make out thoroughly the ^^ • 

cause; hence it is imperativ^e to make a division ^i-f >' V? "''b.-' 
of the subject into a variety of forms, but in each jV'^.-C*''^/^ 
and all of them are to be found the pathogenic *tV*%'^*»-V^ 
microbe of diarrhea. ^'^'''-'X^ 

This microbe is the factor of all cases, it bears * 

culture well, and the cultures injected into animals The microbe of 

' . •' diarrhea. 

give us the disease. 

The Summer Diarrhea of Infants. — The factor operating in the 
causation of the summer diarrhea of children is to be found in 

the presence of micro-organ- 
isms in the food, either before 
or after it entered the body. 
Putrefactive changes split up 
complex molecules and form 
chemical poisons. 

Milk is the natural food of 
all young children, and next 
to raw beef is a great attrac- 
'^^f*?>T^^|?^^£ */^^^ tor of germs, especially so 

' ' ->^-,tr,v.,?,.;^V ./ V.<n-:r^ '<- when the insanitary sur- 
roundings are bad, an organ- 
ized ferment is present ; this 

The summer diarrhea of infants. j^ ^^jj^^ tyrOtOXicOU, prCSent 

in milk when exposed to germ-laden atmospheres, and when sub- 
ject to variations of temperatures as in the thawing and again 
freezing of ice-cream, and in the imperfect curing of cheese. 
This highly poisonous substance can be isolated from all cow's 
milk, when that fluid has been subject to changes or exposure, 
or a temperature of from 90° to 100° F., and when given to 
children causes violent vomiting with purging. 

The most efficient preventive treatment consists in withdrawing 
the milk or in taking means to sterilize it, or in prescribing steril- 
ized malted milk, so as to insure the destruction of the bacteria. 

These views are confirmed by the most eminent bacteriologists 
of this country, who emphatically state that the chief factor at 
work in the production of the summer diarrhea of children is to 
be found in the food, water, insanitary surroundings, with in- 
creased solar heat 

The change by which toxic principles (ptomaines) are evolved 
is due to the presence of the microbe amylobacta and its own 
microbe. 




256 



DISEASE GERMS. 




This micro-organism by itself may cause mucous, serous 
diarrhea, but when it is active, as it is in certain grades of milk, 

it excretes ptomaines and a peculiar 
poisonous substance, ^* tyrotoxicon /' 
then in addition to the diarrhea, there is 
violent vomiting, purging, emaciation, 
and often death. Certain grades of ice 
cream, and cheese, contain those poison- 
ous principles in great activity. 

It is indispensable therefore that milk, 

unless sterilized or malted, must be rigidly 

forbidden as an article of diet. 

Milk globes as^eln in fresh sweet Thc principlcs of treatment to either 

Sim'TSilfMaUedB stcrilize or annihilate the microbe are: 

Co of Raciue, Wis In such Cold watcr baths twicc daily, fresh air 

milk no " tyrotoxicon. . ir- i- • ^ - 

animal and larmaceous diet, with rest i« 
bed. Some germicide application applied to abdomen, either 
aromatic spices or concentrated ozone, with chloroform. 

Select one or other of the following drugs, and administer ia 
small doses every hour when awake. 

Essence of mustard, a few drops in a decoction of kaki. This 
essence ranks next in bactericide power to the chloride of calcium. 

Resorcin, a few grains extremely efficacious. 

Naphthaline, a germicide of rare power in microbial bowel af- 
fections. 

Salol must not be overlooked, on account of its chemical affin- 
ity for this germ. 

Ozone water, peroxide of hydrogen, must not be overlooked 
as great intestinal disinfectants. 

Cascaradyne lozenges are also of the utmost utility. 

The above have entirely superseded the use of the salicylate 
soda in summer diarrhea ; all are effective in killing the germ 
amylobacta and antidoting the tyrotoxicon. 

Fectdent Diarrhea, generally due to bad, indigestible food, 
impure water, such as contains the decomposing juices of animal 
or vegetable matter, is a fruitful source of this form of diarrhea, or 
an aid to the evolution of germinal matter and its ptomaines. 
Unripe fruit or vegetables as well as decayed are very deleterious. 

Fish, shell fish, if not perfectly fresh, may cause considerable 
distress with nausea, vomiting and purging. All meats, fruits, 
vegetables, no matter what their chemical character may be, pre- 
served in hermetically sealed cans, are but microbial masses of 
all sorts of bacteria, which when swallowed on the stomach begiii 
to germinate, breed, develop spores and ptomaines, and cause 
diarrhea mechanically as well as toxically. 



BACTERICIDES. 



257 



In simple irritative diarrhea, the patient will feel, a few hours 
after a meal, some flatulence and pain in the bowels, followed by 
loose evacuations ; this purging may and generally does relieve 
the pain; the motions are feculent, and consist of a brown fluid 
containing small lumps of solid faeces; if the purging continues, 
the motions become more liquid, and contain mucus. Generally 
the diarrhea will cease of itself as the noxious cause is removed 
by the purging. If the cause should be diseased or putrid food 
and water, then the diarrhea will be more severe and exhausting ; 
there will be considerable constitutional disturbance; the pulse 
may become feeble, and the surface of the body is colder than 
usual. In children simple irritative diarrhea is very common in 
the summer and autumn months. If the attack comes on in 
previously healthy children, it generally attacks, and is attended 
with vomiting of the contents of the stomach; at first the excreta 
are natural, then they assume a yellow color, which changes to 
green on exposure to the air, or they are slimy. The following 
microscopical illustrations will demonstrate more clearly than 
words some of the causes of diarrhea : 




Bacillus Figiirans, mag- 
nified 400 ; found in 
garden earth and on 
green vegetables, as 
parsley, salads, etc. 



si*' ^ ^ 



S l^-.*"v .. c" 'v ' 



ft 



Comma Baoillus, as seen in 
river water into which 
sewage eniers, and which 
supplies home of our large 
cities— a common cause of 
diarrhea to strangers. 



\ 

Bacillus Megatherium, 
as seen in sauer-kraut, 
productive of intes- 
tinal irritation. , 



V. - 



Water in marshes, usually 
loaded with Spirillum voli- 
tans, which gives rise to 
diarrhea. 




Various forms of Animalcules. 

Found in stagnant drinking water, which give rise 
to diarrhea. . 



17 



258 



DISEASE GERMS. 




Bacilli in putrid fish, showing the protoplasmic 
threads ; the eating of such is not only toxi- 
cal, but is productive of diarrhea and leprosy. 



"O^- . d ^o 






'^cac^ 



<^. 



1^ 



000 ^Cb 



9i^ 






Bacillus Alvei, as found in honey, which, 
if used, is not only productive of diar- 
rhea, but mellituria. 






% 




r(fl\ II 



Bacillus Alvei, as found in honey, 
which is eaten by children, is 
productive of diarrhea. 




Bacillus Megatherium on boiled cab- 
bage half an hour after being 
cooked, gives rise to irritation ot 
the bowels, diarrhea. 



In the treatment of feculent diarrhea, caused by the ingestion 
of bad or germ-laden water, or by deleterious food, or otherwise, 
the stomach and bowels should be cleansed out by an efficient 
cathartic ; rest enjoined ; concentrated ozone applied over the 
entire abdomen ; over and above the flannel roller. Following the 
action of the cathartic, select some one of the following bacteri- 
cides and administer in suitable doses every hour, as amelioration 
takes place at longer intervals between. Peroxide of hydrogen, 
resorcin, naphthaline, salol, salicylate soda, acetate of ammonia, 
etc., or fl. ext. stone crop, or collinsonia, or infusions of kaki, 
or bayberry, etc. 

Mucous and Serous Diarrhea, the former where the mucous 
coat is relaxed ; the latter when the serous coat is irritated. 



BACTERICIDES. 



259 



Both forms, if the tongue is clean, may be successfully treated 
with rest, the application of a flannel roller over abdomen, and 
mild vegetable astringnets, such as infusions of kaki, cranesbill, 
stone crop, coUinsonia, or by the mineral acids and quinine. 

Germicides, as sulphur water, resorcin, naphthaline, creolin. 

Boiled milk in which cinnamon sticks are incorporated. 

Biliary diarrhea is most common in the summer months, 
caused by intense solar heat, carbonaceous food, alcoholic 
drinks ; malaria, or the damp, faint-smelling emanations from 
a marshy district, which are very injurious ; in summer time, 
walking along the banks of the river, where the stream is sluggish 
and rank vegetation abundant, it may be often noticed that, as 
evening comes on, a faint, damp smell is present, which is very 
injurious to those subjected to it. Bad dwellings and cold, damp 
houses, especially those which are situated low and badly drained, 
will cause this disease ; and so also insufficient clothing will aid 
in its production. 

This form of diarrhea is easily recognized by the injected con- 
junctiva, brown skin, and heavily coated tongue; stools exhibit a 
great excess of bile. 

In the treatment, rest, in the recumbent posture, hot fomenta- 
tions over liver ; if there be nausea, vomiting, an emetic of ipecac, 
cleanse out the bowels with one, two, or more doses of euonymus 
and caffeine, follow with : Comp. tr. cinchona, four ounces ; nitro- 
muriatic acid, three drachms; simple syrup, two ounces. Mix; a 
teaspoonful every three hours. Quinine and aromatic sulphuric 
acid, peroxide of hydrogen. 

Chronic diarrhea is said to exist when either of the other forms 
last a long, time. There is very apt from the nature of things, to 
exist some, if not a good deal of ulceration of both the mucous 
and serous coats. Besides, in chronic diarrhea, we have to con- 
tend with a perfect loss of tone in the bowel, an inability on the 
part of the lacteals to absorb the digested products, and on the 
part of the bowel to hold its contents. 

In all forms of chronic diarrhea, the diet should be solid, light 
and of the most nutritious character. Forbid fruit, the flannel 
roller should be worn and rest inculcated ; an alterative and 
tonic course prescribed. Movements of bowels restricted to one 
per day with a pill composed of equal parts of pulverized opium 
and tannin. Sufficient quantity to be taken to insure the result. 
Then follow with special remedies to vitalize the bowel, such as 
kaki, bayberry, collinsonia, poplar bark, and stone crop. A 
strong infusion of one of them should be made every morning 
and drank freely during the day. The stone crop and collinsonia 
are best prescribed in the form of a fluid extract — in teaspoonful 



26o DISEASE GERMS. 

doses, thrice daily — using one for a week, then alternating with 
the other. 

In the Diarrhea of Typhoid bactericides should be energeti- 
cally pushed, especially naphthaline, creolin, and resorcin. The 
diarrhea must be arrested at all hazards, never encouraged on 
the fallacious idea that the microbe escapes by the stools. True 
the retention of the germ is bad, but diarrhea is always weaken- 
ing, and very dangerous as it tends to [rupture the thin-based 
ulcers on the bowels. 

Melcena or black stools in diarrhea, or evacuations like tar, are 
due to the presence of blood from the stomach and bowels, acted 
on by the intestinal juices. Degeneration of the liver necessarily 
gives rise to congestion of the gastric and intestinal vessels, a 
condition that gives rise to extravasation of blood from the 
gastro-intestinal membrane. It may be present in enteritis and 
other morbid conditions of the alimentary canal. 



A disposition, some constitutional affection of 

Diathesis, the body, some predisposition to certain diseases 
more than others. Before the discovery of the 
germ theory of disease, there was a large variety of diatheses 
ingrafted on all our medical works, as the tubercular, cancerous, 
gouty, rheumatic, etc. More recently the classification has been 
greatly curtailed, reduced to three, namely : 

The uric acid diathesis. 

The phosphatic diathesis. 

The oxalic acid diathesis. 

The uric acid diathesis is the most common, and to appreciate 
it thoroughly we must have a due appreciation of the function of 
the kidneys. 

The human kidneys are situated in the region of the loins, on 
each side of the spine, and are imbedded in a layer of fatty tissue. 

The averag-e length of each kidney is about four inches, its 
weight from four to six ounces. The substance of the kidney is 
dense, extremely fragile, and of a deep red color. 

A vertical section of the kidneys will show them to con- 
sist of different substances, which are named from their position, 
the external or cortica, and the internal, or medullary substance. 
The cortical substance forms by far the greater portion of the 
gland, and sends numerous prolongations inwards between the 
pyramids and medullary substance. It is soft, granular, and con- 
tains numerous minute, red, globular bodies, diffused throughout 
it, which are called from their discoverer, the Malpighian bodies. 
Its substance is made up of uriniferous tubes, capillaries, lym- 



BACTERICIDES. 26 1 

phatics and nerves, held together by an intermediate parenchyma- 
tous substance. 

The medullary substance consists of pale, reddish, conical 
masses, usually twelve in number, although these often vary from 
eight to eighteen, their apices point to the hollow space, which is 
termed the pelvis of the kidney, which occupies the interior of the 
gland. The medullary substance is firmer than the cortical, and 
instead of being granular, presents a striated appearance from its 
being composed of minute, dense, gray, uriniferous tubes, which 
run in straight lines through the kidneys, after having received a 
highly convoluted course through the cortical portion. 

The cavity or pelvis of the kidney is lined by mucous mem- 
brane through the medium of the ureters, which extend into the 
tissue of the kidney to meet the uriniferous tubes. The mucous 
membrane forms cup-like cavities around the termination of each 
pyramid. The cavity termed the calyx receives the urine from 
the open termination of the tubes and conveys it towards the 
pelvis, from whence it passes down the ureters into the bladder. 

Each kidney is supplied with blood by renal artery, a large 
trunk which comes off at right angles to the aorta. The blood 
enters the kidneys and is there subjected to a filtration or separ- 
ation of the various matters which constitute the urine, after 
which it is returned into the venous system by the renal or emul- 
gent vein. 

The nerves are derived from the renal plexus and belong 
entirely to the sympathetic system. 

The respective function of the essential elements of the kidneys 
is the anatomical arrangement of the tufts, so as to secrete urine 
from the blood, to separate the various organic constituents and 
inorganic salts, which collectively form the solid constituents of 
the urine. 

The secreting cells do not undergo rapid decay and renewal, 
they seem impervious to change, but their great faculty is their 
innate power of selecting certain waste materials from the blood, 
and eliminating them without the disintegration of their own 
structure. Their function is secretion of urine, one of extreme 
importance, for if arrested by any cause, death is inevitable ; the 
selection, the secretion of waste, effete matter, complex fluids 
which have played their part in the organism from the blood. 
They do not eliminate disease germs, although those microbes 
may aggregate in the kidneys, block up the tubuli, and force 
theni'^elves through by a laceration of the tufts, as seen in scarlet, 
malarial and yellow fevers. 

An ordinary sized man in twenty-four hours willpass fifty-two 
fluid ounces of urine. This yields, on evaporation, nine hundred 



262 DISEASE GERMS. 

and thirty-five grains solid constituents ; five hundred and twenty 
of this is urea ; two hundred and sixty-six chloride and phosphate 
of soda, lime, ammonia, creatine ; while the remaining one hun- 
dred and forty-nine grains is uric acid and its salts ; depending 
much on the kind and quality of the food and drink. These 
constituents in health render the urine very slightly acid, but the 
acidity of the secretion of the kidneys and stomach stand in an 
inverse relation to each other, so that the urine loses its acidity 
and may even become alkaline during stomach digestion. Dis- 
ease either diminishes or increases certain urinary elements, and 
tells whether the disease is gaining or losing ground. 

In all fevers and inflammations, except the nervous, the uric acid 
is vastly increased owing to the metamorphosis of tissue. In 
gout and rheumatism, in a state of sameness, isolation or mono- 
tony, the urea and uric acid is greatest, incidental to a perverted 
state of nutrition. 

Just as sexual neurasthenia increases so does the rate of kidney 
trouble and disease, for the weak back and albuminous urine are 
present in self abuse, spermatorrhoea, prostatitis, impotency, per- 
verted sexual appetite, debility. 

All disease germs, their spores and ptomaines, when in the 
blood, if not destroyed, have a damaging effect on the kidneys. 
The microbe of scarlet fever, variola, measles, the bacteria of er\-- 
sipelas, the streptococcus of diphtheria, the bacillus of malaria 
and numerous others, become impacted in the kidneys, give rise 
to congestion and passage of albumen. Properly speaking no 
disease germs can be eliminated ; they must be destroyed in the 
blood. In the migration of disease germs, when they are pre- 
sent in the blood, the liver, spleen, lymphatics, glands, especially 
the rectum, become the abode of the living, breeding micro- 
organisms ; the kidneys resist the egress of living germs, 
although it is a hot-bed of spores and ptomaines. The dead 
germs of tubercle, cancer, .syphilis, of malaria, of fevers, are to be 
found here. 

The presence of the living germs of disease, either alive or 
dead, in the kidneys, weakens their structure, impairs their secret- 
ing power, deranges their function, so that the urea is imperfectly 
sep.irated from the blood, and consequently imperfectly elimin- 
ated, congestion ensues and exudation of albumen and fibrin is 
the result. 

If disease germs could only pass through the kidneys, instead 
of lodging in their interstitial structure, humanity could be spared 
a vast deal of Bright's disease. 

This terrible malady is due in two-thirds of all cases directly or 
indirectlv to microbes in the blood, and the other third to strains. 



BACTERICIDES. 



263 



blows, venereal excesses, drugs, drinking, over-indulgence in malt 
and alcoholic liquors. 

Disease germs, in the blood, their micrococci lodged in the 
kidneys, give us the languor, the lassitude, the debility, the neuras- 
thenia, albuminous urine, the drowsy aspect, the bloodless, 
flabby, uriniferous look of a large percentage of our people. 

The late increased prevalence of kidney trouble has been attri- 
buted to drinking of the well-drugged beer of the present day ; 
but although true to a certain extent, it would be more correct to 
place it to the credit of genital debility in young men whose 
genito-spinal centre has been unduly excited by excesses in mas- 
turbation, who have fallen into a state of mental and physical 
bankruptcy, suffer from albumen in the urine, of nerve origin. 

Urea is, however, the grand source of nearly all kidney trouble. 
The sources of urea, besides the ordinary tear and wear of the body, 
arise from all the vices and defects of civilization ; from adulter- 
ated food and drink, from insanitary states, isolation, monotony, 
sameness either in habits, food, or otherwise, from disease, espe- 
cially gout or rheumatism ; a perversion of nutrition takes place 
and an excess of uVea or uric acid, 
and with it degraded living mat- 
ter, disease germs. 

The uric acid diathesis may be 
recognized by chemical and mi- 
croscopical examination of the 
urine, and general languor, las- 
situde and debility, which 
variably present, by a 
state of the co-ordinating chemi- 
cal centre in the brain, which, 
gives rise to indigestion, and a 
conversion of all the starchy and 
saccharine elements of the food 
into uric acid ; that this faulty 
digestion and imperfect assimi- 
lation, are greatly aggravated by 
monotony of life, isolation, confinement indoors ; sameness of 
diet and habits ; that this mal-conversion is aggravated by the 
sarcinae ventricuh, disease of the liver and pancreas ; imperfect 
aeration of the blood by the skin, lungs ; rapid oxidation as in 
fevers, or excessive muscular exercise ; its recognition is assured 
when we find a persistent copious deposit of red gravel, a brick dust 
sediment, from a few grains to a considerable amount, deposited 
when the urine cools. Uric acid is most most irritating to the kid- 
neys, bladder, prostate, giving rise to undefined sensations of irrita- 




is m- 
damaged 










^i<^l 



■Slagnified view of uric acid in different forms. 
The dumb-bell shaped forms seen in upper 
part of the figure were formerly supposed to 
consist of oxalate of lime. It has recently 
been shown that they are a form of uric acid 
crystal. 



264 DISEASE GERMS. 

tion in the loins; sometimes excruciating pain in the kidneys; nau- 
sea, vomiting, aching in the thighs; retraction of the testicles; irri- 
tation of ovary ; itching at the orifice of the urethra ; irritable 
bladder, with continence or incontinence of urine. The passage 
of the urine causes a burning or smarting sensation ; and when 
the uric acid crystals are large, a cutting, tearing sensation, as if 
particles of glass were being passed, with bearing-down and 
prostration. 

Treatment. — Special attention should be paid to giving the 
patient immediate relief, and this can only be done by the admin- 
istration of alkalies, a class of remedies whose use is likely to be 
detrimental if administered for any length of time; still, for a few 
days, they had better be given, say, five or ten grains of bicar- 
bonate of potassa thrice daily, While thus affording temporary 
relief, proceed to the removal of cause — sameness, monotony, 
isolation; inculcate change of habits, diet, of everything that 
savors of sameness or monotony, for a high grade of mental and 
physical existence can only be attained by change. The essential 
element of life is incessant change; and in order that the highest 
state of existence may be procured, this must be attained. The 
make-up of the tissues of the body exhibits that facts ; the fresher 
they are, the more complete their change ; provided construction 
exceeds destruction, the more serviceable they are. The secre- 
tions are to be regulated ; daily tepid alkaline bathing ; flannel 
clothing; moderate exercise in the open air; diet is to be vari- 
able but nutritious, rigidly forbidding fat, malt and spirituous 
liquors, sugar, or starchy agents. 

In the medical treatment, vegetable alteratives and tonics are 
always of the greatest efficacy. 

Discontinue the alkali, and substitute benzoic acid in ten-grain 
doses, with same amount of boroglyceride, for the purpose of 
changing the uric acid into a non-irritating agent in the body. 
If for some cause it is not thought best to give the benzoic, sub- 
stitute the salicylate of soda, with acetate of ammonia which is a 
rjmedy of the greatest efficacy. This remedy has the effect of 
improving or restoring the tone of the co-ordinating chemical 
centre, and preventing the formation of the acid, and also of 
chemically causing its disintegration. The uric acid solvent is of 
the greatest efficacy in all cases. 

Sulphate and phosphate of quinia are also valuable, but possess 
none of the chemical properties of the salicylates. 

Besides the above, a course of alteratives and tonics for a few 
months, embracing compound extract saxifraga, ozone-water, 
glycerite of ozone, and kephaline. 



nAClKKlCIDtS. 



265 



The phosphatic diat/icsis, in which the urine is persistently 
loaded with phosphates and chlorides, which are deposited in the 
form of a floury mass, or white, gritty substance, calcareous in its 
character, called white gravel. The urine may or may not be 
alkaline but microscopically ha-^ 
this appearance. 

V/hen human urine becomes 
alkaline, it is due to one or 
other of the following condi- 
tions: To excess of the alkaline 
carbonates of potassa and soda, 
which is apt to occur after a 
meal, especially of fruit and 



vegetables; to excessive elimi- 




Pho?ph uic Urine. Magnified urinary sediment, 
cons stina; of large prismatic crystals of triple 
phosphaie (or pho-phaie of ammonia and 
mag esia^ and slobular bodies cf.en studded 
w'nh points, which consist of ura'e of ammo- 
nia : from the a kaUne ui ine of i patient suffer- 
\ni from paraplegia, conseciuent on disease of 
the vpinal cor<l or bram 



nation of the phosphates, as in 
brain and bone waste ; to the 
formation of ammonia in the 
urine from decomposition of 
urea. 

The reaction of the healthy 
urine in the twenty-four hours is 
slightly acid ; but if separate 
samples are taken at different intervals, great variation is ob- 
served ; and these are constant. The acid reaction increases and 
diminishes, commonly, with the secretion of gastric juice — acid 
before a meal, alkaline after and during digestion. This is called 
the alkaline tide, and may be caused by the entering of newly- 
digested products into the blood, or a preponderence of alkaline 
bases in articles of diet. 

There is another channel by which acid is withdrawn from 
the blood besides the gastric juice secretion, and that is by the 
lungs. The exhalation of carbonic acid gas by the lungs is in- 
creased by food and the conscious state, and diminished by fast- 
ing and sleep. 

The urine need not, however, be alkaline, in the phosphatic 
diathesis ; it is sufficient, in order to constitute this condition, 
that there be an excessive elimination of brain elements, that it 
be loaded with phosphates, the metamorphosis of such tissue. 

Causes. — Cerebral exhaustion, shattered nervous system, 
nervous disease, nervous dyspepsia, chronic disease, irritation 
transmitted, study, worry, gout, sexual excesses, etc. 

Symptoms. — The general indications are those of an intense 
nervous temperament; white skin; sharp features; emaciation; 
some chronic or nervous disease. There is no pain or irritation 
whatever ; hence it is often unobserved by the patient ; so there 



266 DISEASE GERMS. 

are few symptoms but the amount of gravel present in the urine 
each twenty-four hours, which, grain for grain, represents so 
much waste of brain-tissue, just as the uric acid represents fibrine, 
muscle, etc. If the alkaline conditio i be present, it is due to 
two causes: either from the presence of the carbonate of a fixed 
alkali (potash or soda), or of the alkaline phosphate of sodium ; 
or from the presence of the carbonate of the volatile alkali, am- 
monia, which is due to the decomposition of urea. 

The white gravel that is deposited in the last, the decompo- 
sition of urea, is formed as follows : Healthy urine contains phos- 
phate of magnesium in a state of solution ; if the urine becomes 
alkaline from decomposition of urea, a portion of the ammonia 
combines with the phosphate of magnesium and forms a triple 
salt, which is insoluble in the urine. This triple phosphate is 
usually an admixture of phosphate of lime. Urine of this kind, 
being allowed to settle, a scum forms on its surface, which under 
the microscope, resembles the salts we have described. But the 
urine may become alkaline from the presence of the carbonate 
of potassa or soda, and then, no ammonia being present, instead 
of the triple salt, there is a deposit of amorphous phosphate of 
lime. In these cases the urine is generally alkaline, pale, 
copious, slightly turbid, of a low specific gravity, and of a pe- 
culiar odor. 

Treatment. — Generous diet ; daily bathing ; flannel clothing ; 
well-regulated secretions ; the treatment of the morbid condition 
upon which it depends, and a resort to general alteratives and 
tonics. 

The special remedies are such as chemically disintegrate 
calcul. Pichi, as prepared in the uric acid solvent; has a most 
remarkable action upon all calculi and is worthy of a trial. 

The oxalic acid diathesis, is one of the leading symptoms of 
intense neurasthenia, and is often present in nervous disease, its 
characteristic is oxalic acid formed and appearing in the urine. 
Now, this diathesis is dependent upon very great nervous pros- 
tration, especially in the nerve-centre and nerves that supply the 
lungs, stomach, pancreas, and liver. Generally found in old 
cases of chronic bronchitis or nervous dyspepsia, and is charac- 
terised by the persistent appearance of crystals of oxalate of lime 
in the urine. 

Rhubarb may cause a temporary appearance of oxalic acid, 
which disappears as this vegetable is discarded or discontinued. 

The crystals appear in the form of minute, transparent octa- 
hedra, or like dumb-bells. 

The persistent presence of oxalic acid in the urine indicates 
the very low state of vital power, and is very liable to give rise 
to two distinct and dangerous complications : 



BACTERICIDES. 



26; 



1. A concretion of oxalate of lime (mulberry calculus) may 
form, either in the kidney, bladder, or prostate. 

2. The poisonous action of oxalic acid in the blood is liable 
to produce irreparable lesions in the brain, heart, stomach, etc. 

Treatment. — Great attention should be paid to diet. It should 
be generous, consisting of animal food, eggs, fish, milk, etc.; all 
articles that contain oxalic acid, as rhubarb, sorrel, tomatoes. 



sugar, etc., be forbidden ; daily shower-baths 
flannel clothing. Vegetable al- 
teratives and tonics should be 
administered. Our best tonics 
are iron, cinchona, hydrastis ; 
muriatic acid in compound tinc- 
ture chincona is invaluable in al- 
ternation with the uric acid sol- 
vent and peroxide of hydrogen. 

The above three states are 
what is understood when we use 
the term " gravel,'^ being the pas- 
sage of one or other of those 
three bodies in the form of a 
gritty powder, or sand-like bod- 
ies, or small calculi, occasioning 
pain, irritation of kidneys, ureters, 
bladder, and urethra. 

Of those three principal forms, 
the uric acid is present in about 
eighty per cent, of all cases, and 
gives rise to more irritation than 
either of the other two forms. 



followed by friction ; 




vi ;^- -. 






^1 



v^>, 



^^. 




Oxaluria Alagnified urinary sediment, coa- 
sisting of uric acid, urate of soda and oxalate 
of lime ; from a person convalescent from 
typhus fever The uric acid crystals are 
here chiefly seen in large dense bundles, 
joined two and two by their bases, each 
bundle being composed of an enormoui 
number of the long whetstone crystals. The 
dark crystals with light cross-bars are com- 
posed of oxalate of lime, while the dark- 
colored granules occurring either singly oc 
in masses are urate of soda. 



All 



ages 



and both sexes are 



or 



liable to be affected. They often give rise to nephralgia 
neuralgia of the kidneys. 

In order to relieve this condition promptly, hot baths, hip- 
baths, hot fomentations to loins ; open bowels with salines, and 
administer copious drinks of mucilaginous agents, in alternation 
with the uric acid solvent, or tincture of the green root of gel- 
semium. 



In the human blood, in a normal condition, 
Diphtheria, we have the living matter or bioplasm, which 
gives nourishment to brain, bone, skin, muscle, 
gland, every structure of the body. It is a well-known fact that 
this living matter is capable under adverse states of being- 
changed, altered, degraded into other living matter, which is 
capable in or out of the body of an independent power of existence, 
provided heat, nourishment, and moisture be present. 



268 



DISEASE GERMS. 



Thus for example, the degraded hving matter of ordinary- 
nutrition becomes bacteria ; that which constitutes the nerve- 
nutrient matter, the microbe of typhoid fever, etc. Among the 
^ower animals, even vegetables, we see the same laws prevailing, 
A'henever or wherever they are brought in contact with condi- 
tions inimical to their well-being and growth. A^nong vegetables, 
cereals, plants, trees, vines, when the soil is poor, or exhausted, 
a change of their normal living matter takes place, which is 
termed a blight or rot. A change or degradation of the cell 
elements of the organism of the plant, cereal or tree We see 
ilaily examples of this in the potato or grape rot, in the spurred 

rye, corn smut — being contagious and 
infectious in the vegetable, as well as 
the animal kingdom. 

In the human body, when vital 
force is very low, reduced to bank- 
ruptcy, suffers great deterioration, 
whittled down to a very low point, 
we, too, take the rot, or blight. Cer- 
tain vital elements within us are 
changed, degraded into a • disease 
germ. 

This micro-organism is best seen 
in the false membrane of a diphtheric 
patch on the mucous membrane of 
the fauces ; although it can be iso- 
lated from the blood or caught from 
the breath on a piece of glass held 
to the mouth coated with glycerine. 

The microbe isolated from ± patch, 
forms a streptococcus, consists of oval 
cocci, lying singly, in pairs, in rosaries, 
in spherical or cylindrical masses. 
The streptococcus of diphtheria is an active ,^ ,^, 

microbe, causes directly the formation of the 
false membrane on the mucous membranes 
o\\ all parts of the body ; indirectly it is a 
most active ptomaine excretor, hence its 
toxical w^ork is soon visible in the produc- 
ti(Mi of death. Very doubtful if any chemi- 
cal agent has yet been discovered which 
will destroy its spores. Even buried in the 
earth its protoplasmic life remains good. 

They are found in all the fluids and 
solids of the body. In badly smitten cases, the blood, capillaries, 
and uriniferous tubules are blocked up. 




he microbe of diphtheria, forming a 
polypoid mas'^, growing from the edge 
cf uvula, completely arrested and de- 
stroyed by painting and spraying with 
lactic acid, dil. 




The Streptococcus of Diph- 
theria. 



iiACTERICIDES. 



269 



No doubt, this disease has existed from time immemorial, in 
localities in which intermarriage was common, in which the 
drinking water was calcareous ; in which overcrowding, and 
other insanitary states prevail. 

Both the microbe and its spores are aerobic, as millions upon 
millions emanate from one infected individual every hour, every- 
thing animal : woolens, carpets, clothing, cats, dogs, rabbits, 
within a radius of fifty feet are literally swarming ; so it spreads 
by infection and contagion, and prevails endemically, as well as 
sporadically. 

As the term rot, is not congenial to the ears of the fastidious, 
pusillanimous members of modern society, it has been dignified 
by the name of diphtheria. 

The predisposifig causes are very numerous, and embrace such 
states as a tubercular diathesis, inherent weakness of constitution 
— a reckless carelessness of all sanitary measures. The drinking- 
water of our large cities, and quite a deal of our food are contami- 
nated with sewage. 

Cases could be cited in which this microbe appears among our 
domestic animals, as turkeys, chickens, calves, cows, dogs, cats, 
rabbits, etc., having the disease, and propagating either directly 
or through their milk or flesh to man, giving him a predisposition 
to the disease. The microbe on the tongue and trachea of a 
turkey is microscopically and chemically indentical — pathogenic 
of the same affection in man. 

The emanation from salt on ice or snow on railroad tracks— 
the fumes from imperfect combustion of kerosene oil ; the vapor 
of sewer gas, are highly depressing, nay toxical, to the laryngeal 
mucous membrane, it affords a predisposition, affords a causation, 
at least, of the malignancy of the disease. Malignant cases where 
tracks are salt, terribly epidemic where oil is burned. Putrid 
sore throat and diphtheria are certainly more common and more 
fatal when those states exist. 

Although these aid materially as predisposing causes, they do 
so by depressing the powers of life. 

The exciting causes embrace all insanitary states, as overcrowd- 
ing, stagnant, pent-up, air, reeking with animal effluvia, poor 
and adulterated food. 

As the germ of diphtheria has a special affinity or attraction 
for all animal matter, no pet bird, dog, cat, or any domestic animal 
within a radius of 300 feet is free from the germs of the disease, 
with a diphtheric patient in that area. 

Such are to be classified as exciting causes, namely, close con- 
tact to sucL 



'70 



DISEASE GERMS. 








The rot fungus foot disease oidium albicans, magnified 750 diam- 
eters, so common among milch cows who feed on damp pas- 
7~tures, or stand upon imperfectly cleaned stalls — a prolific 
'"source of the streptococcus of diphtheria and scarlet fever. _ 



The milk from cows, both in the rural districts as well as that 
in cities, is a fertile source, and a most active exciting cause of 
this malady. Insanitary states, such as grazing on dairy meadows, 
or drinking marsh water, or being housed in wet, filthy sheds or 

barns, bring upon 



cows the foot fungus 
disease, which by 
some unknown trans- 
formation becomes 
the diphtheric mi- 
crobe. 

Prophylactic meas- 
ures are of the great- 
est utility. The dis- 
ease is essentially 
contagious and in- 
fectious, and every 
possible means 
should be resorted 
to to isolate the 
affected. Still it by no means follows, that real, inevitable danger 
exists of contagion from one person to another ; if ordin:iry pre- 
cautions are observed, and the highest possible standard of health 
3iiaintained, with strong vital force, it is certainly premature to 
conjure up danger. A teaspoonful of the glycerite of sulphur 
could be taken morning and night, which would keep the blood 
thoroughly sterilized, a state in which if any germ entered the 
blood it would become at once annihilated. With due attention 
to the thorough cooking of all poultry, meat and milk, there 
would be but slight fears of the disease. 

Another valuable prophylactic is the sulpho-carbolate of sodium^ 
its action, very certain to destroy the streptococcus, two to three 
grains every three hours, either on the tongue or dissolved in a 
little water. It is a priceless remedy, destroys all germs, does 
not interfere with any other remedy or mode of treatment. It 
sterilizes the blood, keeps it in such a state that no germ will 
enter it. 

Sulphurous fumigation of all suspected houses of infection 
should be the rule. 

The special characteristics are in all typical cases, with the 
formation on the mucous membrane of the tonsils, uvula, tongue, 
cheek, of the white layer, an enormous accumulation of micrococci, 
constituting the false membrane, extending over the fauces, 
.larynx, trachea. 

A piece of this membrane placed either on blood serum, or in 



BACTERICIDES. 



271 



but 
the 




Section of a aiphtheric membrane, the embryonic micrococci 
seen in the process of evokition ; the membrane is a focus ot 
microbes. 



veal or iamb broth, affords magnificent culture of the germ^ 
their inoculation into healthy animals does not give us 
symptoms of the disease, but produces septicaemia. 

The contagium vi- 
vum resides in the 
walls of the rods con- 
stituting the chains, it 
is pathogenic, but 
from the purest cul- 
tures thus far succes- 
sive generations are 
not obtainable. 

The question how 
this microbe acts as 
the factor of disease has long been in doubt, but the progress 
of science has in some measure cleared away this obscurity. 
The first idea was that when first evolved or taken in, they 
acted like parasites, lived upon the blood and tissues of their 
host. To a certain extent this is true, that they swarm in the 
blood, abstract from the red corpuscles the oxygen they require 
for vitalizing the tissues, yet it often happens that death is so 
sudden that the bacilli have not had time to develop in the 
blood in numbers sufficient to produce a fatal result. An ex- 
planation of this state of things is necessary. 

All disease germs excrete or eliminate a poisonous substance, 
resembling snake venom, an alkaloid, the ultimate product of 
putrid fermentation of organic matter, the alkaloid is termed 
ptomaines. As soon as ptomaines are elaborated in the blood, 
rigors, fever, vomiting, diarrhea, spasm, paralysis, torpor, collapse, 
death. Poisoning by tainted meat or fish, is due to the presence 
of ptomaines. 

The action of the pathogenic microbe of diphtheria is complex, 
it is nourished and multiplies at the expense of the vital fluids, 
and it excretes more rapidly and in greater abundance than most 
other germs the alkaloid ptomaine, hence its great mortality, as 
seen in heart failure, paralysis of the larynx and other vital parts. 

The general pathological appearance consists in a membrane 
or a granular infiltration of some mucous membrane, generally 
on the tonsils, uvula, pharynx ; beginning at some point on the 
tongue or nasal passage, the microbial mass may extend either 
downward in the trachea, or upwards into the sinuses of the head, 
eustachian tube or nose. 

By and by all the affected parts become infiltrated, lose their 
normal state and become converted into one homogeneous mass 
of disease germs. Heart is pale, flabby, friable ; blood germ- 



(272) SKCTION OF UIFHTHERIC MEMHRANE. 



BACTERICIDES. 



273 



laden, and embolised ; spleen enlarged, tense, shining ; capillary 
hemorrhage ; kidneys congested, plugged full of germs. 

Infarction, the result of emboli, is apt to occur in all the vas- 
cular organs. 

The symptoms are somewhat variable. When the vital forces 
in children are very feeble, especially if the surroundings are bad,, 
as dirty, damp, badly-drained abodes, it may break out spontan- 
eously ; if so there is usually great prostration ; when received 
by contagion or infection, it comes on slowly and insidiously, 
with languor, lassitude, debility, headache, pain in back, calves 
of the legs, rigors, fever of a continued type ; tongue heavily 
coated, brown, dark at root ; rarely diarrhea ; mental condition 
dull, stupid, drowsy ; heat, pulse, and respirations high ; face 
flushed ; skin hot ; often delirious. Tonsils become inflamed and 
swollen ; the parotid and other glands sympathize. Inflamma- 
tory action spreads to the uvula, fauces, pharynx, deglutition 
becomes difficult; if it is not properly arrested, a soft, plastic 
exudation or growth, vesicular in shape, fibrinous in character, is 
developed on the mucous membrane, in which millions of the 
living streptococci are lodged or imbedded. At first this grovv^th 
looks like little vesicles or blisters, white at first, then ash-colored. 
They speedily coalesce and form large patches resembling dirty, 
damped, washed leather; if vital force is very low they grow with 
extreme rapidity. As they increase in numbers they also increase 
in size, extent, and thickness, firmly adherent to the mucous 
membrane beneath. If forcibly removed a new patch is at once 
formed, and this colony will grow ; besides, the breath, urine, 
stool, are loaded with young germs which are very light, so 
much so that they may alight on the cheek, gums, glottis, con- 
junctiva, vagina. When the germ dies, membrane becomes gan- 
grenous, sloughs, separates, decomposes, and the breath becomes 
terribly offensive. When the mass is thrown off there may be 
sloughing or gangrene, or if vital force be well sustained, the 
tissues around may acquire a healthy appearance. In cases of 
extreme prostration it may appear on the cutaneous surface. 

The constitutional symptoms vary much, the breath being 
very fetid, and occasionally hemorrhages from nose, fauces,, 
bronchi. 

Albuminuria in diphtheria is due to the action of the mycelia. 

The illustration, on the opposite page (272). exhibits a section of the diphtheric 
membrane, showing the mother germ and its spores at work in the formation of exten- 
sive microbiotic masses on the mucosa of the uvula and tonsils. The engraving 
was prepared by the illustrious bacteriologist, Prof. George H. Day, M. D., Monroe, 
Orange County, N. Y., one of the most eminent physicians of the age — the most suc- 
cessful in the cure of microbial disease. 

18 



274 



DISEASE GERMS. 



on the blood and to the fact that the Icidneys are Hterally 
crammed full of the disease germs. Death may take place from 
exhaustion, uraemia, hemorrhage, gangrene, asphyxia, embolism. 
In the event of recovery it is tardy, sequelae being anaemia, 
nerve affections, paralysis, sleeplessness, impaired or defective 
sight or hearing. It is apt to leave a weak or hoarse state of 
the voice. 

Stage of incubation usually about eight days. 
Its duration is from one to two weeks. 
One attack is no protection. 

No disease is so easily recognized as diphtheria, the general 
symptoms are well defined, the languor, debility, prostration, sore 
throat, the false membrane or germ colony, first appearing as 
vesicles, then coalescing into patches, having the peculiar washed 
leather appearance ; invariably the offensive breath ; often a dis- 
charge from the nostrils ; enlargement 
of the lymphatic glands of the neck ; 
rigors; fever, difficulty in breathing, 
stupor, delirium. 

The prognosis in any single indi- 
vidual should be carefully guarded, 
because the microbe of diphtheria is 
of rapid growth and liberates or ex- 
cretes ptomaines abundantly, so that 
death may take place at any moment, 
either from the ptomaines paralyzing 
vital organs as the brain, spinal cord, 
heart, lungs, causing asphyxia; dan- 
gers of anaemia from obstructed kid- 
ney ; from hemorrhage due to anae- 
mia, the microbe destroying the red 
discs. In the event of recovery, the 
spores and ptomaines are apt to leave 
some lesion of the brain or cord which 
gives rise to aphonia, strabismus, paralysis, which time will 
eradicate. 

In the treatment, it must ever be borne in mind that there is 
scarcely any disease so insidious or more fatal. It calls for im- 
mediate energetic administration of germicides and nourishment, 
yet even with our most approved remedies, in the most skilful 
hands, often incurable. Specific treatment a humbug and a farce ; 
the one idea that must prevail is to kill the microbe, build up 
vital force; even bactericides must be administered with judg- 
ment, a judgment which can only be possessed by the highly 
educated medical man. No amateur doctoring in such a fatal 




The membrane of diphtheria, as seen 
on the hard palate, completely de- 
stroyed by papoid and distillation of 
jequirity. 



BACTERICIDES. 



275 



disease as this ; no delay ; no mistake in the Hne of treatment 
when the blood is loaded with germs and their ptomaines, whose 
limits are incompatible with life. 

The patient should be isolated, placed in the best ventilated 
apartment in the dwelling ; free from carpets, and every precaution 
taken to prevent its dissemination, as it is essentially infectious 
and contagious. The entire body twice or thrice daily should 
be sponged off with tepid water to which mustard and peroxide 
of hydrogen are added. 

To the throat a solution of peroxide of hydrogen should 
be constantly applied, removed and re-applied again and again. 
It is customary to administer repeatedly small doses of tinctures 
of aconite and belladonna, to allay irritation in the fauces, and 
reduce temperature ; but this procedure is unnecessary, because 
the germicide which must be administered to destroy or sterilize 
the germ, the factor of the disease, will, by its action on the 
microbe, reduce temperature, relieve pain, ameliorate all the 
symptoms. Sulphur is the natural antidote to the streptococcus 
of diphtheria. 

The best, most efficient preparation is the ozonized glycerite of 
sulphur. The moment the case is diagnosed, this preparation 
should be administered in sufficient doses every hour until it acts 
upon the bowels. This will not occur until every microbe is 
killed. In alternation with this, a few drops of peroxide of 
liydrogen should be administered. 

For inhalation from steam atomizer ; for a gargle slightly 
diluted ; for painting on the diphtheric patch, no bactericide can 
excel the ozonized distillation of jequirity ; this remedy causes 
the membrane to shrivel up and exfoliate, and check further exu- 
dation of germinal protoplasm. The jequirity affects a diphtheric 
patch or colony totally different from all other germicides, caus- 
ing the patch to shrivel up and exfoliate. 

If the physician has not the distillation of the jequirity, then 
lie can use the sulphuret of calcium, which is prepared in the 
following manner : Lime, one part ; sulphur, two parts ; water, 
twenty parts ; boil until the quantity is reduced to twelve parts. 
To be used with the spray every half hour, or less frequently, 
according to the severity of the case. For infants, a small quan- 
tity of water is to be added. A change in the false membrane is 
rapidly induced, and general amendment follows. In some cases 
the membrane had entirely disappeared in one day. 

Cerebral and blood nutrition of the highest possible grade 
precludes the possibility of the elementary bioplasm being de- 
graded. So the moment the glycerite of sulphur affects the 
bowels, the entire microbial mass is steriHzed, on the verge of 



276 



DISEASE GERMS. 



annihilation ; then tonics, as sulphate of quinine, should be ad- 
ministered, and nutrition pushed. 

The very presence of this disease germ among our children 
demonstrates most conclusively and emphatically that vital force 
is low, shattered ; that the brain, the nervous mechanism needs 
nutrition — fertilizers to aid in its reconstruction, to promote 
vitality. 

If from some cause or other, those remedies are not deemed 
the best, then the attending physician must select some other less 
active bactericide from some of the following, w^iich we classify 
according to their intrinsic worth. 

Hydrogen peroxide as a local and internal remedy in diphtheria 
has not received the recognition it deserves, simply because 
worthless compounds have been foisted upon the profession. A 
medically prepared C. P. aqueous solution is perfectly clear, color- 
less fluid, specific gravity 10 12, without odor or taste, having a 
faint sensation of carbolic acid upon the tongue. Hydrogen per- 
oxide does not act so well as the dis- 
tillation of the jequirity as a solv^ent 
upon the diphtheric patch, but it 
effectually sterilizes the blood, anni- 
hilates the entire germ area in the 
blood, prevents the evolution of more 
germs. It is always worthy of a 
trial w^hen the fountains of life are 
stricken with this microbe. 

Ozonized boroglyceride, internally 
and locally, is deemed of utility. 

Excavations ma^y the microbe upon The _ drUg whcU aCtivcly pUShcd, is 

the hard palate; germ evolution ar- eliminated by the mucioarous elands 

rested by spraying it with g ucozone. r ^ i Vi i i- 11 

01 the throat and salivary glands, 
tends to soften and exfoliate the germ membrane. 

Oil of turpentine often affords most excellent results, it is ad- 
ministered in an emulsion in doses from one-half drachm up, dis- 
guised with oil of peppermint. 

Veiy favorable results are also obtained from lactic acid, pyri- 
din, creolin, chlorate of carbon ; sodiurn salicylate and benzoate ; 
creosote, iodoform, papoid and trypsin.; hydrocyanic acid; chin« 
oline, chloral hydrate, eucalyptol, quinine. All the essential oils, 
such as peppermint, rue, thyme, cloves, cinnamon, and other 
odoriferous bodies, when exposed to the atmosphere, are ab- 
sorbed by the oxygen, which enters into combination with them 
and forms new bodies. This power of absorption is possessed 
by them all, but in the highest degree by turpentine and pepper- 
mint camphor. 




BACTERICIDES. 



277 



Expose any essential oil to the atmosphere, about summer 
"heat, oxygen is absorbed, the oil oxidized, an unstable com- 
pound is the result, which in the presence of water is split up into 
peroxide of hydrogen and an exceedingly soluble camphoric 
acid. This process of oxidation and conversion into negative 
ozone, is peculiar to all essential oils which contain tcrebene or 
camphoric oil. 

One of the sources of ozone in the atmosphere then is due to 
the slow oxidation of the essential oils or perfumes which are 
giv^en out by odoriferous plants when exposed to the sun. Their 
action either destroys or weakens microbes, or so attenuates 
them that their destructive action is prevented, hence their use 
in all germinal diseases. 

Very favorable results are obtained by inhalation ; glucozone in 
a hand spray atomizer, or better still the ozonized distillation of 
the jequirity in liquid ozone in a steam atomizer. 

Mercurial fumigations;" iodoform dissolved in liquid ozone is 
said to have a marvellous action. 

Gargles or mouth washes of chlorate of potassa and tannic 
acid, or of resorcin must not be neglected. 

Bactericides then are the remedies to kill the streptococcus; 
the selection is important. 

Once recovery is assured, the greatest possible precautions 
should be observed for a few months, for there is still danger of 
paralysis and heart clot from the ptomaines of the germ. 

Quarantine for a period of twelve weeks. All persons re- 
covering from diphtheria should be considered dangerous ; 
therefore, such a person should not be permitted to associate 
with others, or to attend school, church, or any pubHc as- 
sembly until the throat and any sores which may have been 
on the lips or nose are healed, nor until in the judgment of a 
careful and intelligent health officer he can do so without endan- 
gering others; nor until after all his clothing has been thoroughly 
disinfected, and this without regard to the time which has elapsed 
since recovery if the time is less than one year. Nor should a 
person from premises in which there is, or has been, a case of 
diphtheria, attend any school, Sunday-school, church, or public 
assembly, or be permitted by the health authorities, or by the 
school board to do so, until after disinfection of such premises 
and of the clothing worn by such person if it shall have been 
exposed to the contagion of the disease. The body of a person 
Avho has died of diphtheria should be washed with a zinc solution 
of chloride of great strength, then wrapped in a sheet wet with 
the zinc solution, and at once be buried. In no case should the 
body be exposed to view\ 



2/8 



DISEASE GERMS. 



No public funeral should be held at a house in which there is 
a case of diphtheria, nor in which a death from diphtheria has 
recently occurred. Except under extraordinary precautions there 
should be no public funeral of a person who has died from diph- 
theria. No child should attend, and it would be better in most 
cases that few adults should attend, a funeral of a person dead of 
diphtheria. 

To Avoid Taking Diphtheria. — Avoid the living germs of the 
disease. This is especially important to be observed by children, 

and all whose throats are sore from 
any cause. Children under ten years 
of age are in much greater danger 
of death from diphtheria than are 
adults ; but adult persons often get 
and spread the disease, and some- 
times die from it. Mild cases in 
adults may cause fatal cases among 
children. Because of these facts it 
is often dangerous for children to 
frequent places where adults might 
go with impunity. 

Do not let a child go near a case 
of diphtheria. Do not permit any 
person or thing, or a dog, cat, or any 
other animal to come direct from a 
case of diphtheria to a child. Unless 
your services are needed, keep away 
from the disease yourself. If you do 
I visit a case, bathe yourself, and 
change, and disinfect your clothing 
before you go where there is a child. 

It is probable that the contagion of diphtheria may retain its 
virulence for some time, and be carried a long distance in various 
substances and articles in which it may have found lodgment. 
Diphtheria contracted from germs carried several blocks in a 
sewer may, perhaps, be as fatal as when contracted by direct- 
exposure to one sick with it. While it is not definitely proved 
that the germs of diphtheria are propagated in any substance 
outside the living human or animal body, it is possible that they 
may be found to be thus propagated. Therefore, and because 
the breathing of air laden with emanations from decaying fruit, 
vegetables or meat, or from sewers, cesspools, sinks and other 
receptacles of filth, is believed to endanger health, great care 
should be taken to have the house, premises and everything 
connected with dwellings, kept clean and dry ; to have sewer 




The germ actively at work on each side 
of the uvula ; painting and spraying 
with distillation of jequirity. 



BACTERICIDES. 279 

connections well trapped and house drains constantly well venti- 
lated, and to have all carriers of filth well disinfected. Do not 
permit a child to enter a privy, water-closet, or breathe the air 
from the water-closet, sewer, etc., into which discharges from 
persons sick with diphtheria have entered, nor to drink water or 
milk which has been exposed to such air. 

Do not permit a child to ride in a hack or other closed carriage 
in which has been a person sick with diphtheria, except the 
carriage has since been thoroughly disinfected with fumes of 
burning sulphur. 

All influences which cause sore throats probably tend to pro- 
mote the taking and spreading of this disease. Among the con- 
ditions external to the body liable to spread diphtheria, perhaps 
the most common are infected air, infected water and contact 
with infected substances or persons. Because of this, and as a 
means of lessening the danger of contracting other diseases, the 
following precautions should always be taken, but more particu- 
larly during the prevalence of any such disease of diphtheria. 
Avoid exposure to wind and to breathing cold, dry air ; also the 
use of strong vinegar or any other article of food which tends 
to make the throat raw or tender. Do not wear or handle 
clothing worn by a person during sickness or convalescence from 
diphtheria. 

Beware of any person who has a sore throat. Do not kiss or 
take the breath of such a person. Do not drink from the same 
cup, blow the same whistle or put his pencil or pen in your 
mouth. 

Beware of crowded assemblies in unventilated rooms. 

Do not drink water which has a bad taste or odor, or which 
comes from a source that renders it liable to be impure, especially 
if there is reason to believe that it may contain something derived 
from a person sick from diphtheria, such as the drainage of a 
burying ground into a well or river. 



Dropsy consists in an accumulation of watery 
Dropsy, fluid in the lymph spaces of the subcutaneous cel- 
lular tissue, and in the serous cavities of the body. 
This fluid or lymph is derived from the capillaries, and under 
normal circumstances is poured out into those spaces, but taken 
up again by the venous and lymphatic radicles as fast as it is 
poured out. 

For the production of dropsy, the equilibrium of this arrange- 
ment must be upset by either an increase in the outflow of fluid, 
or a failure on the part of the veins and lymphatics to take up 
the effused fluid. 



28o DISEASE GERMS. 

The principal source of power in pumping those lymph spaces 
dry is the heart ; it is assisted by the aspiratory action of the 
thorax in respiration, and the contraction of the muscles of the 
limbs. When the heart fails to maintain a negative pressure in 
the veins, oedema sets in. All that is at present known on the 
subject may be embraced in the following sentence : Dropsy is 
an accumulation of lymph, or watery fluid, in the lymph spaces of 
the body, as a consequence of heart-failure, by which the fluid is 
allowed to accumulate ; changes in the blood and capillaries by 
which the outflow of fluid is increased. 

We must ever bear in mind that in dropsy we have to deal with 
a failing heart, and our chief reliance must be upon remedies that 
increase the heart's energy. Digitalis comes first, strophanthus 
and convallaria next, citrate of caffeine, nitro-glycerine and sul- 
phate of strychnine follow ; then sparteine and a class of minor 
cardiac stimulants. 

The heart is the organ to look after and every possible means 
must be taken to invigorate it : local stimulants over that organ, 
in the form of the irritating plaster ; the most nutritious, highly 
animalized diet ; massage to the entire body, morning and night ; 
an entire freedom from care, worry or excitement. 

Dropsical effusions must be removed by the aid of diaphoretics, 
diuretics, hydragogue cathartics. 

The best of all diaphoretics is the alcoholic vapor bath (See in- 
terstitial nephritis) ; the most efficient diuretics are the hair-cap 
moss, apocynum, juniper berries, bitartrate potass, nitrate potass, 
broom. 

The most active hydragogue cathartics are elaterin, colocynth. 



An affection of microbial origin, which gives. 
Dysentery, rise to irritation, inflammation of the different 
coats of the rectum and colon, which terminates 
in ulceration of the different coats of the lower bowel. 

Isolated from the muco-purulent matter and other products, it 
^ appears in the field of the microscope as a 

♦ ^^^•x body slightly elongated and oval, or short 

#^i»*J*\^ \ and cylindrical, with rounded ends. They 
^ " ^ ' •'•* - divide by fission, like micrococci, the indivi- 
duals elongating and becoming constricted in 

^^,, ^ , the middle, capable of spontaneous locomo- 

* *•• \ 1 f tion, having a flagellum at one or both ends, 

•* with which they perform active spinning or 

The microbe of ayscntery. j^rting movcmcnts. Tlicy form zoogloeain 
the corrugations of the bowel, in which the interstitial gelatinous 
substance is more copious. 






BACTERICIDES. 



281 



The microbe is pathogenic of the disease, repeated cultivations 
in any nourishing broth, even for successiv^e generations ; the 
cultures injected into animals produce in them the original disease 
in all its virulence. 

It is contagious and infectious in the true sense of the term. 

The presence of this microbe in the rectum, sprouting and 
breeding spores by millions, gives rise to great constitutional dis- 
turbance and fever, and the microbe excreting ptomaines gives 
us the intolerable griping and tenesmus, with bloody mucus. 
During our heated term this microbe is one of the greatest 
scourges of our country. 

The presence of this germ in the rectum and colon is found at 
all seasons of the year, but it is roused into activity and rapid 
growth, prodigious spore evolution and ptomaine excretion by 
weakness, solar heat, moisture, dampness, hot oppressive atmos- 
phere, ice water, indigestible articles of food, green fruit, alcoholic 
drinks, malaria, mental depression. 

These and numerous other causes do not operate directly upon 
the rectum and colon, but rather upon the liver. They cause a 
general condition of congestion, debility, in which area of vital 
depression the dysenteric microbe puts in an appearance. 

Symptoms. — Great constitutional disturbance in the acute form ; 
rigors, headache, fever, biliary symptoms, brown tongue, sallow 
skin, conjunctiva tinged with bile, nausea, perhaps vomiting ; fre- 
quent evacuations of the bowels, accompanied with pain and 
uneasiness of a griping or bearing-down character; the inclination 
to go to stool is frequently accompanied 
with ptomaine excretion and tenesmus. At 
first, the stools are dark, ginger-bread color ; 
then mucous, thin, scanty, bloody and often 
mixed with Httle hard lumps of faeces. The 
scanty stools give great distress ; the griping 
and straining, or tenesmus, is most excru- 
ciating, with evacuation ; m.otions are often 
dark-colored, and peculiarly fetid, mixed with 
blood, muco-purulent matter, and shreds of 
lymph. The bladder sympathizes ; micturi- 
tion is frequent, and a constant desire to 
urinate ; there is strangury, or only a few 
drops coming at a time; amount of urine 
scanty and high-colored; in some cases 
there are violent hemorrhages. 

It may last a few weeks and terminate in recovery, or run into 
a chronic form : or recovery may take place with thickening, 
effusion of lymph, and stricture, or gangrene of the bowel and 




Appearance of the mucous 
surface of the rectum in 
the first stage of dysen- 
tery ; ihe microbe actively 
at work. 



282 



DISEASE GERMS. 




Appearance of the mucous 
membrane of the rectum 
in the second stage of 
dysentery ; the microbe 
making ravages in the 
ulcers. 



death ; or the patient may succumb to the violence of the kvcr 
and inflammation. 

The pathological appearance of the walls of the rectum are 
most significant, especially during the first and second stage, if 
permitted by inefficient treatment to run that way. Every day in 
which germicide remedies are delayed, more havoc is made by 
the germ degeneration of the intestinal glands, atrophy of 
the mucous membrane, indurated cicatrices in 
both colon and rectum. 

In the treatment, general principles must 
guide ; if there be a very irritable state of the 
stomach, an emetic may be administered with 
advantage, followed by an alcoholic vapor 
bath, and it would be well to cleanse out the 
alimentary with a powder of euonymine and 
caffeine, say one and a half grains of each, 
every hour till they had done their work. 

Rest in the recumbent posture in bed ; one 
dose of exalgine in the morning, another in 
the evening; during the day tincture of green 
root of gelsemium should be given, alternated 
with peroxide of hydrogen, it will completely paralyze the or- 
ganism. If not it may be noted that this microbe is either 
sterilized or completely annihilated by the administration of 
either of the following germicides, which can be used here with 
brilliant success, one of which could be selected : 

Naphthaline in five grains, in a capsule, repeated frequently. 
Resorcin and turpentine, combined in mucilage of acacia, per- 
fectly annihilates the microbe. 

Eucalyptol, ten to thirty-drop doses, is excellent. 
Caffeine, one grain every hour. 

Stone crop and sulphate of quinine are most efficacious. 
Resorcin, naphthaline, perfectly annihilate the microbe. 
Kaki, as an infusion, does effective work in effacing the microbe 
from the bowel. 

This is an efficient germicide where we have a specific micro- 
organism inhabiting the intestinal canal, as in typhoid, diarrhea^ 
dysentery ; besides it has a decided action in neutralizing the pto- 
maines, generated or excreted by the microbe. Its first dose affords 
relief, fetor disappears from the stools ; subsidence of pain ; stop- 
page of the diarrhea or hemorrhage, reduction of temperature and 
a general return of all the vital functions. 

The bark of the root of calotropis gigantea is even more power- 
ful than kaki ; like kaki, best administered in infusion of the pow- 
dered bark. 



BACTERICIDES. 



283 



The bisulphide of carbon is much esteemed as a germicide in 
dysentery, the dose is variable, but when administered it quickly 
relieves the tenesmus, the motions diminish in frequency, the 
stools lose their offensive odor, the germs disappear. 

Enemata of infusion of kaki, green root tincture of gelsemium^ 
creolin and resorcin kill the entire colony of microbes. The 
method of giving the enemata must be considered ; the patient's 
buttocks should rest upon a pillow at the edge of the bed, so ele- 
vated that the natural tendency of the fluid entering the rectum 
would be to travel down into the colon. A fountain syringe is 
the best, with a long flexible pipe. An effort should be made to 
pass this into the sigmoid flexure. One enema is often sufficient 
to effect a cure. Whatever remedy is selected a cocaine supposi- 
tory should be inserted up the rectum thrice daily. 



Difficult or painful menstruation appears 
Dysmenorrhoea in gynecological practice under three forms, 
(Neuralgic). the first being due to neurasthenia. — Nervous 
dysmenorrhoea is very common among highly 
educated and refined ladies — those who have developed their 
nervous systems at the expense of the physical, those who have 
insufficient exercise for body, who lounge, and keep reading our 
fictitious, debasing, modern literature — that deadly poison which 
undermines their nervous systems. It may appear at puberty, 
but more generally it comes on from enervating causes after some 
years of painless menstruation, especially in the unmarried. In 
married fife it may come on from the irritation of frequent abor- 
tions, and the use of means to accomplish that act. It may be 
due to incompatibility in the sexual act. 

Symptoms. — General languor, lassitude, debility, headache, 
with pains in the back, sacrum and lower part of abdomen, com- 
ing on a few days prior to period ; an aching soreness of inner 
and upper part of the thighs; bearing-down, with a sense of 
weight in the pelvis. As soon as the discharge comes on freely, 
relief is promptly experienced ; if the flow is scanty, and comes 
on in slight gushes, the suffering is often excruciating ; it becomes 
paroxysmal, pain comes and goes ; often considerable pain in left 
ovary, sometimes in both ; no swelling or heat, or increased sensi- 
bility in parts. There is flatulence, constipation, hysterical 
symptoms or convulsions. 

If the patient is seen during an attack, a warm hip-bath, tea- 
spoonful doses of comp. tincture of serpentaria and the intro- 
duction both into the rectum and vagina of an obstetric cone — 
patient in bed. Usually this affords instantaneous relief If it 



284 DISEASE GERMS. 

fails, let her inhale twenty to thirty drops of chloroform, and an 
hypodermic injection of a quarter of a grain of sulphate of mor- 
phia might be given. She must be tided over the crisis with 
great care. If aware of the attacks coming on, they often can be 
prevented by inducing anesthesia of the lumbar plexus of nerves 
Avith belladonna, a plaster of this, four inches wide by nine inches 
longways across the loins; the administration of tincture of 
belladonna internally, till throat becomes slightly dry and pupil 
dilated ; the introduction of a pastile up vagina, and suppository 
up rectum, every night at bedtime, each containing one grain of 
opium and one-quarter grain extract of belladonna. The above 
to be commenced five days before period. 

From two to three weeks during the interval, the following 
treatment should be carried out : Daily, alkaline baths, followed 
w th friction or massage ; flannel or silk under-clothing must be 
worn next the skin, especially over the loins ; most nourishing 
easily digested food, avoiding tea, coffee and other stimulants. 
Sleep must be limited to eight hours, abundance of gentle exer- 
cise, games, moderate work so locomotion is active ; if circum- 
stances permit, horse-back exercise. Rigidly forbidding seden- 
tary habits, novel reading, and if married, sexual congress. If 
there is any evidence of indigestion, columbo infusion or some 
bitter tonic, bowels to be regulated by taking two cascara 
lozenges after meals. 

Then the true treatment of the case begins, and select four of 
the best remedies in the materia medica to vitalize the uterus and 
overcome this neurasthenia, namely, tincture of oats and kepha- 
line, with wine of aleteris farinosa and comp. syrup partridge 
berry. Place the patient upon two of them, oats and aleteris, one 
week ; kephaline and partridge berry the next, and so repeat 
till case is cured. 

All other remedies as pulsatilla, cimicifuga, are greatly inferior 
to the above. 

In ladies of a rheumatic and gouty condi- 

Dysmenorrhcea tion, afflicted with intra-uterine catarrh, 

(Congestive). there are in the cavity of the uterus quite a 

conglomeration or heterogeneous number 

of disease germs in the cavity of the uterus, as the amoeba, 

yeast-germ, sarcinae and others. Such microbes naturally excite 

irritation of the internal uterine walls, and when the menstrual 

function is excited there is great hyperaemia of the entire uterus. 

Those of a sanguine, plethoric or lymphatic temperament are its 

victims. 

Causes. — Aside from the diathesis, gouty or rheumatic, and 



BACTERICIDES. 



285: 



pelvic irritation, general plethora of the genito-urinary organs, 
from sedentary habits and occupations, it may be caused by local 
irritation, as abortion, exposure to cold and moisture ; sluggish- 
ness of the liver, displacement of uterus, and metritis. 

Symptoms. — Suffering begins four or five days before each 
period, in a general sense of languor, or weariness, with head- 
ache, pains in the loins ; a feeling of weight in the pelvis ; gen- 
eral restlessness, and irritability of the bladder; there are heats 
and colds, with other evidences of nervous depression. The 
weight in the uterus becomes a pain of a throbbing character ; 
then dragging in the back, aching in the hips and thighs, and 
bearing-down, especially when pain is on. Discharge, after a 
few days suffering, makes its appearance, usually slowly and 
gradually, scanty at first, but subsequently, after the system is 
relaxed by the condition of prostra- 
tion, it comes freely. It may come 
in small clots, or shreds, or flakes of 
membr^anes, or sometimes in the 
form of a large pear-shaped clot, 
covered with a false membrane, an 
exact cast of the cavity of the uterus. 
This membrane looks like the epi- 
thelial membrane lining the cavity 
of the uterus, analogous to the de- 
cidua. In some cases there is no 
congestion of the uterus, in others 
it is much engorged, often displaced ; 
ovaries very tender, with swelling 
and tenderness of breasts. If the 
portal circulation is sluggish there 
will be piles. 

The treatment, during the period, should consist in ameliorat- 
ing the condition as far possible, hot vaginal injections of a solu- 
tion of boroglyceride, warm hip baths; free action of the bowels, 
the administration of obstetric cones per vaginam and rectum, 
with warm, relaxing infusions of asclepias, or eupatorium per. 

When the period is over, and for the next three weeks, patient 
should be placed upon good food, daily warm alkaline baths, 
followed by massage ; bowels to be kept open with the cascara 
sagrada lozenge ; the patient to be placed upon alteratives and 
tonics, saxifraga, alternated with the aleteris far. ; phytolacca 
comp. alternated with the partridge berry. With an energetic 
course of these remedies for four or five months, a cure may be 
effected. 

A cure, however, may be effected much more speedily, when 




The yeast plant and sarcinae present in 
all cases of intra-uterine catarrh ; the 
yeast plant, sarcinae and other germs 
found in the cavity of the uterus in. 
congestive dysmenorrhcEa. 



286 DISEASE GERMS. 

germicidal bougies are used about every four days. These 
bougies are composed of thallin, resorcin, naphthaline, creolin, 
etc., and other bactericides, and are inserted into the cavity of 
the uterus, patient in the recumbent posture, and permitted to 
dissolve and come in contact with the internal walls, entirely re- 
juvenating them, and destroying all germs. If any difficulty is 
experienced in introducing, the original plant can be dissolved 
and a four or six catgut bougie can receive a heavy coating and 
be introduced, say for one-half an hour, until the germicidal sub- 
stance is dissolved. The method is most successful. 



This term is applied to a thickening, in- 

Dysmenorrhcea duration, cartilaginous degeneration, or 
(Mechanical). stricture of the external and internal os 
uteri, or neck, or a narrowing of the entire 
canal of the neck. It may also be due to some tumor, or uterine 
displacement, as ante or retro-flexion ; these latter we do not in- 
clude in the following remarks. What we speak of here is either 
a narrowing of the canal of the neck, or its infiltration with 
lymph, or cartilage, or a true stricture of the external or internal 
mouths of the cervical canal — conditions that cause sterility as 
well as dysmenorrhcea. 

Causes. — The causes that give rise to this induration, or me- 
chanical obstruction, are inflammation, such as acute and chronic 
vaginitis, leucorrhcea, self-abuse, excessive coition ; congenital 
irritation common cause. 

Symptoms. — Are those indicative of obstruction to the escape 
of the menstrual fluid. There is the languor, prostration, nausea, 
vomiting, pain in loins, hips, and thighs, bearing-down ; pain in 
ovaries and uterus, usually some time before a scanty flow makes 
its appearance. When discharge does come, it is in gushes, 
each gush preceded by pain, and an aggravation of all the symp- 
toms. The bladder becomes irritable, and there is often con- 
siderable tenderness over both uterus and ovaries ; anaemia, con- 
stipation ; very much resembles labor; uterus struggling to expel 
its contents. An examination of these cases reveals either a 
small OS uteri, or an orifice of the natural size, but the canal 
leading to the internal os, thickened, indurated, strictured, or suf- 
fering cartilaginous degeneration — conditions that can readily be 
felt with the finger, or the uterine sound. In some cases the ob- 
literation is confined to the inner os. In nervous or neuralgic 
dysmenorrhcea, the repeated irritation from month to month 
often aids in bringing about this condition. 

In the treatment of these cases, the same plan of treatment 



BACTERICIDES. 



287 



should be adopted as in the neuralgic during the flow, comp. 
serpentaria tinct., the introduction both per vaginam and rectum 
of the obstetric cones, and all failing hypodermic injections of 
morphia. 

During the intermenstrual period, there are various forms of 
treatment which might be resorted to. In all cases, it is well to 
place the patient upon an alterative and tonic course, administer- 
ing either comp. saxifraga, or phytolacca, alternated with aleteris 
farinosa ; relieving the dyspeptic symptoms with bitter tonics and 
the constipation with cascara sagrada lozenge. Every other 
night, the vagina should be packed with boroglyceride paste, and 
permitted to remain over night. During the eight hours of sleep 
there will ooze away from four to six ounces of serum ; this has 
a most marvellous effect on an indurated, structured, or hyper- 
trophied neck, besides it is most vitalizing to the blighted os. 
Perseverance with this remedy is invariably attended with success. 

Another method, still more heroic, attended with less trouble, 
but still most efficacious, is the introduction of one or two jequi- 
rity wafers or capsules right against the uterine neck, permitting 
them to remain over night. These if properly appHed, will cause 
a complete exfoliation of all the tissues with which they come in 
contact. If it is not deemed advisable to use it in that way, the 
contents of the capsule can be blown on the os and neck of the 
uterus, and the same result obtained. This procedure will bring 
-away large fibrinous masses, a peeling off without causing any 
breach of surface. Its use should be followed with mucilaginous 
injections. Most successful, still there are cases it fails to reach. 

Dilatation, by means of sponge-tents, sea-tangle, and metallic 
and rubber dilators are worse than useless, setting up more irrita- 
tion and additional obstruction. Those expanding instruments may 
produce no bleeding, but they are very destructive, and if often 
repeated are most harassing to the patient, and invariably after 
their use the canal returns to its former size, even a little nar- 
rower. There is no good in either slow or rapid dilatation, and 
■even the new method of dilating, lacerating, tearing, by divergent 
blades, is useless ; there is danger of irritation, if not of metritis, 
pelvic cellulitis, or peritonitis. 

Incision is the best plan, as it gives rise to no suffering, gives 
•a sure result, and is free from danger if properly performed and 
rapid. This is best performed by a pair of scissors, made for the 
purpose, one blade terminating in a probe-pointed end, which 
enters the os ; the other by a hook, which seizes and fixes the 
vaginal portion at the point desired. One stroke of the scissors 
divides the intervening tissue in a straight line. The proceeding 
is then repeated on the other side of the os, and the operation is 



288 DISEASE GERMS. 

then completed. There is a tendency to contract again even 
after that. To meet this, there should be a slight nick made of 
the internal os, just sufficient to divide the mucous membrane 
and some of the superficial circular fibres of the muscular coat» 
This will allay spasmodic sphincteric action. The incision should 
be no greater, because it is superfluous, and even dangerous. 
At the mouth of the inner neck there are blood vessels in pro- 
fusion, and of considerable size. Large veins, without valves and 
small arteries, gap at the uterine level, and are apt to bleed very 
profusely if uterus is cut into. A piece of lint, saturated with 
the juice or extract of hemlock bark, is to be inserted between 
the cut edges, and patient kept in bed under opium. 

If the patient and friends are willing, the best plan, if the 
suffering is great, is to perform the operation at once, as it is 
only a waste of valuable time to exhaust the usual list of reme- 
dies on her first. 

Indigestion, terms used to express or indicate 
Dyspepsia, a train of symptoms caused by a functional de- 
rangement of the digestive processes ; when they 
are confined to the stomach, they constitute gastric dyspepsia ; 
when in the bowels, duodenal dyspepsia. 

The indigestion, or failure on the part of the stomach to digest, 
takes place immediately after a meal, and continues for two, four, 
or more hours, according to the gravity of the disease, or kind or 
quality of food introduced; whereas, in intestinahor bowel dys- 
pepsia, the uneasiness or symptoms of indigestion do not com- 
mence for several hours after eating. In the stomach, the food, 
after being slowly and perfectly masticated, and incorporated with 
the secretion of the parotid and other glands of the mouth, is 
subjected to the action of the gastric juice, a powerful solvent, 
being made up of a substance called pepsin. In the bowels, the 
digested food or chyme, is subjected to the action of the pancreatic 
secretion, (a gland almost immaculate, enjoying a freedom from 
disease most remarkable,) which emulsifies the fat, starch, and 
other products, rendering them fit to become proper constituents 
of nutrition. The process of healthy digestion is easy, speedy, 
and complete ; there can be no excess of it, for food cannot be too 
quickly and completely converted into blood ; whereas, indiges- 
tion is slow, painful, and imperfect. 

Painful, from a slight uneasiness, to pain, or actual torture ; 
sloiv, when the stomach fails to digest in the ordinary time, and 
chemical decomposition or change takes place ; defective, when 
the food is either altered, or fermented, or decomposed, or formed 
into vegetable germs, like a yeast plant. 



BACTERICIDES. 



289 



Indigestion is divided into numerous forms or varieties accord- 
ing as one or more symptoms predominate. 

It is called simple, when there is loss of appetite, pain, weight, 
fullness or oppression about the stomach after meals ; flatulence, 
nausea, vomiting, constipation or diarrhea, coated tongue and 
fetid breath, with headache, palpitation, heartburn, water-brash, 
hypochondriasis. 

It is called slow digestion, Avhen there is a deficient secretion 
of gastric juice ; a feeling af fulness and distension at the pit of 
stomach, with the other s)^mptoms. 

It is called painful, when gastralgia and heartburn are the pre- 
vailing indications. 

Wind Dyspepsia, when flatulence, eructations of gas, and acid 
water, as water-brash or pyrosis ; there is usually gastrodynia, or 
stomach-ache. 

It is termed Bonliniic Dyspepsia, when, with the ordinary symp- 
toms, there is an excessive hunger or craving for food, and even 
not appeased by large quantities of food. 

Nervous Dyspepsia, when there is a nervous temperament, white 
face, sharp features, emaciation, phosphates and chlorides in 
urine; all or most of the symptoms are present, but especially 
headache, like a band or scalp flying off, and hypochondriasis a 
decided and prominent symptom, etc. 

Causes. — The causes are not only numerous but varied, and 
embrace every derangement and lack of tone in any organ, or of 
the entire body. Hurried eating, with imperfect mastication from 
whatever cause ; improper food ; drinking of fluids at meals, or 
the use of iced or cold drinks or food, highly depressing to stom- 
ach which arrest digestion ; want of exercise ; mental anxiety ; 
strain on mental powers by study or struggle for existence ; gen- 
eral debility, or nervous exhaustion ; use of whiskey, beer, tobacco, 
and drugs ; excessive drinking, especially cold drinks ; diseases 
of the blood ; and often due to reflex causes, as diseases of the 
liver, spleen, lungs, heart, kidneys, and to diseases of the nervous 
system generally. There is, so to speak, an endless chain of 
sympathetic and other causes. 

Symptoms. — Are very variable in their nature and severity. 
Loss of appetite, pain, weight, fulness at or about the stomach 
after eating ; acidity, flatulence, eructations, nausea, vomiting, 
pyrosis, tightness, heartburn, oppression, wearing cramp, lan- 
guor, debility, giddiness, with headache, frontal, or like a band 
round head ; a sensation as if there was a movement of the 
ground ; constipation most common ; still, there might be diar- 
rhea ; tongue coated white or brown, or if intestinal, buff coat, 
with transverse fissures; fetid breath; palpitation; pains in loins 

19 



290 DISEASE GERMS. 

or limbs ; often cough ; liver very torpid ; eyes tinged with bile ; 
urine scanty, high-colored, and deposits phosphates and chlo- 
rides ; skin dry, contracted ; the brain is often seriously affected, 
both through reflex action, want of nutrition, and otherwise ; 
so that hypochondriasis is always present in either a mild or 
aggravated form. 

A look at the physiology of the stomach will satisfy anyone 
of the existence of an immense nervous connection — the very 
secretion of the gastric juice being a nervous act — for there is no 
gastric juice in a healthy stomach until the stimulus of food is 
impressed upon the gas ric nerves, which is carried to the brain, 
and if that organ is healthy, gastric juice will be thrown out. 
The ultimate relation of the stomach with the great sympathetic, 
and the intimate union that exists between the stomach and other 
organs, cause non-sentient nerves to become highly sensitive. 
The abdominal plexuses of sympathetic nerves always play an 
important part in the production of indigestion. 

Treatment. — In all its forms, there should be an avoidance of 
all care, worry, and anxiety, study, or any mental strain. A 
vigorous brain is of essential importance, and an easy sympa- 
thetic soul of great moment. Every drain upon the nervous 
system must be blocked off; no over-work, nor care, nor sexual 
excesses. Pure blood is also important; and active, but not 
fatiguing exercise in the open air; daily bathing; if the cold 
douche or shower-bath can be borne, it is best, to be followed by 
friction and flannel clothing ; a diet highly nutritious but light, 
should be laid down, consisting of broiled tenderloin steak, or 
chicken, soft-boiled eggs, boiled fish, toast buttered, oatmeal 
mush, roasted potatoes, ripe fruit, mocha coffee. 

Veal, pork, salt or corned meats or fish, fried or boiled meat, 
all slop, as soups, pastry, pies, nuts, sweets, cabbage, tea, 
tobacco, alcohol, or all fermented liquors, should be carefully 
avoided. 

Another important point is slow eating, thorough mastication; 
no fluids, warm diet, perfect regularity in eating, sleeping, and in 
a daily movement of the bowels, and in perfect rest to stomach 
between meals ; no nibbling, or odd snaps, or lunches. Not 
more than three meals per day, with proper intervals between. 
Bowels to be opened with enemata daily every morning after 
breakfast. 

Special symptoms must be relieved or palliated, in order to 
give relief, until a cure is effected. 

The most valuable remedy in dyspepsia is a healthy condition 
of the mouth and teeth, and thorough mastication of the food. 
We all eat too hurriedly. There is too little mastication, not a 



BACTERICIDES. 



291 



proper admixture of the salivary secretion ; so that there is 
crammed into most stomachs a mass of inadequately crushed or 
undivided solid matter, which acts as a mechanical irritant, sets 
up disease. Eating quickly, filling the stomach with indigestible 
material, unprepared food, renders it incapable of recovering its 
tone. All animals intended to feed hurriedly have the powers of 
rumination, or are provided with gizzards. Man is not so 
furnished, and it is fair to assume he was made to eat slowly. 
Hurried meals are highly mischievous. Then there should be 
rest, for a considerable time after meals, of mind and body, but, 
on no consideration, sleep. To sleep after meals is the worst 
aggravation a weak stomach can receive. During sleep, digestion 
in the stomach is, to a certain extent, suspended. 

For the Relief of Eructations and Vomiting. — One of our best 
remedies to effectually relieve this condition is either pepsin or 
papoid. It should be administered with or at the meal. Its use 
causes little demand to be made upon the stomach for its di§|ps- 
tive secretion, and artificial digestion, promptly carried out, pre- 
cludes the possibility of either eructation or vomiting. There is 
no drug to equal it, as it gives vitality to a weak organ by giving 
rest. The digestive powers are assisted, and the food which, in 
other cases, ferments and irritates, because undigested, readily 
becomes assimilated, because it is now digested. Some think it 
best to give the pepsin or papoid a little while before meals, so 
as to afford it some time to combine with the existing condition 
of the stomach, and produce a more natural effect upon the food 
when swallowed, after being acted on by the salivary secretion. 

The idea is to give the stomach rest, and promote the formation 
of peptone ; and as soon as normal vigor is acquired, the organ 
will soon respond to the production of its natural fluids. 

The use of alkalies in the treatment of dyspepsia, should as far 
as possible, be discouraged, as they tend to weaken the mucous 
coat of the stomach, and give rise to catarrh. Perhaps the 
most innocent alkali would be one teaspoonful of Hme-water 
to half a tumblerful of milk, or five grains of bicarbonate of 
potassa to the sam.e quantity of milk, once, twice, or even thrice 
daily. 

For the Relief of Gastrodynia or Stomach Cramp. — As a rule 
this form of pain comes on following a meal. It is of the same 
character as neuralgia ; it is the gastric nerves crying for more 
nutrition — something to vitalize them. 

The various preparations of bismuth and cerium will relieve 
this pain, but their efficacy in other respects is not good. We 
witness their baneful effects in ladies who use it as a face powder 
or in cosmetics, and to introduce this deadening, benumbing drug 



292 



DISEASE GERMS. 



directly into the stomach is reprehensible if any other remedy can 
be procured. 

Capsicum, or white mustard seeds, especially the former, is an 
excellent remedy, a ^ood stimulant, does not irritate like black 
pepper, and its use affords almost instant relief. A good form is 
the compound tincture of myrrh, from half to one teaspoonful 
after meals in warm coffee. Half or drop doses of dilute hydro- 
cyanic acid act well, and being an ingredient of normal gastric 
juice, it could be added to the pepsin. A solution of quinine in 
aromatic sulphuric acid is also of utility ; mineral acids, carbolic 
acid and tincture iodine ; warm plasters, as hemlock or belladonna 
plaster, over stomach. 

For the Relief of Pyrosis or Water-Brash. — To mention acidity 
is equivalent to rushmg for an alkali, but a bitter will answer 
better. Still, patients will persist in their use on account of the 
immediate relief tbey afford. 

(^ycerine added to milk; one tablespoonful to half tumblerful, 
and taken after meals, relieves flatulence, acidity, pyrosis, or water- 
brash. Usually it is speedily and completely successful, as it pre- 
vents fermentation and putrefaction. Although glycerine prevents, 
putrefaction of nitrogenous substances, it does not prevent the 
digestive action of pepsin and hydrochloric acid ; hence, while it 
prevents the formation of acids, checks fermentation, it in no way 
hinders digestion. 

For the Relief of Gastralgia or Heartburn. — Reject alkalies and 
try nitric acid in compound tincture of cinchona, or dilute nitro- 
muriatic acid. If these fail, use hydrocyanic acid dilute. If that 
does not afford relief, steep gentian and horse-radish in good 
whiskey enough to cover, and use in tablespoonful doses ; or nux 
vomica in fluid extract of columbo or cascarilla. 

If, however, the dyspepsia has been in existence for some time, 
the stomach needs such a stimulant as the following: Pepper- 
mint water, eight ounces; tincture nux vomica, three drachms ; 
tincture belladonna, two drachms; carbonate ammonia, sulphate 
of magnesia, of each three drachms; tincture of ginger, half an 
ounce. Mix. One tablespoonful after meals. 



All microbes in their ingress into the skin ex- 
Ecthyma. cite irritation, erythema and effusion of lymph, 
thickening nodules, pustules. Very common on 
the face of both sexes about or subsequent to puberty. In older 
subjects they are found on the feet and hands. Ecthyma is com- 
mon as a result of any ordinary inflammation of the skin, pro- 
vided the system be somewhat debilitated. 



BACTERICIDES. 



293 



In the treatment the general powers of Hfe should be well sus- 
tained by the best of food. Germicides should be administered : 
as glycerite of ozone, avena, compound oxygen ; locally, to the 
affected parts, solutions of boroglyceride, peroxide of hydrogen, 
creolin, ichthyol should be used. 



An inflammatory disease of the skin, which 
Eczema, is not contagious, is polymorphous in charac- 

Moist Tetter, ter, and may be acute or chronic. Its poly- 
morphous or multiform character is one of its 
most marked features. Formerly described as a vesicular affec- 
tion, but it is erroneous to regard it solely as such. Vesicles, 
though frequently present, are not the sole elementary lesions 
met with ; in many cases, indeed, none are discoverable. Any 
one of the following primary lesions may occur : Simple redness 
(erythema), papules, vesicles, pustules. According to the lesion 
present the observer might thus be inclined to term the eruption 
erythematous, papular, vesicular, or pustular. It will have been 
noted that, in the classification adopted, eczema appears in several 
classes, but it will be convenient to refer to its vario is forms in 
the present place. A typical case is described as commencing as 
a patch of erythema, passing on to the formation of papules ; the 
latter then develop into vesicles, some becoming pustules. The 
bursting of the vesicles and pustules (either spontaneously or as 
the result of scratching) is succeeded by a serous or sero-puru- 
lent discharge; this is often very copious and thus justifies der- 
matologists in regarding eczema as a cutaneous catarrh. The 
drying up of the discharge is succeeded by the formation of 
scabs. Many cases, however, are far from presenting this regular 
course. The lesions are often more or less commingled, thus 
producing extremely varied appearances. The eruption may be 
"also more or less entirely confined to one form of lesion. Thus, 
it may be mainly erythematous, or vesicular, and so on. These 
different forms have been named correspondingly. Thus we get 
E, erytlieinatosum^ E. vesicitlosum, E. pustidosuin, etc. The red 
and moist condition of skin often seen in infants in the groin or 
between the nates, and beneath the breasts in stout women, is 
termed E. intertrigo ; in the official nomenclature it is classed as a 
separate disorder under the heading Intertrigo. In E. riibnnn or 
E. madidans there is intense redness of the skin, which is ex- 
coriated, largely denuded of epidermis, and exudes a copious 
watery discharge ; it is generally seen on the lower limbs. E. 
paptdosuvi is a form of eczema closely resembling lichen, which 
latter eruption is, indeed, described by some authorities as merely 



294 



DISEASE GERMS. 



a form of eczema. Similarly, some writers include impetigo under 
eczema, regard it as merely a variety of E, pustulosum. When 
the surface of the skin is red and inflamed, discharge scanty, but 
scabs formed in abundance, the resulting condition is termed E. 
squamosum ; the latter term was also employed by dermatologists 
to describe some varieties of psoriasis. The eruption may also 
be named according to the part affected, e. g., E. capitis, E, 
facialis, etc. 

Eczema is an exceedingly common affection. Statistics show 
that from one-third to one-fourth of the cases of skin diseases 
seen in practice come under this heading. It may occur at any 
a,ge, but is more common in young children — especially at or 
about the period of teething ; often (generally erroneously) attri- 
buted to vaccination. More common in males. May be of local 
or constitutional origin. Inflammation of the skin set up by ex- 
ternal irritants differentiated by some dermatologists as dermatitis. 
In most cases, external irritation is an important factor as, when 
not actually causing, it often materially aggravates the disorder. 
Eczema is often hereditary. Gout, scrofula, alimentary disorders, 
and circulatory derangements are said to predispose to it. Preg- 
nancy, lactation and uterine complaints are enumerated as causes 
of eczema, and it may also occur as a " trophic lesion" in various 
nervous disorders. 

As there are no specifics in medicine, none in cutaneous dis- 
ease, each case must be managed on its own merits and general 
principles ; so in treatment, we can only draw brief attention to 
the main indications for treatment. 

The general condition of the patient demands careful attention ; 
every effort should be made to discover the cause of this trouble- 
some and frequent skin disease. The diet should be carefully 
regulated, plain and nutritious, easy of digestion. Shell fish, 
alcohol, tea and coffee forbidden. 

Constipation is almost invariably present, and calls for imme- 
diate attention, as the ptomaines from microbes are always present 
and greater too if the peristaltic wave is slowed. Kola nut 
lozenge, better still the cascara sagrada lozenge, which stimulates 
the liver and aids elimination of excess of uric acid which inva- 
riably co-exists with eczema. General alteratives and tonics. 

Tincture of sulphur, alternated with nux vomica, or lycopo- 
dium do well, better by far than the indiscriminate use of arseni- 
cal solutions. 

An excellent formula for general use is : Comp. tincture cin- 
chona, four ounces; acetate of potass, half an ounce: tincture of 
nux vomica, two drachms. One teaspoonful in a glass of water 
after every meal. Another good formula is: Ozonized sulphur 



BACTERICIDES. 



295 



water and comp. tincture of gentian, equal parts of each, a tea- 
spoonful in a little water after meals, alternated with nux vomica. 

Locally washing to be avoided, but as this must be done, 
white castile soap should be used and a few drops of the peroxide 
of hydrogen added to the water. 

In cases with little secretion, we often meet with great success 
with a dry dressing, as simply dusting on the anti-microbe 
powder. 

To allay itching, a solution of boroglyceride ; or an ointment 
of ozone ointment and resorcin are excellent. 

Ichthyol, as an external remedy in the form of a solution or 
ointment, in strength varying from five to fifty per cent. It acts 
in three ways : (i) As a Protective. — When a solution of it is 
painted over the skin surface it quickly dries, forming a thin 
layer somewhat resembling friar's balsam or collodion, and so 
protects the skin from the air, dust, etc. (2) As a Reliever of 
Congestion. — When applied to healthy skin its effects seem nil^ 
but where there is an active congestion of the part it acts 
promptly by causing contraction of the arterioles, and so dimin- 
ishes the vascularity of the part. (3) As a Desiccant. — As it 
reduces the vascularity of congested skin, the outward flow ot 
serumi is also reduced, and consequently the part becomes drier. 
In these three actions are the essentials of the treatment of many 
skin diseases. 

Resorcin in glycerine or as a jelly ; ointment of iodoform, iodol, 
oleate of zinc ; oil of boroglyceride ; nitrate of mercury ; caustic 
potassa ten grains to the ounce of vaseline ; salicylic acid five to 
ten to the ounce of vaseline ; siegesbeckie cerate most effica- 
cious ; all internal and local remedies to be of utility should be 
changed weekly. 

The tubercular bacilli appears in a great 
Elephantiasis, variety of forms in the cuticle, true skin and 
subcutaneous tissue. In certain cases in 
which the nerve forces are decidedly bankrupt, and the external 
surroundings of the worse possible kind, the bacillus excites 
irritation, effusion of lymph, which form germ nests, great hyper- 
trophy, and induration. Associated with the hardness, there is 
considerable pain. Sometimes the parts are dry and mealy, in 
other cases serum exudes. 

It usually attacks the lower extremities, scrotum and depending 
parts, and progressively extends upwards. 

Before the introduction of so many bactericides, it was deemed 
incurable, now a cure in the earlier stages is looked upon with 
more hope. 



296 DISEASE G-ERMS. 

Physicians of undoubted veracity say that the boroglyceride 
paste during the day, and the resorcin paste during night, are 
effective in getting rid of the infiltration. 

The usual internal remedies for the cure of tuberculosis 
certainly deserve a fair and impartial trial. 



The presence of the bacillus pyogenes in the 
Empyema, cavity of the chest — usually the result of pleurisy 
in debilitated subjects. It is liable to follow 
scarlet fever in children ; pneumonia and tubercular disease of 
the lung in adults; the bursting of a hydatid cyst into the 
pleura, or the bursting of a tubercular cavity of the lung into the 
thorax. Often it supervenes without any assignable cause. 

Symptoms. — There is at first pain of a sharp and shooting 
character in the affected side, and this is generally confined to 
one spot; the patient cannot cough or take a deep breath with- 
out increasing this pain. In a few days, when the fluid is poured 
out into the pleura, the pain may diminish considerably ; but 
there is more or less distress of breathing, because, from the 
pressure of the fluid, air cannot enter the lungs on the affected 
side, and the other lung is called upon to do all the work ; hence 
the patient lies on his back or diagonally towards the diseased 
side, so as to give the healthy side of the chest all the room he 
can to expand. From the first there are the usual signs of fever — 
a furred tongue, quick pulse, loss of appetite, and much thirst. 
The temperature, too, of the body rises considerably, and is liable 
to much daily variation, being high at night and perhaps two or 
three degrees lower in the morning. When the disease is well 
.established, the diseased side of the chest is larger in circumfer- 
ence than the other, and there is bulging of the intercostal spaces ; 
the veins also are obstructed over the part, and appear as blue 
lines running over the chest. The dyspnoea is great, and 
increased on exertion ; each respiration is hurried and shallow; 
the countenance is anxious, and sometimes pale or livid. Gener- 
ally the patient is worse at night, and becomes hotter and more 
oppressed ; at times a hectic flush appears on the cheeks, at others 
there is much perspiration over the head and body ; rigors or 
shivering are very usual in the early stages of the disease, but 
become less frequent afterwards. 

/// the treatment, the patient must be kept in bed, in a warm, 
well ventilated room, the air kept moist, and at a temperature of 
65° to 75° F. Food of a highly nutritious character adminis- 
tered, as malted sterilized milk, beef tea, broth; and a moderate 
amount of stimulants administered. 



BACTERICIDES. 



297 



A course of internal bactericides, as the exhibition of the di- 
oxide of hydrogen, comp. oxygen, ozonized sulphur water. 

Jackets of bactericides have been tried, prepared of iodoform, 
and kindred germicides, occasionally a case seems to yield to them, 
but their uncertainty of action renders them practically useless. 

The living microbial mass should be removed either by aspi- 
ration or tapping the chest. The latter procedure is the best. 

For this purpose an incision, about an inch long, or rather 
less, is made through the skin, about, the sixth or seventh inter- 
costal space, and in the line of the axilla or arm-pit. A trocar 
and canula, about one-fourth or one-fifth of an inch in diameter, 
is then introduced, and when the trocar is withdrawn the pus will 
run through the tube most readily. The wound should not be 
allowed to close, but a piece of tubing of gutta percha should be 
kept in, so that any more pus that forms may escape at once, 
and not accumulate again. Even in very favorable cases pus 
continues to be secreted and to flow through the tube for days 
and even weeks after the original puncture. The quantity pro- 
duced dai^y gradually diminishes until at length it ceases. All 
this while the patient will be easier ; he can breathe more com- 
fortably ; there is less fever and hectic ; he will recover his appe- 
tite, and rest better at night ; but in all cases that recover, conval- 
escence is a very slow process, and tonics, generous diet, cod-liver 
oil, a visit to the sea-side or country are indispensable aids for 
regaining health. If the lung cannot expand after the matter has 
escaped, the chest-wall of the affected side will be pressed in by 
the external atmosphere, and so be smaller than the other, and 
in this way such patients often have lateral curvature of the spine 
afterwards. In time the healthy lung becomes much increased 
in size, and does in a great measure the work of both. The mor- - 
tality from this disease is considerable, and it is nearly always 
fatal when arising from pyaemia, or when the patient's health has 
been worn down by previous disease. In a few cases the pus has 
made its way through the skin of the chest, and burst externally 
of its own accord ; but it is best to tap the chest before such a 
process has taken place. 

A morbid state of the blood, in which it has a 

Embolism, tendency to clot or form fibrinous concretions, 

^ which either adhere to the walls of vessels or are 

carried onward by the current of the circulation, and plug up or 

impede its normal course. 

The causes are varied : in-door life, insufficient aeration of 
blood by skin or lungs ; its imperfect decarbonism by the liver 
in drunkards; the pressure of the gravid uterus on the liver, and 



298 DISEASE GERMS. 

non-ogygenization by pressure on the diaphragm. It is present 
in ague, typhus and other fevers ; also in croup, diphtheria, 
pneumonia, scarlatina, erysipelas, caused by the ptomaines of the 
germ of each, respectively. It is also caused by diseased vege- 
tables, fruit, meat, and cereals, such as ergot of rye, ustilago 
maidis, so that ergot during parturition produces it in mother 
and child, and is one of the most common causes of death to 
both. 

In an examination of the blood after death there is usually a 
large coagulum found in the heart ; fibrinous specks, patches, 
plugs can be seen in brain, lungs, heart, liver, and arteries. On 
an exam.ination of these clots or plugs by the microscope, they 
seem, in nearly all cases, to be a mass of bacteria interspersed 
with cadaveric alkaloids. 

It is often difficult to recognize the disease during life as the 
symptoms are quite variable, but if any of the above causes exist, 
it is positively present to a greater or less degree, and particu- 
larly so if the patient complains of strange sensations about the 
heart, and has a tendency to fainting. 

In all diseases in which this is present, or where it is suspected, 
the patient should be kept as quiet as possible in the recumbent 
posture, never being permitted to sit up, and nothing allowed to 
disturb him in any way, and have an abundance of fresh air. 
The diet should consist of milk, eggs, soups; the secretions 
attended to. 

In order to meet the pathological condition of blood, tincture 
of belladonna, alkalies, and peroxide of hydrogen should be 
administered. 

All acro-narcotic remedies have a wonderful effect in causing 
and maintaining a fluid state of the blood. Belladonna has this 
property in a high degree. A teaspoonful of the tincture in half 
a tumbler of water, of which a teaspoonful should be given every 
one or two hours, never administering it so frequently as to cause 
dryness of throat. 

In the sesquicarbonate of ammonia we have an excellent 
alkali. This either alone or combined with a few grains of 
bicarbonate potassa soon relieves the condition ; besides, the 
ammonia is destructive to living germs in the blood. Bromide 
of ammonia answers well if a deposit of fibrin has taken place. 
Salicylate soda in acetate of ammonia. Sulphate of soda is also 
valuable, so is the permanganate or chlorate of potassa. In dis- 
eases associated with embolism, iron and mineral acids should be 
avoided in treatment. 

The term thrombosis is applied to a clot of fibrinous blood 
causing a partial or complete closure of a vessel. 



1 



BACTERICIDES. 



299 



A pouch or air-sac in the lungs. Two 

Emphysema, varieties. Vesicular and inter-lobular em- 
physema. 

Vesicular Emphysema. — Consists of a debilitation, enlargement 
and coalescence of air-cells, atrophy of their walls and oblitera- 
tion of their vessels, may affect one or both lungs, or a part of 
each, especially anterior edges and apices. 

Its causes are degeneration, a sort of interstitial death, destroy- 
ing elasticity and contractility of affected tissues, the air-cells and 
their surroundings, which conditions may be caused or intensi- 
fied by running, jumping, hoisting, playing base-ball or wind- 
instruments, singing, shouting, lifting, diggir\^, rowing, running 
up stairs, or by anything that would cause the patient to take 
prolonged deep inspirations, 
or sudden check to an ex- 
piration ; a sequel of hoop- 
ing-cough, asthma, chronic 
bronchitis. 

Inter- Lobular. — Consist s 
of an infiltration of air into 
the interlobular areolar tis- 
sue, or into sub-pleural 
areolar tissue. This form 
is generally caused by rup- 
ture of the air-cells by vio- 
lent strain, or fractured ribs, 
and is generally met at the 
corners or abrupt angles ot 
the lungs. The distincti <\\ 
is important, as the lobular 
form is very hopeless, and 
can only be relieved by 
antispasmodics. 

Emphysema is often latent, dates back to early years ; an iso- 
lated spot of the lung weak, which affords an anatomical substra- 
tum for its occurrence ; a substantive inherent unhealthiness ot 
lung tissue, which gradually increases with years. This is the 
true pathological process, which is easily microscopically demon- 
strated, and is at the bottom of all cases ; gives rise to a predis- 
position, in an incomplete respiration and retention of air, and 
in time gives rise to microbiosis of patches in the lung, and lat- 
terly in the formation of large rarefied air spaces. 

Symptoms. — The symptoms are the same in both forms. Gene- 
ral debility, with shortness of breath and difficulty of breathing, 
increased by slightest exertion, and general distress, that the suf- 




A beautiful illustration of vesicular emphysenu 
showing a well-developed air sac in each lun§ 
with two small ones fully formed. 



300 



DISEASE GERMS. 



ferer is unfit for any active occupation ; feeble cough, expectora- 
tion of frothy sputa, dusky appearance of countenance, weakness 
of voice, stooping gait; loss of flesh and strength, lowered tem- 
perature, 85° F'ahr.; very weak and slow pulse, fifty to sixty; re- 
spiration twelve per minute ; constipation, occasional paroxysms 
of asthma ; chest barrel-shaped, scarcely any movement of the 
intercostal muscles in breathing; on percussion, an unnatural 
clearness tympantis can be mapped out, and to be found there at 
all times. Ausculation reveals indication of vesicular murmurs 
as must rule us in bronchitis. Heart sounds are very feeble, and 
that organ is frequently displaced. Disease of the right cavities 
of the heart, with venous congestion and dropsy. Diseased side 
bulging, round or prominent in bad cases. 

Treatment. — Emphysema is generally regarded as an incurable 
affection, and that is correct in a large proportion of cases ; still 
there are few cases that do not admit of much amelioration, 
and very many of the vesicular form curable. 

All conditions that would be likely to cause sudden iaspiration 
or expiration should be avoided, as mental and physical excite- 
ment, no shouting nor attempts at running, lifting, rowing, etc. 
Warm flannel clothing, very generous and strengthening diet, 
and tonics to stimulate the appetite. Some remedies have a re- 
markable power over the interstitial tissue and stroma of the 
lungs in atrophy or in sclerosis, such as lobelia, quinine and 
hyoscyamus ; one grain of each thrice daily operates well, and 
effects some good cures put up in pill form ; liquor ammonia, 
sambul, phosphate of iron and quinine, also, are of great efficacy. 
The lobelia, quinine and hyoscyamus pill is our best combination ; 
next, bromohydric acid ; warm, moist atmosphere. 

Quebracho is also a good drug to relieve the difficulty of 
breathine. 



It is difficult to define this disease, but it can be 
Epilepsy, described as a weakness or irritation of a patch of 
the brain, with an impaired cerebro-spinal centre 
which leads on the slightest disturbance to an explosion between 
the positive and negative forces of that organ, which produces 
the characteristics of sudden loss of consciousness and sensi- 
bility, power of voluntary motion, with tonic convulsions lasting 
a few seconds, and followed by clonic spasm of voluntary mus- 
cles ; cessation succeeded by exhaustion and coma. Attacks 
recurring at intervals. Without a weakened bulb and neighbor- 
hood epilepsy could not exist. 

The causes may be embraced under three general heads : 
(i.) Centric causes. (2.) Reflex. (3.) Blood diseases. 



BACTERICIDES. 3OI 

1. Hereditary conformation, consanguinity, peculiar shape of 
skull, depression or excrescence from its walls, tumor, worms ; 
weakened patches by falls and blows in infantile life. 

2. Reflex : caries and overcrowding of teeth, vaulting of the 
roof of mouth, giving rise to irritation of the trigeminus, the 
most reflex nerve in the entire body. Irritation anywhere, espe- 
cially in the abdomen, for of all the regions of the body none 
reflect more strongly on the brain than the visceral organs ; so 
we must look well to the stomach and bowels for worms ; if 
there is great mental depression, melancholia, for a loaded or 
sacculated colon, the kidneys, bladder and irritation of the gen- 
erative organs in both sexes, etc. 

3. The blood, the living germs of tubercle, cancer, syphilis,, 
rabies, and even the ovum of parasites will nestle and form colo- 
nies in patches of the brain weakened by falls and blows, and 
thus increase the condition of molecular death. 

Epilepsy is characterized by general languor, debility, lassi- 
tude ; patient soon acquires a nervous temperament, sharp fea- 
tures, white skin, with an excess of brain-waste in urine in the 
shape of phosphates and chlorides. If the fits are about to ap- 
pear, there are in about two-thirds of all cases what is termed 
warnings or premonitory symptoms, which consist usually of 
some nervous sensations, different in duration and character, 
such as spectral illusion, hallucination of smell, taste, headache, 
giddiness, vertigo, twitching, confusion of thought, sense of 
fear, etc. But the aura epileptica occurs in the large propor- 
tion of cases; some compare this to a current of hot or cold air 
passing by ; others to a stream of cold water running on the 
skin, a fulness in head, a sense of burning or tingling or a prick- 
ing sensation, drawing inwards of the thumbs, a feeling as if 
insects were creeping, the sensation beginning in some remote 
part and extending to the head. Usually when aura ceases fit 
commences. 

The real symptoms : white or cadaverous appearance or pallor 
of features, with utterance of a shriek or scream ; and that may 
not take place, but the patient falls to the ground insensible, with 
loss of voluntary motion and violently convulsed ; convulsive 
movements continue violent, usually more marked on one side 
than the other ; distortion of face, gnashing of teeth, foaming at 
the mouth ; protrusion of the tongue, which is often bitten ; 
eyes partly open and suffused ; eyeballs rolling and insensible to 
light ; skin cold and clammy ; perhaps involuntary micturition 
and defecation ; vomiting ; breathing laborious, seems about to 
be suspended ; when the limbs are stretched out a deep sigh is 
drawn and the fit passes off Patient left insensible and as in a. 



302 



DISEASE GERMS. 



sound sleep, with stertorous breathing, from which he recovers 
with a feeling of stupor and exhaustion and headache, but with- 
out any knowledge of what he has gone through. Some hours 
subsequently small ecchymosis often detected on face, neck and 
chest. « 

The fit may be very light or very severe; its duration may be 
a few minutes or extend to many hours. Fits, when slight, often 
only consist of giddiness, confusion of mind, loss of conscious- 
ness, little or no convulsion and stupor, and all over in less than 
a minute. Seizures occur at variable intervals ; often occur at 
night without being suspected by patient or friends. Repetition 
of attack impairs memory, may cause cerebral hemorrhage, tem- 
porary or permanent paralysis, or dementia, idiocy. 

In all obscure cases, it is well to look for germs and parasites 
or their spores or eggs. 

The most hopeless cases are those due to centric causes in the 
brain or skull, defective nervous organizations, lesions of the 
meninges. Those due to irritation, reflected or propagated, or to 
a morbid state of the blood, if not of very old standing, are 
amenable to treatment. 

The great increase of epilepsy is due to the vices or defects 
of civilization, the brain being more susceptible to irritation; 
abnormal conditions of alimentary canal, uterine irritation, 
masturbation, venereal excesses, alcoholism, tobacco, syphilis, 
mercury, etc. 

Treatment. — The symptoms are those of a sudden explosion of 
accumulated nervous energy. From the periodical character of 
the fits, it is inferred that the accumulation of nervous energy 
goes on for a definite time in the brain and spinal cord until 
an explosion ensues, which spends itself upon the muscles of 
voluntary motion, which are thrown into violent action, and by 
these means the accumulation is exhausted — the explosion being 
followed by coma or deep sleep. 

Many measures have been proposed for preventing the gradual 
accumulation and sudden explosion of the nervous energy con- 
stituting epilepsy, as improving nutrition, restoring mental and 
bodily vigor by any possible means, abundance of exercise in 
open air, daily batliing. 

Treatment during a fit should be directed chiefly to protecting 
the patient from violence, and getting him out of the fit. All 
clothing should be loosened, so that the blood may have free 
circulation to and from the head and all parts of the body. A 
piece of pine wood should be placed within the teeth to save the 
lips and tongue from being wounded by the spasmodic move- 
ments of the jaws. The patient should be placed on right side 



BACTERICIDES. 303 

on bed or floor, head well elevated, and restrained or guarded, 
so that no personal injury is inflicted. Cloths wrung out of 
warm water should be applied to the head ; mustard to the feet. 
Enemas of some broth, or mucilaginous tea, with half a tea- 
spoonful of spirits of turpentine, operate very favorably. Tying 
a ligature around the limb in which the aura is experienced prior 
to the fit, to ward it off, of doubtful utility. 

If fit lasts long, a hypodermic injection of one-quarter of a 
grain of sulphate of morphia in the cellular tissue of nape of neck 
or over deltoid instantly rouses tlie patient up. Snuff, inhaling 
nitrite of amyl, etc., rather to be avoided. 

During the interval, while the fit is off, there must be a 
vigorous eflbrt to prevent a recurrence or suspend the explosive 
tendency of the positive and negative forces of the brain with 
sufficient doses of bromide of potassa and other remedies to 
diminish or allay the reflex excitability and force of the cerebro- 
spinal centres. Such a formula as one of the following is efficient : 
Fluid e^ract of sambul, four ounces; tincture of calabar bean, 
one ounce ; bromide of potassa, one ounce ; bromide of ammonia, 
two drachms ; bicarbonate potassa, two drachms ; tincture ot 
belladonna, thirty drops. Mix. One teaspoonful or more — 
sufficient to ward ofl'the fits; or the following: 

Camphor water, four ounces ; bromide of potassa, one ounce; 
iodide of potassa, two drachms ; carbonate of ammonia, half an 
ounce. Mix. Dose, from one to more teaspoonfuls, sufficiently 
often to ward off attacks. 

The numerous causes of epilepsy have given rise to a variety 
of treatment, among which that of the bromides deservedly takes 
the first rank. For many years, bromide of potassium, sodium, 
ammonium, lithium, calcium, zinc, arsenic, nickel, camphor, ethyl, 
have variously been employed, but their action appears less reli- 
able than the bromide of potassium, or a combination of three — 
potassium, sodium, and ammonium. Lately the author first used 
bromide of gold, and encouraged by the results, has established 
a treatment of remarkable activity. The form preferred is the 
solution, which is of a dark orange color. The least dose for an 
adult is eight milligrammes in twenty- four hours ; for a child, 
from three to six milligrammes will suffice. When wishing to 
obtain a rapid effect in an adult this dose is gradually increased 
until the effect is obtained. If the dose is increased a persistent 
headache m.ay occur, which ceases when the dose is lessened. 
The author has never exceeded a dose of twelve milligrammes. 
The advantages are the small quantity required, compared to the 
bromide of sodium or potassium necessary to obtain a good 
result; and the absence of digestive disturbance renders it pos- 



304 



DISEASE GERMS. 



sible to continue the treatment for a long time without inter- 
mission. No phenomena of bromidism have been noticed ; no 
cutaneous accidents, nor loss of memory, or diminution in sexual 
functions. Every one is familiar with the grave result of the 
bromide treatment upon the general health of epileptics. Bromide 
of gold is more rapid in its effects, and gives rise to none of these 
very disagreeable phenomena. Another point worthy of attention 
is that the effect is lasting, and remains sometimes for many 
years without other treatment and with no return of the epileptic 
attacks. 

Bromide of potassa is a salt of high diffusive power, readily 
entering and quickly leaving the blood. It should be given 
freely diluted with water on an empty stomach, otherwise, part 
of it escapes from the system without being absorbed. Besides, 
its well-known power in producing anesthesia of the medulla 
oblongata, thus diminishing central irritation, it has a similar 
effect on the motor and sensory nerves. Bromide of lithium is 
a more powerful salt than the potassium, containing %nore bro- 
mine, but is not efficient in epilepsy. The dose of the bromide 
of potassa should be from forty to sixty grains per day ; not 
one grain more should be given than the quantity required. 
The addition of the bicarbonate of potassa in the one prescrip- 
tion and carbonate of ammonia in the other, increases the action 
of the bromine materially ; besides, they are antacid and pro- 
tect the stomach against brominism. The rule is, bromine enough 
to act successfully on the bulb, but not to produce a catarrhal 
condition of mucous membrane with a train of miserable symp- 
toms in which the remedy must be stopped. Bromide operates 
best on the heavy fits ; it has less effect on the light. 

What is really the value of the bromides in chorea and epilepsy 
due to the germs of tubercle, syphilis, or starved brain areas ? 
We cannot correctly appreciate. 

A weakened patch in the brain or bulb, with either of those 
two disease germs in the blood, will give rise to epilepsy. An 
imperfect nutrition or weakened patch in brain and cord, with 
impaired nutrition of the nervous ganglia, or group of nerve 
cells, with the same or other germs present, will give rise to 
chorea. Besides, there are the ordinary reflex causes. The two 
affections demand an alterative and tonic course of remedies, 
— all the time — with repeated small blisters of about the size of 
a silver dollar, to nape of neck, for six hours daily, twice a week, 
as there is always a co-existence of spinal tenderness, greater 
spinal impressibility and other hybrid ailments. In addition 
nothing should militate against the use of avcna sativa day by 
day, as the tissues are starved. It increases the motor power of 



BACTERICIDES. 



305 



the heart, tones the nerves, increases the number of nerve cells^ 
overcomes the want of equihbrium between the grey and white 
matter of the cord ; reheves insomnia, overcomes mental weak- 
ness, and incoordination of muscles. If, however, the motor 
phenomena are peculiarly violent, the patient must have rest — 
rest from excitement, from noise, from harsh words, from taking 
an active part in the struggle of life. 

We do not endorse the use of the bromides in either; it is 
true they suspend the reflex impressibility of the medulla oblon- 
gata — the seat of reflex action — but it is also, too true that they 
diminish nervous energy ; true vital stamina is lowered ; motor 
and sentient power diminish under their use. They soothe, dis- 
pose to sleep, but they blunt the intellectual faculties, impair the 
memory, confuse the ideas, render the individual dull, stupid^ 
apathetic, with a tendency to somnolence. They impede speech,, 
weaken special senses, make the body infirm, feeble, unsteady. 
Its effects on the ovaries and testes are to destroy, or obliterate 
the secreting cells ; being analogous to castration, so that sexual 
power is abolished. The bromides devitalize the mucous mem- 
brane of the stomach, give rise to gastric catarrh (sarcina ven- 
triculi) nausea, flatulence, etc. It also slows the heart, covers 
the skin with acne (the bromine rash). 

Now none of these symptoms are produced by the ozonized 
fluid extract sambul. It has precisely the same action upon 
suspending the fits or the choreaic twitching, but never impairs, 
nor damages, nor atrophies the sexual apparatus. The bromide 
craze has had its day. Many brilliant minds have been wrecked^ 
by its indiscriminate use ; it has caused impotency to be very 
general, and sterility exists from its use to a very alarm.ing degree. 

Simiilo, for epilepsy, nervous and hysterical cases, has not 
realized the anticipations formed of it. Its properties are iden- 
tical with the fl. ext. or essence of hyssop. It is a germicide of some 
power, but not efficient in epilepsy, and cannot cure it. True, if 
suitable cases are selected, those due to disease germs, it will da 
work, but never can make the inroad on the weakened bulb 
which is effected by the sambul. 

(Enanthe Crocata, or cowbane, is conspicuous as a remedy m 
epilepsy, it succeeds in warding off fits by arresting the molecular 
activity of the brain ; it is worthy of a trial. 

The tincture of cocculus indicus in ten-drop doses, morning and 
night, and gradually increased until it produces cerebral conges- 
tion. The drug keeps the cephalic vessels in a state of relaxation 
and thus prevents the vascular spasm which produces cerebral 
anaemia, the fundamental condition of the initial stage of an epi- 
leptic attack. It is most useful in old chronic cases, in whicli. 
20 



3o6 DISEASE GERMS. 

bromine and sambul have failed. The remedy must be carefully 
guarded. 

Exalgine possesses some remarkable properties in epilepsy in 
certain cases ; its action resembles the bromides — that to obtain 
its effects, it must be given in large doses and persevered with. 

Osmic acid, alternated with nitro-glycerine, has met with success. 

Other remedies often of utility are the mono-bromide of cam- 
phor, valerianate of zinc, cannabis indica,conium, Fowler's solution, 
bclerotinic acid, Chian turpentine, Calabar beans, lobelia. 

The elucidation of the germ theory of disease with its bac- 
tericide remedies has clearly shown that many obscure brain 
lesions are due to disease germs and uric acid in the blood. 
Many epileptiform seizures are preceded by hemicrania, and are 
readily kept in check by peroxide of hydrogen, uric acid solvent, 
etc. The use of these remedies in epilepsy bids fair to bnng this 
hitherto stubborn affection within the class of diseases amenable 
to treatment. It is therefore a good plan in all cases, after ward- 
ing off the fits either with ozonized extract of sambul or some 
other remedy, to place the patient upon some efficient bacteri- 
cide; such a course is attended with most marvellous results. 

If it is a boy or young man with short hair, an ointment of 
equal parts of chloral hydrate and camphor dissolved in vaseline 
should be rubbed into the entire scalp at bedtime ; in case of a 
lady, well up in nape of neck. It is a valuable help, whether it 
acts by continuity of tissue or by causing some molecular altera- 
tion in the periphery of the nerves and occasioning the same 
alteration in the nerve trunks, or in their nuclei, or by reflex ac- 
tion, it is impossible to say. 

The liver and colon should be roused into action by compound 
licorice powder and colocynth. There is a la*-ge number of 
cases where the central irritation is kept up by eccentric causes, 
as a worm, fistula, tight or elongated prepuce, or clitoris, which 
latter being removed, the central irritation is easily combated by 
the application of ice to the sympathetic nerve which issues from 
the last cervical and upper dorsal vertebrae, and by small doses 
of the bromine. The value of ice is effective in proportion to the 
youth of the patient and acuteness of the case. It is rarely bene- 
ficial in the chronic epilepsy of adults. 

Young children, from one to six years, sleeping in closed rooms, 
are subject to frequent attacks at night of screaming, with insensi- 
bility and semi-convulsions, due to the protracted inhalation of 
air deficient in oxygen and laden with carbonic acid gas. For 
this the chlorate of potassa is a sovereign remedy, and for the 
true convulsion and epileptic attacks in children it often proves 
curative. It is of no utility in the adult, unless combined with 
bromide. 



BACTERICIDES. ^O/ 

While wardiag off attacks, remove the cause if it is admissible. 

In distinguishing the true epilepsy from the feigned, the follow- 
ing are good landmarks for a guide. In the feigned, the patient 
does not fall violently but deliberately, to avoid injury; eyes are 
closed but pupils contract to the stimulus of the light; tongue 
and lips never bitten ; face red, congested instead of being pale ; 
skin healthy ; blow snuff into the nostrils and patient sneezes. A 
proposition to apply the actual cautery to the spine effects an in- 
stant and permanent cure. 

In infantile epilepsy, we must look for falls, blows, teething, irri- 
tation of the stomach and bowels, worms, and remove by lancing 
gums, emetics, cathartics and vermifuge remedies. 

If caused by fright or mental emotion, aconite, belladonna, hyos- 
cyamus, citrate of caffeine, etc. 

If caused by indigestible substances, emetics, compound anti- 
bilious pills, etc. 

If by worms, the active principle of pomegranate root, valdivine. 

If by suppressed menstrnation, compound betin pills, warm teas, 
etc. 

If by masturbation, large doses of tincture of green root gel- 
semium, with circumcision and shortening clitoris. 

If caused by blood disease-germs^ as tubercle, syphilis, etc., 
iodine, glycerite of ozone and water, nitric acid in compound 
tincture of cinchona, iodide of potassa, phytolacca, general altera- 
tives and tonics, as laid down under each ; and in all cases, either 
repeated blisters or irritating plasters, or the antimonial plasters 
below nape of neck, an open sore, so as to attract the germs of 
disease to another pasture-field, away from the vital organ — the 
brain. 

The bioplasm of normal nutrition, changed, 
Erysipelatas. altered, degraded by adverse conditions preju- 
dicial to vitality into a disease germ. The mi- 
crococcus erysipelatous is very small, consisting of minute cocci in 
chains, found in the mouth, breath, blood, kidneys and in the 
erysipelatous blush. They occupy the lymphatics of the skin 
and spread along them as the disease advances or progresses. At 
the margin of the erysipelatous zone, where the microbes are 
multiplying by millions, marked by the characteristic redness 
and swelling, the lymph glands are filled with zoogloea of micro- 
cocci, and the injection of these vessels keeps pace with microbe 
growth. 

Artificial culture of the germ succeeds well in almost any nu- 
trient fluid ; such cultures or even successive cultures inoculated 
into animals, produce erysipelas. 



308 



DISEASE GERMS. 



tl 




fl 


'''^ 


.\''' 


' / 


• ?• 


^'. 


'^'"' 


A 


1/ 




Streptococcu 


p erysi 


ipelas. 



The presence of this germ in the blood of an individual gives 
rise to languor, lassitude, debility, pain in the head, back, calves 
of the legs, tongue coated with a heavy brown bacterial coat, 
usually constipation, albuminuria, rigors on the sprouting of the 
germ, and a high grade of fever, either prior or subsequent to 
the chill an inflammatory blush upon some part of the skin 

which was accidentally weakened. This 
inflammation of the skin is thus accounted 
for by micrographers, the streptococcus 
erysipelatous, having used up in their 
own growth, nutrition and multiplication 
all the oxidizable properties in the blood, 
and are in danger of starvation, becoming 
weak and attenuated, seek the cutaneous surface to have free 
access to oxygen. Here they received an infusion of new life 
and vigor, and have an unprecedented growth, spreading widely,, 
but invariably selecting weak or devitalized parts, where the 
vessels are weak and patulous. 

The most successful treatment consists in annihilating the 
germ, overcoming malnutrition, arresting germ evolution. 
To sterilize and annihilate the microbe : 

Internally try either brewers' yeast or ozone water ; or resor- 
cin or compound tincture 
kurchicine, or lactic acid ; 
sulphide of lime. 

Locally, try either satu- 
rated solution of borogly- 
ceride or ichthyol, one 
drachm of the latter to the 
ounce of distilled water ; 
painting it on every four 
hours, forms a complete 
protection, under which 
microbes die. 

Literally speaking, ichthyol is no antiseptic, in itself it cannot 
destroy the erysipelatous cocci, but it starves the nutrient soil, so 
that the skin is no suitable location for their multiplication. But 
the solution of boroglyceride is the remedy which annihilates, and 
that speedily ; a remedy one can depend on to wipe out every 
microbe. . 

This invariably depends on the presence of a 

Erythema, germ, and is the name given to an eruption of the 

skin which is attended by a diffuse redness over 

a larger or smaller tract of skin. This disease is something like 




Section of the skin in erysipelas. The microbe 
breeding in the lymphatics in chains ; multiplied 
looj diameters. 



BACTERICIDES. 309 

a mild attack of erysipelas, and in some cases may shade into it, 
but it is much less severe in character, and although troublesome, 
is not dangerous. Unlike erysipelas, it is not confined to the face 
and head particularly; it is not attended with inflammation of the 
true skin, nor with any marked pain or fever. When the skin is 
dry, as in old people, and when it has somewhat lost its elasticity, 
it is very apt to become erythematous ; the face and neck may 
become in this condition from walking out in a cold northeast 
wind. These simple cases may be treated by resting the affected 
part, keeping it covered up from the air, and bathing it with tepid 
water several times a day. Another kind, which is more impor- 
tant, but still very curable, has been styled erythema nodosum. 
It is generally seen in children, and is found in the form of dirty 
purplish patches in front of the ankles. These are raised above 
the surface, and are painful on pressure ; they are worse after 
walking about. This state is due to blood and serum being 
effused under the skin, and it is thus different from the other va- 
riety. With rest in bed^ plenty of nourishing diet, such as milk, 
meat, strong beef tea or broth, and a little medicine of a tonic 
character, such as fluid extract of yellow dock, four ounces ; ace- 
tate potass, half an ounce ; tincture nux vomica, two drachms. 
Mix. Dose, a teaspoonful every three hours. Dusting the erup- 
tion with the anti-microbe powder, a cure soon takes place. 
This form is sometimes met with in cases of rheumatic fever. It 
more frequently affects young women and girls than the male 
sex ; yet it is met with in feeble boys. There is slight fever with 
it, and a feeling of languor and discomfort. Red, elevated spots, 
oval in form, then come out in a few days, and they are generally 
situated along the length of the limb or in a vertical direction. 
The lumps in a short time become purple, as if they were cold, 
and this in time dies away, leaving no mark behind. The disease, 
when it occurs, is met with in debilitated persons, and therefore 
measures should be taken to improve the general health. 



A cutaneous disorder, affecting chiefly those 
E>rythrasma. regions of the body where exposed surfaces of 
the skin are in contact, characterized by ery- 
thema, rose-shaped maculations, and due to the presence of 
microsporon missitissimum. 

The growth is in the superficial layers of the epidermis. The 
fungus to which this disease is attributed is remarkable for the 
extraordinary delicacy and fineness of its threads and spores. 
They are cylindrical bodies of variable size, inextricably inter- 



310 



DISEASE GERMS. 



woven. Bacteria and heaps of zoogloea are visible among the 

scales. 

It is easily recognized by being encountered only v.'hen op- 
posed surfaces of the skin 
come in contact, as in the 
axillae, groin, cleft of the 
anus ; by the definitely cir- 
cumscribed maculations. 
Color varies, vivid red all 
over or only the borders ; 
when old, yellowish or 
brownish tinge. It does not 
feel as if there was any eleva- 
tion, but throws off a fine 
flour-like furfuraceous de- 
squamation. 

Vesiculation and papula- 
tion do not occur. Color 
changes frequent, as red, 
reddish brown, pale reddish 
The most successful remedies 












Microsporon missitissimum. 



yellow and light or dark orange 

are either the boroglyceride paste or lotion, anti-microbe powder 

with improvement of the general health. 



The elements of nutrition, under adverse 

Fatty conditions to vitality, can be altered, changed 

Degeneration, modified or degraded into other living m.at- 

ter, which constitutes a diseased germ, such 

as cancer, syphilis, tubercula. 

Independent of this, living matter can be degenerated, the in- 
fluence of the formative force which builds, maintains existence, 
and then dies, leaving behind a tissue or structure of an organ, 
worn out, effete, useless, adds to the general state of general dis- 
solution. Degeneration is an indicator of advancing age, a 
necrobrosis, as we begin to live, we begin to die. 

Another special form of degeneration is the result of disease, 
slow, certain ; a slight, but continuous failure of nutrition, in 
which we recognize fibroid, fatty, pigmentary, calcareous, athero- 
matous degenerations of arteries, glands, nerves, which aggra- 
vate all maladies. 

is usually met with in one or other 

Fatty Degeneration of two forms ; that is, fatty tissue may 

of the Heart usurp its muscular structure, or there 

may be an accumulation of fat upon 

its surface so great as to interfere with its systolic and diastolic 

action. 



BACTERICIDES. 



3H 



The causes of fatty degeneration of the heart are evidently those 
things which interfere with the nutrition of the heart. 

It is essentially a disease of middle life, associated or blended 
vvith senile decay, predisposed to by the use of tobacco, fast liv- 
ing, chronic alcoholism, systemic syphilis, gout, rheumatism ; 
states or conditions which directl}^ enervate the heart, give it a 
tendency to degenerative changes. In addition a want of nutri- 
tion may be the result of atheroma, or calcification of the coro- 
nary arteries ; embolism, obstruction, or to the use or absorption 
of phosphorus ; to the action of the yellow fever fungus on the 
liver. 

Fatty infiltration of the heart is directly caused by beer drink- 
ing and various other vices of modern society. 

In its occurrence, the changes noticed are ^ want of nutrition-; 
muscular structure becomes pale, loses its contractility, because 
its nuclei and muscular tissue begin to disappear, become 
completely granular, anaemic, filled with albuminoid matter ; oil 
globules obliterate normal fibres. As the muscular structure 
degenerates it assumes a dirty buff brown or yellow color ; loses 
its elasticity, power of resistance. Breathing is difficult ; heart 
liable to be hypertrophied. The coronary .,,^,^ 

arteries either atheromatous, calcified or 
obliterated. 

When the fat accumulates upon the sur- 
face of the heart, it is liable to cause atrophy 
with rupture. 

Fatty degeneration of the heart may go 
on unrecognized for quite a number of years, 
a pressing debility, a gradual inability to 
endure exertion for any length of time; sud- 
den fits of suffocation, with violent palpita- Teamed fibres from the heart 
. ' sr r in fatty degeneration. 

tion not mlrequent ; skm is pale, pasty, 

yellow color, extremities cold ; oedema not uncommon, espe- 
cially in old age ; digestion feeble ; perspiration profuse on the 
sUghtest exertion ; invariably suffering from difficult breathing 
after exercise ; occasional pain about the heart ; liver and kid- 
neys become affected, and as this takes place, respiration becomes 
irregular and feeble. 

Cardiac insufficiency is progressive ; and simultaneously all 
the tissues of the body become soft, flabby, affording strong 
evidence of arterial degeneration; the arcus often present; 
temper irritable, depression of spirits; disturbance of vision; 
failure of memory, giddiness, vertigo ; sudden cerebral anaemia 
during excitement ; syncope, epileptic fits ; pulse variable in 
torce, but feeble, yet accelerated. Later on angina pectoris ; the 
apex heart-beat is indistinct; no impulse can be detected. 




312 



DISEASE GERMS. 



The prognosis is unfavorable, as the usurpation of the muscu- 
lar structure of the heart by fat has either a fatal termination by 
rupture or cerebral anaemia. 

No plan of treatment can be laid down which is positively 
curative. No drug or combination of drugs can restore degen- 
erated muscular fibre, but much good can be accomplished in 
ameliorating and retarding the disease by improving the tissue- 
making power of the blood, which is best effected by very gentle 
physical exercise in the open air, by bathing and persistent mas- 
sage, by good nutritious food. 

Our best remedies to increase fibrine are comp. tincture cin- 
chona and mineral acids ; comp. tincture marticaria ; cardiac 
stimulants, like digitalis, strophanthus, should be administered 
with great care. ,^ 

Tobacco, beer, alcohol, worry, care, should be avoided. 



occurs either as a general or partial 
Fatty Degeneration infiltration of the liver with fat, or as a 
of the Liver general metamorphosis of the structure 

of the gland into adipose tissue. 
Associated with this in all cases is a gradual, painless, enlarge- 
ment of the liver. 

The victims of this disease are generally in the middle period of 
life ; men who have been large consumers of fat or other hydro- 
carbons, as beer, alcohol, wine, with 
little physical exertion. 

- The presence of certain disease 
germs in the blood give rise to 
fatty degeneration, such as the tuber- 
cular bacilli; the fungus of yellow 
fever, the microbe of typhoid, puer- 
®\-f^ r^%^ peral, scarlet fever, variola, malaria, 

pyaemia. The use of certain drugs, 
as arsenic, antimony, phosphorus, 
ether, chloroform, tobacco ; old age, 
^''"^' ''''^''- etc., produce certain changes in the 

blood, which give rise to fatty liver. 

Once a liver is infiltrated with fat, it increases in size, steadily 
and persistently, and commences to have a peculiar flattened 
appearance, a smooth surface; a pale brown or light color; a 
doughy, flabby feel, pits on pressure. Its capsule is tense, shin- 
ing, transparent ; vessels become enlarged and tortuous. Cutting 
the liver with a warm knife, the blade is coated with oil globules, 




BACTERICIDES. 313 

very little blood flows from the cut surface. If the patient died 
in a very early stage, the liver would be reticulated, dotted or 
mottled, of a dull yellow color. The central veins are intensely 
congested and pigmented with fat, or the. whole substance may 
present a yellow appearance. 

It is not uncommon to meet with both fatty and amyloid de- 
posits in the same liver. 

An aggregation of fat in the liver varies considerably ; small 
deposits the size of a pea, interspersed through the gland, large 
nodules or patches in the liver of beer drinkers ; seventy-five per 
cent, of the entire organ is usurped by fat. 

There is always present in fatty liver, dyspepsia, flatulence, loss 
of appetite, want of nutrition, splenic enlargement, some pain 
over the liver, pain in the shoulders, dulnessin the apex of right 
lung. The slightest indiscretion in eating or drinking causes 
attacks of gastric irritation and diarrhea. Gradually the patient 
becomes anaemic, moody, suffers a loss of muscular power with 
a disposition to sleep. The skin is pasty, and smooth, soft, and 
flabby. Difficult breathing results from loxaema, enlarged liver, 
ascites. 

If acholia be present, with pale, clay-colored stools, the hepatic 
degeneration speedily proceeds to a rapid termination 

Fatty and waxy degeneration are often mistaken for each other, 
the history of the case- when in doubt has an important bearing 
in diagnosis ; in the waxy form, a history of syphilis, disease of 
bone, suppuration, etc., are, or have been present; whereas in 
the fatty form, chronic alcoholism, high living, malaria. The 
blood is watery in fatty liver; an increase of the white corpuscles 
in the waxy, a fatty liver is soft, flabby ; a waxy liver is hard. In 
waxy liver, faeces are pale, deficient in bile ; in fatty liver, faeces 
are often normal till disease has become well advanced ; with a 
waxy liver, spleen invariably in same condition ; with fatty liver, 
spleen often normal. 

Fatty liver is a disease invariably attended with great danger 
to life; death may take place at any moment from epileptic fits, 
apoplexy, or other grave lesion. 

Treatment can effect much in warding off, even if it cannot 
cure the disease ; a restricted diet with no fat, sugar or starch ; 
regular daily open air exercise, with baths and massage. Resi- 
dence if possible in a temperate region, free from malaria ; stop 
all alcoholic drinks gradually. 

A general alterative and tonic course inculcated, as comp. 
saxifraga, alternate with comp. tincture of matricaria, chionan- 
thus. 



314 DISEASE GERMS. 

Usually the result of desquamative 
Fatty Degenerated nephritis, or Bright's disease. If it 
Kidneys. occurs without the precursory disease, 

intemperance and bad living may bring 
it about. Kidneys are usually large, pale, soft, doughy, and fatty. 
Symptoms. — A recapitulation of all the symptoms enumerated 
in Bright's disease, but greatly aggravated ; debility increases 
rapidly ; the uriniferous aspect, pallor, and anaemia much intensi- 
fied ; the pulse is now irritable and frequent ; there is general 
oedema ; puffiness of face and hands ; frequent micturition ; dys- 
pepsia, with attacks of vomiting ; a tendency to inflammation of 
the membranes of brain, pleura, peritonaeum, pericardium, and 
amaurosis, due to albuminuria, retinitis, and degeneration ; 
anasarca of the limbs and dropsy of the cavities. Indications of 
uraemic poisoning show themselves often in convulsions, coma, 
etc. The urine in fatty degeneration from the very commence- 
ment exhibits oil-globules, is very scanty, low specific gravity, 
and highly albuminous. There are also cast-cells filled with oil, 
presenting the appearance of dark, opaque masses, besides the 
oil-globules. 

When the urine is highly albuminous and presents a large 
number of oil-casts and cells, the case is to be regarded as a 
serious one, as they indicate an intractable form of the malady. 



In aged persons, especially females, con- 
Fsecal fined to bed or leading very inactive lives. 

Accumulations, and in whom nervous sensibility is more or 
less dulled, faecal matter is now and then 
found to accumulate, and in time to become so hard and large as 
to resist the natural expulsive action of the bowel. Most liable 
to occur in the aged or infirm ; still examples of it are often found 
in young subjects. 

Enemata of warm glycerine, which is so valuable in constipa- 
tion, have a most excellent effect in relieving faecal accumulations, 
a warm thrill is experienced, penetrating through the intestines, 
followed by vermicular movement which precedes peristalsis, fol- 
lowed by an urgent call. 

Enemata form, without doubt, the most efficient means known 
for dealing with fecal accumulations. The injection should be 
copious, and should be given, when possible, in the knee-and- 
head, knee-and- elbow, or lateral abdominal position. The best 
material is water at a temperature of about ioo°, although some 
prefer mixtures of soap and water, or of turpentine and water, or 
of oil. No anesthetic should be used, so that the patient's sensa- 



BACTERICIDES. 



315 



tion may afford some test of the amount of pressure employed. 
If any symptoms are present that raise a suspicion of stercoral 
ulcers, it is needless to say that the injection should be conducted 
with the greatest caution. The fluid should be very slowly intro- 
duced, and should be forcibly retained for ten or fifteen minutes ; 
and while the colon is well occupied therewith the faecal mass 
should be gently kneaded. 

Massage is of great utility, a most potent mechanical tonic 
and vitalizer. In its application the patient lies upon his back ; 
the hands of the operator are oiled, and, with the fingers widely 
opened, both palms are laid upon the abdomen ; the hands are 
made to pass systematically in various directions ; the pressure 
exercised is steady and deep, and the movements are slow; the 
manipulation on each occasion should extend over fifteen or 
twenty minutes, and should be repeated at such interxals as may 
be considered advisable. 

It is a mechanical agent, influencing the stercoral mass and 
modifying its position ; it is a stimulant, an exciter of the peris- 
taltic wave through the abdominal nerves which contain both 
excitatory and inhibitory fibres — a therapeutic measure of great 
value. 

A condition in which the vital forces have rect ived 

Fever, a shock and are struggling to regain their supremacy 
— an effort of impaired vital forces at restoration. 

The common causes of all fevers are disease germs and their 
ptomaines. 

The mode or manner of ingress of microbes into the body is 
still an unsettled question. The action of heat and cold, mechan- 
ical injuries of all kinds, poisons, may so degrade, alter, change 
elementary molecules into other living matter, or simply depress 
the vital forces and pave the way for the ready ingress of disease 
germs from without, such as the germs of malaria. 

The ordinary symptoms of fever are languor, lassitude, debility, 
pain in the head, back, and calves of the legs, rigors, high heat, 
frequent pulse and respirations, with derangement of the 
secretions. 

The poison or living germinal matter that produces these 
symptoms may have gained access to the patient's body through 
the air, or water, or food, or it may be the degraded or changed 
living matter of his own body. The salivary glands of the mouth 
are the most eligible channels of a poison gaining access to our 
bodies. This is apparent by the disturbance of the stomach. 
Once the poison has gained admission and found its way into the 
blood, it grows with great rapidity, and is diffused throughout 



3i6 



DISEASE GERMS. 



the entire body, disturbing the vitality of organic living matter 
with which it comes in contact. The destruction caused by fever 
or germ-disease involves every constituent of the body. 

General nervous depression is the characteristic of all fevers. 
The prostration,, rigors, headache, with pain in the back and 
calves of the legs, denote a partial death of the nervous system. 
Pain exists in every sensient nerve in the body, but is experienced 
most keenly by the patient in the large superficial sensient nerves 
of the back and calves of the leg. In fever we have a diminution 
of evaporation, the dormant skin does not act as a refrigerator, 
destructive metamorphosis is great, the semi-vital chemical 
changes raise the temperature, — there is rapid oxidation, the 
passage of organic into inorganic matter, the blood loaded tvith 
germinal matter; and its growth together with the irritation of 
brain and the eighth pair of nerves that supply the Hver, causing 
an excessive secretion of glucose, all of which go to explain the 
heat of fever. 

The controlling action of the brain being impaired, the heart 
and lungs are irritable, and their action accelerated. The brain 
needs more vital force to hold them in check. All the secretions 
and excretions are depraved. 

The termination of fever is either recovery or death ; the 
former may in some cases be imperfect, terminating in other 
forms cf disease, as anaemia, paralysis, etc. 

Some fevers, due to disease germs, a specific contagion, have 
a definite period of existence in the body, which limits their 
duration. Nearly all contagious diseases are of this class. 

Fevers are easily recognized by their symptoms:, languor, pain 
in the head, back, calves of legs, rigors, with high heat, frequent 
pulse and respirations, with perverted secretions. 

If the heat of fever does not exceed 103° Fahr., with favorable 
surroundings, hygiene, nursing, and no irreparable lesion, good 
hopes may be entertained of rapid recovery. 

The treatment of all fevers is based upon certain, well defined 
rules, viz.: Either sterilize, kill, or annihilate the microbe, the 
factor of the fever, and to maintain the vitality of the patient. 

To arrest in all cases, the destructive metamorphosis of the 
disease germ, bactericides must be administered ; these are the 
true remedies to lower temperature, reduce the action of the 
heart, diminish the respirations. 

In the incipient stage of all fevers, very great benefit is derived 
from an emetic to unload the stomach, an active or gentle 
cathartic to relieve the bowels, and an alcoholic vapor bath or 
some form of bathing to start the function of the skin. 

The utility of an emetic is apparent ; the living poison that 



15ACTERICIDES. ^^j 

probably caused the fever has been taken in by the salivary glands, 
swallowed, and lowers the vitality of the stomach. It loathes 
food, fails to dis^est, and the symptoms are much ameliorated by 
an emetic. Before administering this, the patient should drink 
freely of tepid water with a small amount of bicarbonate of soda, 
so as to neutralize the acid secretion from the walls of the stom- 
ach. Following the emetic, the alcoholic vapor bath, then the 
cathartic. Typhoid fever is the solitary exception among all 
fevers to the use of purgatives ; in that fever they are not admis- 
sible, except in some rare instances. 

If the patient is unable to sit up or very young, or pregnant, 
instead of the alcoholig vapor bath, sponging the entire body 
should be resorted to with tepid alkaline water. In some cases 
vinegar is a good addition. 

Then the regular treatment for the case should be laid down. 

The room selected for the patient during his illness should^ if 
possible, be isolated, well ventilated, no draught, abundance of 
light, free from carpets, curtains, and paper on the walls, as they 
retain the seeds of disease. If possible, an open fire-place, and 
if the season permits, a fire, so as to destroy the disease-germs as 
they escape from the patient. If convenient, two beds should be 
placed in the apartment, so that the patient's clothing and bed- 
clothing can be changed daily, and he lifted from one bed to the 
other. In all cases the head of the bed should be placed to the 
north, feet to the south, and insulated from the floor with glass 
castors or pieces of glass, so that the patient may be in unison 
with the magnetic law of the earth. The greatest cleanliness 
should be observed. When clothing and bed-clothing are re- 
moved, they should at once be immersed in water with an anti- 
septic. No unused food should be permitted to remain in the 
room. Antiseptics, such as chloride of lime or carbolic acid, 
buckets of water with bromine, or iodine, or permanganate of 
potassa, should be exposed in different corners of the apartment. 
If a nurse is to be selected, let her be young, strong, vigorous ; 
few" attendants except the nurse, so that the contagion be limited 
as far as possible. All superfluous matter should be kept away 
from the patient, even books. Magazines and papers should never 
be permitted to get out ; after perusal they should be destroyed. 
In all cases the hair should be cut short and the cut portion de- 
stroyed or deodorized. The recumbent posture is the true one, 
it retains the nervo-vital fluid in the spinal cavity and not in the 
cranium, and gives a diminution of pulse of at least ten or twelve 
beats per minute, with a corresponding lowering of heat and re- 
spirations. The entire body should be sponged three times daily 
with an alkaline wash, such as castile soap and warm water, or 



3i8 



DISEASE GERMS. 



bicarbonate of potash and tepid water, well dried, and then rubbed 
with the dry hand. It is sometimes beneficial to follow this with 
vinegar and water, which is cooling and grateful to the patient 
and excites the normal alkaline secretion from the skin. The 
alkaline bathing removes the disease-germs, opens up the emunc- 
tories of the skin ; the rubbing with the dry hand dislodges the 
disease-germs from the capillaries, removes the stagnation in the 
microscopical circulation, and the reflex effect of it is highly vita- 
lizing to the medulla oblongata, the seat of reflex action and life. 
Besides, the inherent vitality of the nurse is in this manner com- 
municated to the patient, so that instead of elderly ladies being 
selected for nurses, we demand the young and healthy. The law 
of reflex emanation is definite : we assim^ilate the vital condition 
of those with whom we are brought in contact. 

In exhausting fevers, like typhoid, good results are derived 
from the inunction of warm olive oil after the sponging and dry- 
ing off. This aids nutrition, supplies the place of arrested seba- 
ceous follicles,, and softens the skin, for exhalation attracts the 
germs to the surface and smothers it. Oil is perfectly compatible 
in the living tissues. 

Physiological chemistry explains the imperative necessity of 
drink in fevers. Water requires to be in excess of the demand ; 
acidulated drinks of water, with a few drops of acetic or hydro- 
chloric acid, enable the albumen to be acted on by the gastric 
juice. All acid substances have the power of increasing the nor- 
mal alkaline secretions of the body. 

Apply heat to the feet in all cases of fever, for though the 
action of the heart is violent, yet it lacks the stamina or power to 
send the blood to the capillaries ; besides, the nervous system, 
upon which the circulation depends, is incapable of performing 
its function in aiding the circulation, and artificial heat aids in a 
renewal of life. As to the clothing of the patient, cotton and 
linen should be avoided, and woolen or silk preferred as con- 
servators of v^ital force and being impervious to atmospheric 
changes. 

In fever the nitrogenous tissues are devitalized, drained away, 
and it is important that they should be replaced, so that small 
doses of nitrogenous aliment should be given frequently. These 
pass over the irritated stomach unconsciously, and are taken up 
by the iacteals in the intestines, requiring very little to make 
them fit for absorption. The most suitable food is milk. It 
forms the most appropriate nourishment for fever patients. Two 
to three ounces should be given every two hours with half a tea- 
spoonful of lime-water. If it disagrees, substitute beef tea for 
the milk. If the patient is properly nourished, it renders the 



BACTERICIDES. 3IQ 

■danger much less. Albumen, such as we possess in eggs and 
oysters, is highly nutritious if quickly absorbed, but if delayed, 
as they are likely to be by the impaired condition of the stomach, 
their decomposition is highly injurious — the sulphuretted hydro- 
gen and other gases evolved are so poisonous that an aggrava- 
tion of symptoms is the result. A good condition of gastric 
power is necessary for the digestion of eggs and oysters. 

Alcohol is a poor stimulant; it has no food or blood-forming 
faculty ; its only property in fever is an arrester of destructive 
metamorphosis or change, so with reference to its use in fevers 
we must be guided by the amount of disintegration going on. 
If there is great prostration, low muttering, delirium, excessive 
phosphatic elimination by the kidneys, it should be given. It 
acts well if there is tremor of the muscles, a sharp, weak, un- 
equal pulse, or rapid respiration. 

Sleep is most essential in fever. It is only during sleep that 
the brain picks up its nutrition or pabulum from the blood. 
There is no nutrition Avithout sleep. 

In our pathology of fever, we recognized the microbe as its 
factor, depressed vital force, as the condition or sphere of exist- 
ence of microbial life. Bactericides must be administered every 
hour; just as they kill the germ, temperature is lowered, respira- 
tions and pulse become normal; if indications exist administer 
either aconite or antipyrine, or veratrum or antifebrine, or gelse- 
mium or exalgine. Careful nutrition and nursing. 

The division of fevers, now that the germ origin of disease is 
thoroughly established, must be as follows : 

Simple Fever, Dengue, 

Gastric Fever, Cerebro-spinal Meningitis, 

Bilious Types of Fever, Puerperal Fever, • 

Malarial Fever, Surgical Fever, 

Relapsing Fever, Measles, 

Typhoid Fever, Scarlet Fever, 

Yellow Fever, Small-Pox. 



One-day fever, the simplest type of fever, re- 
Fever, suiting from a slight shock to the nervous sys- 
Ephemeral. tem, rigor and a fever, in which the vital forces, 
aided or otherwise, react in twenty-four hours, 
or a few days at most. 

The cause is usually cold, wet, exposure, overwork, mental de- 
pression. 

The usual symptoms are: the patient is seized with lassitude, 
debility, nausea, want of appetite, chilliness, pain in head, back. 



320 DISEASE germs! 

limbs. After a few hours rigors and fever, high heat, frequent 
pulse and respirations, headache, thirst, constipation, dry skin, 
scanty urine, perhaps slight delirium ; symptoms aggravated at 
night. After a few days a remission ; critical sweating or diar- 
rhea. Convalescence often somewhat slow. 

It usually terminates in recovery. 

It is easily recognized by its cause, mildness, short duration, 
by its common occurrence in children, persons of feeble vital 
force, and nursing women. 

In the treatment general principles are to be followed out ; if 
there be much nausea or disposition to vomit, a very mild emetic 
may be useful, and open the bowels with some saline. 

A warm or a Turkish, bath, or alcoholic vapor bath, or one 
or two doses of fluid extract jaborandi should be resorted to 
to excite the action of the skin and stimulate the periphery of 
nerves. 

Patient must remain in bed, recumbent posture, then one or 
other of thefollowing remedies should beadministered: aconite, an- 
tipyrine or exalgine, in doses sufficient to lower temperature, pulse, 
respirations. Whichever one is selected, it should be alternated 
with a bactericide, as a few drops of peroxide of hydrogen or 
compound oxygen. This latter is essential, as the breath, saliva, 
tongue, are loaded with a conglomerated mass of micro- 
organisms. 

Just as soon as fever abates a good tonic should be adminis- 
tered, as compound tincture of cinchona or matricaria. 

As recovery progresses, diet should be more liberal ; compli- 
cations guarded, every symptom promply relieved. 



So called, because induced by some agent 

Gastric Fever, which irritates and weakens the stomach, 
and causes a perversion of normal nutrition, 
and the appearance in the mouth, saliva, breath and coating of 
the tongue, the bacteria as seen in this illustration. 

It is almost exclusively peculiar to children, and its origin can 
be traced to eating pastry, cabbage, nuts, candies ; alcohol. 

There is a period of prostration, during which the child suf- 
fers from languor, lassitude, debility, nausea, vomiting, followed 
by rigors and a fever, in which the predominating symptoms 
are nausea, vomiting, pain over the region of the stomach ; acid 
or fetid breath, white-coated tongue are always present. 

Its duration is from seven to fourteen days, and if properly 
treated terminates in recovery. 

It is easily recognized by its history, derangement of stomach,. 



BACTERICIDES. 



321 



nausea, vomiting, white coat on tongue, irritation 

and 



of brain, and 
that it is pe- 



the entire absence of any other type of fever 
cuh'ar to children. 

Treatment. — As soon as recognized, give the little sufferer an 
emetic. The peculiar shape of a child's stomach enables it to 
vomit easily and effectively. To very young children the wine 
of ipecac, to those more advanced in years an infusion of lobelia. 
In all cases precede the emetic with drinks of tepid water with 
bicarbonate of soda, so as to neutralize the acid secretions of the 
stomach and permit of an easy absorption of the emetic, and a 
thorough washing out of the stomach ; follow this with a warm 
alkaline bath, then give a teaspoonful of the neutralizing mixture 
with one grain of leptandrin, every hour, until a free movement 
of the bowels is obtained. While pursuing the above treatment, 
aconite, veratrum, and sweet spirits of 
nitre should be given as in the preced- 
ing fever. 

Another excellent plan of treatment 
even better than the above, would be 
to start in and persevere with one or 
other of the following germicides. 

Ten grains of resorcin could be ad- 
ministered in water every three hours, 
or a few drops of the peroxide of hydro- 
gen or salicylate soda in the liquor 
ammonia acetatis ; or com. oxygen ; or 
ozonized sulphur water, etc. 

If there is still a disposition to nausea 
or vomiting, apply a plaster made of 
pulverized cloves, allspice and capsicum, 
moistened with vinegar, over the region 
of the stomach, and give milk and lime-water in very small 
quantities every two hours, for diet. Gi\ e the stomach all the 
rest possible ; as a drink, boiled water on toast or crackers, or 
barley-water. 

Several days after the fever has entirely disappeared is the 
proper time for tonics, as the wine bitters, elixir cinchona, sul- 
phate cinchonine. 

Otherwise, the treatment should be the same as for fevers 
generally, especially insisting upon rest in the recumbent posture, 
and sponging the body thrice daily. 
21 




rhe bacteria— the degraded bio- 
plasm of nutrition — the prevail- 
ing microbe of mal-nutrition — ■ 
gastric fever. 



322 



DISEASE GERMS. 



A fever induced by some shock to the 
Simple liver. 

Bilious Fever. The common causes are blows, articles of 
dress irritating the liver, microbes in the 
blood, as syphilis, and mercury, eating and drinking excessively 
of carbonaceous articles. 

The ordinary symptoms are prostration, in which we have lan- 
guor, lassitude, debility, nausea, vomiting, brown-coated tongue, 
yellow skin, pain perhaps over the region of the liver or in the 
shoulder, constipation or diarrhea, with rigors and fever, the 
yellowness of the skin increasing and heavily tinging the white 
of the eye, with dulness, stupor, coma, and itching of the skin. 

This simple form of bilious fever should be managed with 
great care, and a most active treatment in gU cases resorted to. 
Exalgine should be adniinistered in proper doses to lower 
temperature and equalize the circulation, the surface should be 
bathed thrice daily ; stimulants should be applied over the 
region of the liver. The bow^els should be opened by some 
remedy calculated to stimulate the liver, as either phosphate of 
soda and chloride of ammonia ; or euonymine and caffeine. 
Those remedies act well as liver stimulants. As a rule the case 
progresses well under these mild remedies. 

Just as febrile action is effectually controlled, the following 
acts most efficiently : Comp. tincture cinchona and simple 
syrup, of each two ounces; nitro-muriatic acid, two drachms; 
water, half pint. Dose, a tablespoonful every three hours. 

Other cases again can be managed by the administration of 
exalgine, and small doses of either the kola-nut paste or cas- 
cara sagrada lozenges. This latter remedy is of great utility in 
all states in which the liver has suffered damage. 

Diet, malted sterilized milk, arrow-root, and other simple 
articles. 

Intermittent fev^er or ague, whose chief character- 
Malarial istics are that it has febrile paroxysms, coming on at 
Fever. a definite specific time, usually, but not always, 
ushered in with a chili, followed by a fever, ending 
in a critical sweat, and during the intermissions or remissions, 
there is an interval of apparent good health, and at the end of a 
certain interval, tlie phenomena of rigor, fever and sweat are 
repeated again and again, until a cure is effected. 

The cause of this peculiar type of fever is the spore or germ of 
decaying vegetable matter, acted on by solar heat ej^ceeding 75° 
or 80° F., becomes active. The germ or spores may come from 
any decaying matter whether it be on the ground, in a marsh, in 
the soil or ground, stagnant pool, or water we drink. 




BACTERICIDES. -^23 

In all countries whose temperature exceeds 80° F., and decay- 
ing vegetable matter present, there is a bacillus evolved which, 
under favorable circumstances, enters the body either by air 
breathed, or water drank, or by endosmosis through the skin. 
Once the germ enters the blood, if vital force is normal, it will 
be repelled, ousted out; but let vitality be depreciated, the bacillus 
will grow, sprout, seed, evolve spores, cause grave changes in the 
blood and vital organs. 

The bacillus is found in the blood of the patient during the 
rigor, as in the annexed cut, while during the sweat or decline 
only spores are found. The same microscopic organism is found 
in malarial sections in a strata of air which floats above the 
ground. The microbe is pathogenic, capable of cultivation, the 
cultures injected into animals produce the dis- 
ease, the microbe being found in the spleen, 
lymphatics and pink marrow of the bones. 

The fact that the bacillus and its spores are 
successively found in the blood explains the 
intermittent type of the fever. 

Vegetable decomposition is the source of the 
germ. From the ponderable character of the 
spores, they lie close to the e^round, so that ^^ ^ .„ , , 

} , ^, . . r J n ^ The bacillus of malaria. 

those who sleep m the nrst rioor lower rooms 
of dwellings are easily contaminated with it. Fires destroy them, 
hence the denizens of large cities, as a rule, are exempt from 
their attack. Certain trees which evolve ozone, as the willow, 
magnolia, eucalyptus, pine, are, by the pungent, grateful odor 
emitted, inimical to germ and spore, causing their destruction. 

The germ of malarial feyers is an organic germ floating in the 
air we breathe, and capable of introduction into our bodies 
through the food we eat or the w^ater we drink. The pathologi- 
cal effects of the germ upon the human organism are protean in 
their forms, varying from the intense saturation of the system to 
the slightest degree. No organ in the body escapes the influence 
of the germ. 

The characteristics of the bacillus are its periodicy, the com- 
plete evolution may demand twenty-four, forty-eight or seventy- 
two hours ; the access, the rigor corresponds with the greatest ac- 
tivity of the bacillus, and which precedes the emission of spores. 
When the paroxysms occur at the same hour every day, the fever 
is called quotidian ; w^hen every other day, tertiaii ; and when 
absent for two whole days and then recur, quartan. In the 
quotidian^ the interval is twenty-four hours ; in the tertian, forty- 
eight hours, and in the quartan, seventy-two hours. The period 
between the termination of one paroxysm and the commencement 



324 



DISEASE GERMS. 




of the next is the intermission. In the quotidian form, the 
paroxysms occur for the most part in the morning; in the tertian, 
at noon ; in the quartan, in the afternoon. Besides these forms, 
we meet with cases occurring once a week, once a month, once a 
year. Any type may be double, that is, occurring twice during- 
its specified time. 

Once the sprouting is effected the newly-formed or full-fledged 
bacilli imbed themselves in the red corpuscles and cause crescen- 

tic pigmentation of the blood, 
with segmentation of the germ ; 
if vital force be high, even 
normal, they will be repelled. 

The blood of man and do- 
mestic animals in whom the 
micro-organisms of malaria 
have entered, have the disease 
germ enter the interior of the 
red discs, in which they un- 
dergo changes, sprout, develop, 
grow. In their first attack upon 
the red corpuscles, they are of 
an amoeboid form, cause cres- 
centic pigmentation, as seen 
in the annexed wood-cut. 
As they grow older they 
assume the flagellated form, which is the adult condition of the 
germ. Any one can readily verify the fact by drawing a drop of 
blood from any part of 
the body ; place it in 
the field of a microscope 
of 2500 diameters ; take 
a drop in the cold stage, 
and the amoeboid pig- 
mentation will be seen ; 
take a drop in stage of 
decline, and the flagel- 
late protozoa are present 
in millions in a case of 
ordinary quotidian. 

The germs crowd the 
capillary vessels of the 
brain and the blood- 
forming glands, as the 
spleen, suprarenal capsules, pink marrow of bones, lymphatics. 
These, in chronic cases, are filled with dark granules, flagellate 



A beautiful microscopic illustration of the microbe 
of malaria. It is seen as a pigmented proto- 
plasmic body boring into the red corpuscles of 
the blood and destroying them in their process 
of growth. Invariably present in all forms or 
stages of the disease. Truly diagnostic. 




This illustration exhibits the amoeba pigmented bodies in the 
red corpuscles, numerous free circular forms, a few crescents 
and several flagellate organisms. The adult form of the 
germ. 



BACTERICIDES. 



325 




organisms, with an undulating fin-like membrane, highly poly- 
morphic. 

In the tertian, quartan type, and in the comatose pernicious 
forms, the germs are most numerous and most destructive to the 
red corpuscles. 

An interesting practical point is still unsolved, which is, whether 
the micro-organism from 
decaying vegetable matter, 
when it enters the blood, 
coalesces with and destroys 
the red discs, or whether the 
microbe produces a special 
degradation of living matter, 

rhancrpQ if into the mirrohe Typical example of the germ in the blood-forming 

ClldUUCb IL niLU UlC IxUClUUC, glands, as the spleen, pmk marrow, lymph canals. 

CaUSinP" destructive meta- in the pernicious form the capillaries are literally 

, "-^ . r 1 1 Stuffed with micrococci and microbes. 

morphosis 01 the red cor- 
puscles. One thing is certain, that the micro-organism is patho- 
genic of the disease, capable of culture ; cultures injected into 
animals produce the disease. 

Symptoms. — This fever may set in suddenly, or it may come 
on gradually with a feeling of general indisposition, which at the 
end of a few days may culminate in a regular paroxysm. An 
ague fit is composed of three stages, the cold, hot, and sweating. 
The cold stage is ushered in with feelings of languor, lassitude, 
debility, headache, pain in the back and limbs, chiUiness. There 
are sensations as of cold water running down the back ; shiver- 
ing ; the skin is shrivelled and the papillae rendered prominent, 
the skin assuming the appearance of a plucked goose (cutis anse- 
rina), resulting from irritation of the nerves that supply the 
microscopical muscles of that gland, which are called arrectores 
piloriLin. The teeth chatter, the nails turn blue, and the whole 
body is shaken ; there is exhaustion, often urgent thirst ; the 
countenance is anxious ; the features contracted ; eyes dull and ' 
sunken ; pulse feeble ; respiration hurried or oppressed ; mental 
irritability. The duration of this stage varies from a few minutes 
to several hours, and is succeeded by the hot or febrile stage. 

Then all the symptoms of fever are well defined : increased 
respiration ; more frequent pulse ; elevated temperature ; parched 
mouth ; excessive thirst ; painful sense of fulness in the head ; 
great restlessness ; irritability ; delirium. 

This stage may last a short time or for some hours. Then 
follows the sweating stage, beginning with a slight moisture on 
the forehead, then over the entire body. After its decline, all the 
symptoms become ameliorated, and the patient to all intents and 
purposes seems to be in perfect health until another paroxysm 
takes place. 



326 



DISEASE GERMS. 



Sometimes one or two of the three stages are absent. 
The general effects of this microbe are : 

1. More or less irritation of the brain, according to the amount 
of germs present and power of vital resistance. 

2. A blood-disease is engendered ; that fluid is loaded with 
bacteria and malarial germs, and as they increase in number it 
becomes fibrinous or clotty, and dark colored. Such blood 
coagulates readily in the fine, delicate interstitial structure of 
the brain, in the granulated structure of the liver and kidneys, 
in the very vascular structure of the spleen, and even adheres in 
masses to the walls of arteries. When this condition has lasted 
months or years, a white-cell condition or leucocythemia is 
brought about. 

3. This white-cell disease of the blood is properly the third 
stage, and is brought about by the malarial germ using up in 

its own nutrition the ele- 
ments of the red cor- 
puscles, aided by the mor- 
bid condition of an en- 
larged, indurated, or caked, 
or hypertrophied state of 
the spleen or an amyloid 
degeneration of other 
glands. This fever is easily 
recognized by the parox- 
ysms occurring with pe- 
riodicity, being ushered in 
with rigors, followed with 
fever and a sweat. During 
the remissions an interval 
of apparent good health, 
but at the end of a cer- 
tain interval the phenom- 
ena are repeated. 
The morbid conditions are irritation of brain, liver, kidneys, 
spleen, with blood loaded with living disease-germs, creating an 
embolism of the blood. In all forms of shock there is a deter- 
mination of the capillary circulation to the internal viscera ; the 
spleen, the safety-valve of the heart, suffers most, as the blood is 
driven inward. True, the congestion subsides during the inter- 
mission, but repeated attacks with the peculiar bacterial blood 
give rise to hypertrophy, induration, thrombosis. 

In the treatment of all forms of malarial fever, the great object 
in view is to maintain the vital forces by nourishment, bathing, 
comfortable clothing, and rest in the recumbent posture in bed. 




Destruction of the red corpus< les of the hloocl in the 
spleen by the microbe of malaria. 



BACTERICIDES. 



327 



During the different stages of the fever, the patient should be 
nursed and tided over as gently as possible — cold stage, diffusable 
stimulants ; febrile stage, aconite ; during the sweat or decline, 
cooling drinks. 

During the interval, the bacillus, if possible, must be completely 
annihilated. 

There are several preparations of great value, in use for this 
purpose, they are either Warburg's tincture ; or the concentrated 
tinct. of kurchicine; or eucalyptol. Each of the three remedies is 
equally good. One is to be selected, and administered according 
to the following directions: • 

In any given case of malarial fever, of either the quotidian, 
tertian or quartan type, first open the bowels with an antibilious 
purge; then^ three or four hours before the chill or paroxysm, 
administer either half an ounce or one large tablespoonful of the 
tincture, without any water; then follow just a little before the 
chill with another dose. It should be given undiluted, and no 
drink allowed between the doses. If the profuse perspiration 
and disintegration of dead germs prove exhausting, beef essence 
should be freely given. For ordinary fevers, much smaller doses 
are admissible. 

The remedy selected administered in smaller doses for seven 
consecutive days. (For additional formulae see Cinchona.) 



This occurs in the form of continued fever 
Remittent characterized by remissions. There is no cessa- 
Fever. tion of the fever, simply an abatement or diminu- 
tion. The period of remission varies from twelve 
to twenty-four hours, at the end of which time the feverish 
excitement increases, the exacerbation being often preceded by a 
chill. 

The cause is the malarial germ, acting upon vital forces already 
exhausted. It varies greatly in its severity, according to the 
number of microbes present in the blood the peculiarities or type 
of the patient. 

Symptoms. — Usually commences with languor, lassitude, de- 
bility, mental depression, headache, shivering followed by high 
fever, vomiting, sometimes jaundice, often accompanied with 
delirium; pulse frequent and full; tongue dry and furred; nausea, 
vomiting, generally of bilious matter ; sense of pain at the epi- 
gastrium, and tenderness on pressure, with signs of pulmonary 
congestion, great difficulty of breathing, a feeling of oppression 
at the chest, cough, and a livid color of the countenance. The 
urine is usually scanty, high-colored, and loaded with lithates. 



32! 



DISEASE GERMS. 



but passed in increased quantities during the remission. Length 
of remission varies from six to twelve hours and from twelve to 
twenty-four hours; at the end of which time the feverish excite- 
ment increases and the exacerbation is usually preceded by 
chilliness and a rigor. Remission usually occurs in the morn- 
ing ; the principal exacerbation is generally towards the evening. 
The disease may run on for some fourteen or fifteen days and 
end in an attack of sweating, or merge into typhoid or cerebro- 
spinal meningitis. The period of convalescence is usually short, 
except some organic mischief has occurred, in which case con- 
siderable time may elapse before a restoratiou to health is 
effected, the debility being kept up by night-sweats, sleeplessness, 
dyspepsia, neuralgia, jaundice, and dropsy. 

Complications. — The extreme severity of some cases, the de- 
pressed condition of the nervous and vascular systems, with 
defective secretions, the great exhaustion at the termination of a 
paroxysm, collapse, convulsions, or delirium, passing into drow- 
siness and coma, cerebro-spinal irritation, with gastric irritability, 
or with bronchitis, pneumonia, or with hepatitis, jaundice, 
diarrhea, or typhoid symptoms. The chief causes of the com- 
plications are great depression of vital power, with epidemic 
influence and improper treatment- 

As a rule the fever terminates in two weeks in recovery or 
some of its numerous complications. 

Th.e diagnosis is important ; a continued fever with remissions, 
when complications arise, other morbid states taking place, the 
points of recognition may be varied. 

In the treatment of remittent fever, general principles must 
guide us ; the state of the stomach, bowels and skin merit imme- 
diate attention. It must be borne in mind that the febrile exacer- 
bation is of longer duration and of greater intensity than in in- 
termittent, so there is more danger of structural lesion of 
brain, liver, spleen, stomach and kidneys, and our first great 
object should be to effectually equalize the circulation and mode- 
rate the excitement with a mixture composed of four ounces of 
water, to which is added one teaspoonful of tinctures of vera- 
trum viride, aconite, green root tincture of gelsemium and sweet 
spirits of nitre, one teaspoonful every half-hour until all febrile 
excitement has become ameliorated and the pulse down to 
seventy. Then begin with remedies to destroy the germ. For 
this purpose it is best to resort to a combined treatment of the 
two classes of remedies, so as to break it up. So that it is well 
to give quinine, eithernvith prussiate of iron, or in the form of a 
bisulphate, that is, dissolving it with aromatic sulphuric acid in 
from one grain to several, every four hours. Give the two reme- 



BACTERICIDES. 



329 



dies alternately; if the above does not meet the indications. 
Then try either Warburg tincture or concentrated tincture of 
kurchichine, in half or one-teaspoonful doses every three ho*urs.' 
Bathing the entire body has a magical effect in procuring sleep. 

The diet should consist of beef tea or farinaceous food. Com- 
plications looked for and carefully guarded. If there seems to 
be much cerebral disturbance, active purgation, mustard to feet, 
head shaved and evaporating lotions of camphor-water and am- 
monia applied. If there is low delirium or exhaustion, or cere- 
bro-spinal irritation, dry cups followed by mustard poultices to 
nape of neck. 

Haematuria or a hemorrhage of blood from the kidneys is 
often present in both intermittent and remittent fevers. 

The general treatment of the fever must not be interfered with, 
but the patient promptly placed upon as large doses of the green 
root tincture of gelsemium as he can b^ar, with dry heat over 
the loins, and a few drops of peroxide of hydrogen given. 

The bilious type of intermittent and remitterft requires very 
nearly the same treatment. In these the force of the malarial 
and bacterial germs seems to be spent upon the liver, so that in 
those cases the tongue is heavily coated brown, there is nausea, 
vomiting, jaundice, diarrhea and other bilious symptoms ; a state 
that will require special attention in addition to the treatment 
being carried out for the fever, such as the following : five drops 
of nitro-muriatic acid every four hours in water, or an infusion of 
leptandra, drunk freely, or phosphate of soda. 

Some remedy to act efficiently upon the germs that block up 
the liver, managing the fever in the manner already indicated. 



A peculiar type of fever, iatermediate be- 

Remittent tween malignant intermittent and dengue. 

Bilious Fever, occurring in individuals whose vital force is 

Malignant. low. The temperature runs high, action of 

the heart violent, skin jaundiced, stomach 

very irritable, tongue very heavily coated with a brown coat 

and black at the root ; there is often delirium from the brain 

suffering from the ingress of microbes. 

Treatment here must be most energetic, large doses of bacter- 
icides must be administered, such as resorcin or creolin ; the 
circulation controlled with exalgine, and either Warburg's tinc- 
ture or concentrated tincture of kurchicine administered freely. 

The case must be carefully guarded, and general principles 
will guide the selection of drugs. 



330 



DISEASE GERMS. 



Sometimes termed enteric or nervous fever, is 

Typhoid essentially contagious and infectious, owing to its 
Fever. origin in a disease germ. 

Various theories are set forth by nearly all 
authors, as to the origin of the microbe of typhoid fever. A 
certain class advocate the idea that its pristine condition is in 
sewage, that the contamination of our drinking water by sewers 
is one of the chief means of propagation ; others believe in the 
theory of the origin being in a low degree, as a spirillum 
placatile, and that by certain series of progression, passing 
through various stages qf growth and development, it reaches 
the perfection of a full fledged microbe ; others believe that under 
adverse states, the bioplasm of the nervous system is degraded 
into other living matter, a disease germ, that in even very slight 
nervous depression, or shock, the change in the nutrition of the 
nervous system* into a disease germ can be detected. But when 
there is great depression of the sympathetic and ganglionic 
nervous system, typhoid fever by this class of observers is re- 
garded as the climax of all nervous depression. They assert 
that the microbe, the factor of the fever, is simply the degraded 
bioplasm or living matter concerned in the nutrition of the 
nerve cell ; that any condition of nerve-depression may cause the 
change from normal nerve bioplasm into a disease germ, which, 
when once evolved, is capable of prodigious powers of growth 
and development ; that the germ is so light (aerobic) that it will 
float in the atmosphere long distances, penetrate our wells, 
springs and brooks ; that the excretions of individuals so affected, 
passing into the earth either by cesspools or sewage pipes, con- 
taminate everything within its reach. Milk, raw or even cooked 
meat of animals or fowls, coming in contact with the germs in 
the air, may communicate the disease. The microbe of typhoid 
fever has a power, a potency which is incomprehensible. Whence 
this microbe originates, it is undecided. 

TJie predisposing causes are nervous prostration, mental strain, 
worry, exhaustion, overwork, depressing climatic states, solar 
heat, chills, damp exposure. 

The exciting cause is the microbe in the blood, which gives rise 
to those mysterious headaches, lassitude, goneness ; which are 
unclassified, unnamed, often unpitied, which distress the patient, 
puzzle the physician ; for the microbe only finds its abode in the 
weak, the feeble, the shattered. 

Symptoms. — Usually a period of incubation or germ-growth 
varying from ten to fourteen or even twenty-one days, in which 
languor, lassitude, debility, insidiously make their appearance, 
with headache, white face, sharp features, pain in back and calves 



BACTERICIDES. 33 1 

of the legs, nausea, diarrhea, and chilliness. The rigors reeur 
from time to time at uncertain intervals, with an aching all over. 
The rigors increase, and the patient is much prostrated. There 
may be vertigo, deafness, or epistaxis ; great headache ; intoler- 
ance of light ; thirst ; loss of appetite ; great nervous irritability ; 
restlessness ; nostrils pinched ; often a marked, circumscribed 
flush on each cheek; tongue at first white, with red edges and 
tip, later red and glazed, buff dry or brown ; sordes on gums, 
pulse small, wiry, frequent, lOO to 120 or higher; temperature 
from 101° to 104° Fahr., higher in the evening; breath offensive 
and ammoniacal. These symptoms slowly become aggravated ; 
emaciation is great from the destructive action of the germ and 
imperfect renewal of ti=;sue ; continuous destruction ; defective 
supply. The solid constituents of the urine increase ; the ten- 
dency to diarrhea becomes greater ; great interstitial death ; rapid 
metamorphosis of the entire body. 

At the commencement of the second week, or a day or two 
earlier, the typhoid rash appears ; rose-colored spots on the chest 
and abdomen, few in number, circular, disappearing on pressure, 
and fading away to be replaced by a fresh crop. In ten or twelve 
per cent, of cases, no rash. It is a true petechia. After the mid- 
die of the second week, tympanitis, gurgling in the right iliac 
fossa on pressure, diarrhea, stools alkaline, of a pea-soup appear- 
ance. If there is extreme debility with profuse sweating there 
may be sudamina, or small watery blebs on neck, chest, or abdo- 
men. There may be other symptoms present, as violent delirium, 
spasmodic contractions of the muscles, picking at the bedclothes, 
subsultus, hiccough, tinnitus aurium or deafness, muscular pains, 
prostration, bed-sores, and attacks of hemorrhage from the ulcer- 
ated patches in the ileum and perforation of the bowel, with fatal 
hemorrhage and peritonitis. Congestion of the kidney, cerebral 
or pulmonary complications ; the latter is the most common and 
most to be dreaded, and is easily recognized by the flush on 
right cheek ; cough, rusty sputa, dulness on percussion at the 
base of the right lung. During convalescence a venous murmur 
can be detected in the neck, and an inorganic systolic bruit in 
the heart, same as in anaemia, which quickly disappears on giv- 
ing nourishment. 

Duration should be from two to three weeks ; still, some cases 
are prolonged to the fifth or sixth week. 

It may terminate in recovery, paralysis, or death. Death is 
usually due to exhaustion from the protracted fever, or from 
diarrhea ; sometimes to pulmonary and cerebral complications, 
or to perforation of the bowel and peritonitis, or to hemorrhage ; 
occasionally to uraemia. In some cases the patient seems to be 



332 



DISEASE GERMS. 



overwhelmed by the poison-germ and dies easily with cerebral 
symptoms, dehrium, and coma. When recovery takes place with 
paralysis, it is generally due to anaemia, which, in nearly all cases, 
can be overcome with good diet. 

A persistent rise in temperature over 105° Fah. is very un- 
favorable, and several degrees above, an almost fatal result. 

Typhoid fever is easily recognized by its insidious mode of 
attack, by the nervous prostration, by the ringing in the ears or 
deafness, bleeding at the nose, rapid emaciation, white, sharp- 
pointed features, sunken eyes, and pinched nostrils ; dry, buff- 
leather tongue, red tip or edges, or smooth and glassy ; sordes on 

teeth and gums ; small wiry fre- 
quent pulse, irritation, inflamma- 
tion, and ulceration of the glands 
of Brunner and Peyer of the 
small intestine ; with tympanitis, 
gurgling in right iliac ; diarrhea, 
petechia, sudamina. 

It bears no analogy or resem- 
blance to typhus — in no single 
point. Pathologists are agreed 
upon one point, that there is 
nothing in common. In typhus 
fever the poison or fever germ 
is bacteria ; in typhoid, the 
disease-germ vibrios — a specific 
disease-germ, a true contagium 
vivum, having properties as dis- 
tinct and powers of reproduction 
as perfect as any germ or species 
known to botanists and zoolo- 




Microscopical diagram of the vibrios, the mi- 
crobe of typhoid fever, magnified looo diam- 
eters ; magnified 2500, they look like feathers. 
'J'he diagram from the stools. A, bowel 
threads stage of incubation (germination) 
prior to ch;ll ; B, at the period of rigor ; C, the 
seventh day, now curved ; D, the fourteenth 
tl'^Y) germ swollen at the spore-forming end ; 
£, various stages of the developing germ from 
the twenty-first to the twenty-eighth day. 



The most recent observations 
and experiments show that, 
owing to adverse conditions in- 
imical to nerve nutrition and development, such as worry, grief, 
struggle, disease, insanitary states, the bioplasm of nerve nutri- 
tion is altered or degraded into other living matter, which is a 
disease germ — capable in or out of the body of independent 
existence with prodigious powers of growth and reproduction. 

The disease germ thus evolved is pathogenic of all nervous 
diseases, as headache, neuralgia, chorea, epilepsy, brain lesions, 
insanity and typhoid fever; all contagious and infectious diseases 
owing to the presence of the microbe. The above diagram 
represents the vibrios in different stages of growth or evolution. 



BACTERICIDES, 



333 



Feathers, rods, threads bowed or bent. They bear a flagellum 
at each end ; as they grow from the bowed feather rods, or 




"P>'u'::'?%' 



m 



>^; 






Tiif^aMM. 













^issa-^ii^^/li 



Diagram of the microbe on the mucous coat 
of the ileum, first week of typhoid ; hype- 
rsemia attending the germ, planting itself 
in a Peyer's patch. 



The vbros at work, second week of germ 
evoluuon, same location, clumps of micro- 
cocci are seen very extensively on the 
ulceration of the bowels, and in the mucous 
membrane surrounding the ulceration, and 
may even be traced into the mesenteric 
gland and spleen. 



itfS| 



threads, they cease to move, become swollen at their extremity 
and sprout out into spores ; immense spore formation. 

Provided vital force be Kf/^=r. 
low, when this germ is 
evolved in the blood or re- 
ceived by contagion and in- 
fection, it will go through 
regular stages of sprouting, 
growth and development, 
limited by days and weeks. 
These stages of microbe 
growth correspond to seven, 
fourteen, twenty-one and 
tzuenty- eight days or four 
weeks in all. 

Although the tears, breath, 
tongue, gums, urine, stool 
and blood are germ-laden, 
the natural abode of the 
germ is beneath the ganglia 
or little brains of the great 




The germ at work three weeks, shows Peyer's 
patch deeply ulcerated, loaded with germ ; at D, 
eats through, causing perforation of the bowel. 



sympathetic in the glands of the bowels. Corresponding with 
the rigor, the germ in localizing excites irritation, inflammation, 



334 



DISEASE GERMS. 



a catarrhal state of Payer's patches ; these become soft, spongy, 
later on hard and smooth. Germ growth is greatest at the ileo- 
caecal valve. 

This state of hyperaemia, due to the germ burrowing in the 
gland follicles, causes the agminated and solitary glands to become 
more elevated ; rapid growth takes place. The various coats of 
the bowel become infiltrated with germs, necrotic changes are 
established and ulceration definitely commenced. 

The third week exhibits the peeling off of the dead germs 
from each colony, leaving the characteristic typhoid ulcer, which 
sloughs some in order to remove the necrotic tissue ; a loss of 

tissue which extends 
to the deeper layer 
of the mucous mem- 
brane. 

In or during the 
fourth week inflam- 
matory action ceases, 
and the process of 
cicatrization com- 
mences,which usually 
with care progresses 
on until they are 
entirely healed up. 

The mesentery,one 
of that class of blood- 
forming glands like 
the pink marrow and 
spleen, often becomes 
invaded by the mi- 

Sketch showing enlargement of the mesenteric lymphatic glands Crobe, and B. prOCCSS 
in typhoid fever; ^, y4, portion of small intestine; ^, mesen- r .-,„o1/-vrr/-Mic rrArm 

tery; C, glands enlarged ; at i? a gland is shown in section. Ol anaiOgOUS gerul 

colonizing and 
growth takes place same as in the intestine. The enlarged 
glands vary in size, from a hazel nut to that of an egg, most 
numerous over the ileo-csecal valve. The habits of the microbe 
teach us best its mode of annihilation. 

The evidence as to the poison of typhoid fever being a micro- 
organism is : all observers have found it in enteric fever, in the 
mouth, gums, blood, urine, fseces, and after death in the brain, 
Peyer's patches, mesentery, spleen, suprarenal capsules. It is 
constantly and exclusively present; it is never found only in 
bankrupt states of the nervous system; capable of culture in a 
nutrient fluid. 

Independent of the bacillus in typhoid fever and grave nervous 




BACTERICIDES. 



335 




<^3»<^g 



Microbe of typhoid fever as found in the mesen- 
teric gland during the two weeks of fever. 



-affections, there are in fifty per cent, of all cases other germs, 
peculiar short bacilli, rounded at their ends, constricted in their 
middle, some of them containing spores. They stain freely with 
methyl-violet. It is very doubtful whether these bacilH have any 
significance, as they are only present in one-half the cases, and do 
not bear cultivation in any nutrient fluid outside of the body. 

The following conclusions 
have been formulated relating 
to typhoid fever : 

1. Typhoid fever is caused 
by the introduction of a specific 
germ into the alimentary canal. 

2. This specific germ multi- 
plies in the alimentary canal, 
and in turn is thrown off in the 
stools of the patient. 

3. Its vitality is much greater 
than at first supposed, resisting 
a variation of temperature rang- 
ing from even below the freez- 
ing point to 133° F. 

4. The germ may be communicated from one person to another, 
by water, milk, food and air 

5. To prevent its spread, all the dejecta should either be burned 
at once (which is preferable), or thoroughly disinfected, by throw- 
ing them into a pot of boiling water and thoroughly cooking 
them, or using some effective germicide, such as a strong solution 
of the bichloride of mercury in suf^cient quantities to insure 
their destruction before they are buried, which should be at a 
sufficient distance from any neighboring water-supplies to insure 
their freedom from contamination. 

6. If the water-supply is of a suspicious character, thoroughly 
boil it before using, and then place it where there is no possibility 
of its becoming infected. If ice is used, pack it around the 
water- vessel, not allowing the melted ice in any way to enter your 
drinking-water. 

The appearances after death are most significant ; the blood 
and all the tissues and glands are loaded with the microbe in all 
stages of evolution, congestion of the brain or its membranes, 
ulceration of oesophagus and stomach, enlarged or friable condi- 
tion of the spleen. The two lesions that are invariably present 
are inflammation and ulceration of the glands of Brunner and 
Peyer. The alterations in the agminated . glands or Peyer's 
patches are the most marked in the group of glands which are 
nearest to the ileo-csecal valve and in the corresponding glands 



336 



DISEASE GERMS. 



of the mesentery. Frequently the patches have undergone ul- 
ceration. If the case has terminated at an early stage through 
prostration, we may simply find congestion, or a swollen condi- 
tion of the mucous membrane over the patch or gland. Death, 
as a general rule, occurs at a later period, toward the ninth, tenth 
or eleventh day, or at the end of the third week, and then we 
find the true condition of ulceration, in ulcers or sloughs varying 
in size. These ulcers are often the cause of death, either by 
hemorrhage or perforation. Mesenteric glands in the neighbor- 
hood are generally enlarged and softened. The enlargement of 
spleen and left kidney is decided. 

The following are good rules to observe in the diagnosis of a 
case : Peyer's patches an.d the solitary glands of the lower part 
of the small intestine are always affected in typhoid fever, and the 
solitary glands in the large intestine in about one-third of the 
cases ; that ulceration is perfect on the seventh, eighth or ninth 
day of fever; that cicatrization begins in from two to three wrecks, 
but may be delayed indefinitely or prolonged by disturbance, as 
movement and diarrhea. 

To prevent typhoid, our population must guard against over- 
work, privation, sorrow, and maintain a high grade of vital force. 
All insanitary conditions avoided, good drainage, the excreta in 
cesspools destroyed, and above all good water supplied ; no 
sewage to enter drinking water, or any cesspool deep in the earth 
nearer than a mile to a well, and care exercised during convales- 
cence. The patient should not for three months be permitted to 
go among his fellows, as he is liable to disseminate the disease. 

Ti'eatment. — The very instant this fever is recognized, the 
affected individual should be put to bed, and caused to maintain 
the recumbent position, and treatment commenced at once. 

The apartment in which he is placed should be well ventilated, 
and, if possible, not connected with others ; there ought to be 
an open fireplace, and if the weather permits, a fire; there should 
be no bed or window-curtains, no carpets, no superfluous 
furniture in the sick-room ; a disinfectant of some kind should be 
freely used and exposed in the apartment. Two beds are of 
great utility, so that the patient can be lifted from the one to the 
other, and the bedclothes, as well as the body-linen, changed 
daily, and strict quarantine maintained, itw but the nurse and 
physician admitted. No food left uncovered. 

Patient should be sponged off thrice daily with tepid water and 
castile soap, well dried and rubbed with the dry hand of a young 
vigorous nurse. After the midday sponging, the patient should 
be rubbed over with warm vinegar, to which some peroxide of 
hydrogen is added ; this form of germicide bathing excites the 



BACTERICIDES. ^^^7 

normal alkaline secretion from the skin and destroys all microbes^ 
on the surface. Heat to feet, hot poultices every three hours 
over the ent're abdomen ; these poultices should as far as pos- 
sible be medicated with resorcin, or naphthaline, or creolin, used- 
all through the fever. The diet should be attended to with 
great care. In typhoid, and other fevers due to the presence of 
a disease germ, the abnormal salivary and pancreatic secretion 
interferes with digestion and assimilation of all starchy matters, 
and if given, irritate the iatestinal tract, so that the best diet is 
sterilized milk, alternated with beef tea. Stools when passed 
should at once be disinfected or destroyed with a solution of 
bichloride of mercury or sulphate of iron. 

Febrile action should be controlled either with antifebrine, 
exalgine or aconite ; suitable doses administered at stated inter- 
vals to lower heat, pulse, respirations ; in other words, to retard 
germ evolution. Small doses of quinine in aromatic sulphuric 
acid should be given all through the fever. Diarrhea in all cases 
must be controlled by drinking freely of a tea of kaki ; or a pilL 
of opium and tannic acid, or boiling milk with cinnamon sticks^ 
subsequently adding lime water. Sleep is of vast importance. 
All through the fever the patient must have sleep, because there 
is no nutrition without it — no vital force gained to fight the on- 
ward growth of the microbe. For this purpose various remedies 
should be tried. Sulphonal might be tried first, in thirty or forty 
grain doses ; if it fails, try urethan in fifteen-grain doses ; bromide 
of potassa and chloral hydrate in camphor water ; all failing, sul- 
phate of morphia. 

Thirst in typhoid must be appeased by a decoction of kaki, or 
wild indigo, or peppermint, or a few drops of glycerite of kepha- 
line in water. 

If emaciation is great, there can be no doubt of arresting the 
rapid metamorphosis of tissue by the administration of suitable 
doses of brandy in milk, otherwise it is of no utility as a stimu- 
lant. Nitro-glycerite is incomparable as a stimulant in all cases of 
typhoid. 

After guarding all points carefully, the legitimate treatment of 
the fever should begin. This consists in the administration of bac- 
tericides to kill or sterilize the bacillus, the factor of the fever, as 
fast as it is evolved. The febrile action in typhoid is in propor- 
tion to germ growth ; the coma, delirium, diarrhea, correspond 
to the ptomaines excreted. Completely annihilate the microbe 
with the proper germicide and all goes well. 

Some twenty years ago, we published the following germicidal 
formula for sterilizing and killing the bacillus of typhoid, which 
has been in very general use throughout this country : 

22 



338 



DISEASE GERMS. 



Tincture of iodine and carbolic acid ; one drachm of the car- 
bolic acid to one of tincture of iodine, added to fifteen ounces of 
distilled water, in which oil of lemon and a little muriatic acid 
has been dissolved. The addition of the acid and oil of lemon 
dis!:^uises the smell and taste, and obviates any gastric or sensorial 
disturbance. A tablespoonful should be given every hour until 
heat, pulse, and respirations are normal ; then three times a day, 
and continue for three or four weeks after recovery. Since that 
time numerous, most efficient bactericides have been introduced 
into the materia medica, and most extensively prescribed, such 
as salicylic acid and acetate of ammonia ; benzoate of sodium; 
peroxide of hydrogen ; resorcin ; salol ; creolin, naphthaline and 
many others. Turpentine, five to fifteen drops, in mucilage of 
gum acacia flavored with peppermint, when diarrhea persists and 
convalescence is retarded. Serpentaria relieves the delirium ; 
nitro-glycerine an invaluable stimulant. 

All through the fever the infusion of kaki merits the attention 
of the physician; it keeps up a healthy state of the alimentary 
canal, keeps the tongue clean, controls the diarrhea, helps the 
patient to resist the adynamic effects of the microbe. 

Baptisia, yeast, and other vegetable antiseptics are much in- 
ferior to the above. 

The treatment of typhoid with bactericides is the correct one, 
the sure method of mitigating the febrile symptoms and neutral- 
izing the action of the ptomaines in the intestines. 

Every point must be carefully guarded ; for prostration, mut- 
tering delirium, and irregular pulse, brandy should be given. 

Antiseptics act best on the ulcerated glands of the bowels. At 
least three times a day the mouth should be washed out with a 
little wine and water. The bladder must be seen to, lest any sup- 
pression of urine take place. Complications should be watched 
and met vigorously. Guard carefully against pneumonia, which 
is the common sequel. 

Great care should be taken during the period of convalescence, 
lest the cicatrizing ulcers be irritated ; tonics, and a return to 
general diet to be very gradual. No solid food allowed until all 
symptoms have disappeared. A tonic course of treatment, aro- 
matic sulphuric acid and quinine, port wine and Peruvian bark, 
or glycerite of kephaline administered for some months, and the 
recumbent posture rigidly maintained. 



Before the introduction of anesthetics, the shock 

Surgical incidental to the operation invariably gave rise to im- 

Fever. perfect reaction, fever. As a rule this form of fever 

is met with under five different types, a simple type 

of surgical fever, irritative, intermittent, hectic, typhoid. 



BACTERICIDES. ^oq 

General symptoms of fever are present. 

The treatment of those different types of surgical fever must be 
•carried on on general principles. 

In the simple form, rest, bathing, nourishment, exalgine. 

In the irritative type, anodynes, sulphonal. 

In the intermittent form, Warburg's tincture, kurchicine. 

In the hectic type, stimulants, tonics, aromatic sulphuric acid 
and quinine. 

If typhoid symptoms appear treat same as in typhoid fever. 

The most constructive form of treatment should be resorted to 
in all cases. 

This fever has a spontaneous origin in the dam- 
Typhus aged bioplasm of our own or others' bodies ; the 
Fever. result of crowding a large number of human beings 
together ; hence it is described as putrid fever, jail 
fever, plague, pestilence, malignant, ship or hospital fever. Like 
.all microbial maladies, contagious and infectious, often prevails 
epidemically. 

Very rarely do we see this fever in the United States, the 
:slightest precursor of it consists in the occasional appearance of 
purulent ophthalmia among the children of our public schools, 
which is due to the same micro-organism as the fever. 

The usual symptoms are a period of incubation or shock, or 
sprouting of the germ in the blood from a few days to ten or 
twelve, during which time there is often bleeding from the nose 
or deafness, with great languor, lassitude, debility, headache, pain 
in the back or limbs. Then rigors, headache more intense, dry, 
heated skin, flushed face, suffused eyes, dull, heavy aspect, stupor, 
thirst, constipation and prostration. 

Towards evening, irritability and restlessness, with sleepless 
nights. A measly-looking rash makes its appearance about the 
•fifth day, consisting of irregular spots of a dusky or mulberry 
hue, at first disappearing on pressure, later forming stains, which 
are not obliterated on pressure, generally very copious ; seen best 
on abdomen, chest and back, but especially over the breasts ; 
spots are often seen on back of wrists. When the rash is very 
dark colored, the blood has become the prey of the typhus germ, 
and is disorganized by the abstraction of its oxygen. Skin 
generally dusky, and besides the rash, subcuticular mottling, 
rash often remains permanent to the end of the fever, and may be 
accompanied by or become converted into petechia, sometimes 
■mild, in other cases altogether absent. 

During the first week, bleeding at the nose, or deafness, or 
noises in the ears, conjunctiva injected, often constipation, never 



2^0 DISEASE GERMS. 

diarrhea. Pulse from 80 to 100 to 160. Temperature 100° to 
105° Fahr., steady, not variable like typhoid; tongue coated, 
brown and dry ; dulness or stupor, looks like sleep but not re- 
freshing. Urine very scanty in quantity, retention common ; often 
albuminuria ; occasionally total suppression of urine, and uraemia. 

In the second week, great prostration, muscular twitchings, 
delirium, coma and convulsions. The danger is greatly increased 
by an attack or supervention of acute bronchitis, pleurisy and 
pneumonia. Often a critical sleep, or sweat, or an attack of diar- 
rhea, or greatly increased flow of urine. Convalescence is 
very rapid when it takes place, beginning generally on the 
fourteenth day. The fatal period is from the ninth to the 
twelfth day. 

Duration is from fourteen to twenty-one days. 

This fever is easily recognized by its history ; the bleeding from 
the nose and deafness, the stupor or dulness, constipation, dry 
brown tongue, congestion of eyes and face, measly eruption when 
present. The blood is loaded with bacteria, thick, black and 
clotty, and when thoroughly disintegrated becomes fluid, and is 
effused into the brain, heart, lungs ; besides, the liver and spleen 
are alive with bacteria. 

In order to prevent this fever, the people should be supplied 
with wholesome food and properly ventilated dwellings ; over- 
crowding in ships, sleeping-rooms, lodging or tenement houses 
prevented ; smaller school-houses and fewer children congre- 
gated together. All houses, or ships, or almshouses, to be kept 
thoroughly cleansed and whitewashed every three months. The 
clothes and bedding of any one tainted or affected should be dis- 
infected. The patient kept scrupulously clean ; if just convales- 
cing he should not enter a street car or public conveyance. No 
room or house, or public place in which an affected person has 
been, should be reinhabited or occupied until purified with fumes 
of burning sulphur and whitewash, and its walls and floors tho- 
roughly deodorized. The diet of the class of individuals, victims 
of overcrowding, should be improved in every possible manner. 

In the treatment of typhus fever, the patient should be kept in 
bed, in the recumbent posture, disinfectants kept in saucers in 
each corner of the apartment. The most rigid quarantine main- 
tained, none but nurse and physician permitted to enter the apart- 
ment. 

The body should be bathed morning and night with a warm 
alkaline wash. An effort should be made to lower temperature 
by retarding germ evolution, for that purpose a dose of exalgine 
should be administered morning and night, and during the day 
the peroxide of hydrogen should be given every hour. 



BACTERICIDES. 



34: 



The primary action of the microbe of typhus is on the red 
corpuscles of the blood, they abstract the oxygen from them, 
and render the blood unfit to stimulate the nervous system ; the 
secondary action of the germ is to throw off spores, excrete 
ptomaines, and thus thoroughly overcome the vital forces. The 
destruction of the microbe is the great aim of the scientific 
physician. For this purpose, in addition to the two remedies 
already mentioned, there should be an effort made to crowd in 
all the bactericides possible to completely sterilize the blood. 

A selection from some of the following : Carbolic acid and 
tincture of iodine, creolin, resorcin, naphthaline. 



Malignant remittent or recurrent fever is highly 

Relapsing contagious and infectious. At all times a fever, 

Fever. but the remission and relapse take place every 

five or seven days, at which period there is a great 

aggravation of all the symptoms. Epidemics of this fever have 

appeared at different times, which have led authors to describe it 

under various names. 

The real cause of the fever is a dual organism, derived from 
malarial and decomposing animal matter. 

Symptoms. — There is generally a latent period of three or four 
days, during which the patient suffers from prostration, headache, 
languor, lassitude, debility, followed by rigors and a high grade 
of fever. The frontal headache and muscular pains, with pains 
in the back and bones, are so excruciating as to cause great rest- 
lessness and irritability. Temperature often 107° Fahr., with a 
pulse over 160, urgent thirst, often nausea, vomiting, pain in the 
stomach, jaundice often present. A very great aggravation of 
symptoms at night, giving rise to much irritability and sleepless- 
ness. As the disorder advances there is constipation, scanty, 
high-colored urine and increasing prostration; but just as the 
fever seems to be assuming a threatening aspect, about the fourth 
or fifth day, a profuse perspiration breaks out over the whole 
body, a complete subsidence of fever takes place, the patient ap- 
pearing quite well, but weak or suffering from rheumatic pains. 
The patient, and often inexperienced physicians, imagine the 
trouble is over, when all of a sudden, about the fifth or seventh 
day, there is a relapse, a repetition of all the symptoms in an 
aggravated form. Graver, more alarming, week by week this 
goes on, each attack leaving the patient weaker and weaker, till 
on the sixth or seventh week he either succumbs to the poison 
or the case terminates in recovery. Troublesome complications 
often arise which delay recovery, such as petechia and purpuric 



342 



DISEASE GERMS. 



spots, muscular weakness, oedema of the legs and feet, prostra- 
tion. When it occurs in pregnant women, it has a greater ten- 
dency than any other disorder to cause premature labor: It is a 
very fatal form of fever, death taking place at any period from 
sudden prostration. No special lesion can be detected upon 
making a post-mortem examination. The liver seems to suffer 
most from enlargement and congestion ; in other cases the spleen 
is found considerably increased in size. 

The treatment is in all respects similar to that laid down for 
typhoid and malarial fever. 

Large doses of either Warburg's tincture, or comp. tincture of 
kurchicine, or eucalyptol have been successful in breaking up this 
type of fever. 

An endemic, and often an epidemic fever, highly 

Dengue, contagious and infectious, due to the presence of a 

micrococcus in the solids and fluids of the body. 

During the stage of incubation or hatching up to the rigor, the 

micrococcus has the appearance as shown in Fig. i. After the 








• •' v. 


, 


#«;': 


% 


• < ? , •«• .♦.. • 


•**• 


/.•;':•••;. ^- 


.^ 



The appearance of the microbe of 
Dengue at the time of rigor. 



Fig. 2. 

The germ as found in ihe blood 
seventy-two hours after rigor. 



rigor which precedes the fever, the micrococci grows very rapidly,, 
both in number and size, and have the appearance as shown in 
Fi^. 2. 

The germ is pathogenic of the fever, is easily cultivated in 
any nutrient liquid ; cultures injected into animals produce the 
disease in all its intensity and malignancy. 

This fever prevails in the East and West Indies, in all tropical 
and semi-tropical countries on the coast. 

It receives quite a variety of names, such as break-bone fever, 
eruptive rheumatic fever, dandy fever, etc. 

Its cause is undoubtedly the same as yellow fever, to wit, 
malarial and paludal poison, probably modified by acting upon 
persons of a strong rheumatic diathesis. It is fully as contagious, 
as yellow fever and requires the same attention to quarantine 



BACTERICIDES. 



343 



and sanitary surroundings to prevent its spread. Jf due care 
is not exercised, a most extraordinary epidemic may be developed. 

The symptoms as seen in the rice-fields are an eruption resem- 
bling scarlatina, with rigors and a fever combined, with the most 
intense rheumatic pains in the limbs and joints. 

There is also a strong biliary train of symptoms : nausea, 
brown-coated tongue, glands of the throat often implicated ; 
lymphatic glands of neck, axilla, and groin swell, and the testi- 
cles become enlarged. The pains in the joints of shoulders, 
arms, legs, and in the muscles, and, indeed, in all the bones of 
the body, are very great. The duration of the disease is about 
eight days. 

The treatment to be successful must be highly germicidal ; to 
prepare the way for that class of drugs it is an excellent plan to 
cleanse out the stomach with a copious emetic, followed by a 
saline cathartic and an alcoholic vapor bath. 

These preliminary proceedings should be followed with one or 
other of the following remedies : Either concentrated tincture of 
kurchicine, or Warburg's tincture, or eucalyptol ; at least a tea- 
spoonful to the dose every three hours ; whichever is selected 
should be alternated with peroxide of hydrogen. 

If the case does not yield, try salicylic acid in liquor ammo- 
nia acetatis and tincture of the green root of gelsemium, and then 
fall back on the eucalyptol. The case must be carefully nursed, 
and an abundance of beef tea used as a drink. 



Bilious remittent yellow fever, accompa- 
Yellow Fever, nied with acute inflammation of the stomach, 
liver, spleen, kidneys, with severe headache, 
vomiting of black matter, and jaundice, is a fever caused by a 
fungus, produced by the malarial germ, acted on by the mias- 
mata from the sides or beds of rivers. The evolution of this 
germ is limited to tropical countries and not of infrequent oc- 
currence in our Southern harbors. The fungus may be carried 
on ships, clothing, merchandise, etc., but when a temperature of 
75° Fahr. is reached, the microbe becomes dormant, incapable 
of growth. This fever prevails in tropical countries endemically, 
epidemically, or sporadically, and when it occurs is highly con- 
tagious and infectious. Much more common in males than in 
females ; very prevalent among the unacclimatized. One attack 
affords no protection. 

The cause is the malarial germ, mingling with paludal emana- 
tions, giving rise to a dual germ, or fungus ; so far the most emi- 
nent bacteriologists have failed to isolate it. 



344 



diseasp: germs. 



Some have isolated a microbe very similar to that of dengue, 
but all attempts at culture have so far been attended with failure. 

Insanitary surroundings, imperfect drainage, uncleanliness add 
to its malignancy. 

The true victims of the microbe are those addicted to intem- 
perance, excesses, overwork, out at night. 

Preventive measures consist in the removal of all nuisances or 
insanitary states ; every fence, court, alley, cellar, liberally white- 
washed with lime and bichloride of mercury ; thorough ventila- 
tion of all passage-ways, warehouses, holds of ships; the greatest 
possible cleanliness, removal of all garbage ; no one, non-accli- 
matized, should expose himself; diet of all should be plain, nour- 
ishing, avoiding alcoholic drinks, sexual excesses, and should 
have abundance of sleep ; a healthy action of the liver, skin, 
kidneys, bowels ; flannel clothing. 

Symptoms. — Often ushered in quite suddenly with languor, las- 
situde, debility, loss of appetite, giddiness, headache and mental 
depression. At other times begins with coldness of the surface 
and distinct rigors, followed by fever which continues a few hours, 
then remits. In another class of cases there is prostration from 
the first, without any febrile reaction ; stupor, coma, convulsions, 
soon following. When there is decided fever, we have an aggra- 
vation towards night; pulse becomes quite wiry and frequent, 
skin hot and dry, eyes congested and painful, face flushed. Dis- 
tressing headache, often confined to one temple, intense pains in 
large joints and limbs. Nausea, great irritability of stomach, 
vomiting, first slimy, then greenish, then black ; constant vomit- 
ing and retching. Tenderness on pressure over the stomach, 
liver, spleen, kidneys ; a sense of tightness or constriction across 
the chest. Thirst is intolerable ; great desire for cold drinks, only 
to be taken to be rejected. Urine diminished in quantity, highly 
albuminous, of a dark red color. Constipation, owing to an 
entire absence of bile in the stools. The restlessness is in- 
cessant ; extreme mental anxiety; sleeplessness, prostration, active 
delirium. At the end of a few days severity of symptoms gradually 
diminishes, patient feels relieved ; face becomes slightly jaundiced ; 
skin becomes moist and there are copious biliary stools. In favora- 
ble cases convalescence is firmly established. More frequently 
the improvement is of short duration. After a respite of twenty- 
four hours, epigastric tenderness is aggravated ; jaundice increases 
and spreads over the entire body ; tendency to stupor ; pulse be- 
comes feeble, irregular, slow, often as low as thirty beats per 
minute ; tongue becomes very foul and dry ; respirations em- 
barrassed ; hiccough, thirst, nausea, vomiting, are constant. 
Unless symptoms remit, grumous blood is vomited ; black vomit; 



BACTERICIDES. 



345 



urine is suppressed or simply retained ; skin becomes of a dark 
brown hue ; dark-colored blood is effused in patches under the 
skin, or exudes from the nose, mouth, gums, ears, anus, vagina. 
Most offensive, tarry-looking stools. 

There are now all the symptoms of a malignant fever ; almost 
imperceptible pulse, slow or stertorous breathing, involuntary 
evacuations, difficulty of deglutition and articulation, suppressed 
or bloody urine, with formation of buboes or patches of gan- 
grene. Death takes place preceded by coma or convulsions, or 
in some cases the patient retains his consciousness to the last. 

Its ordinary duration is from three to nine days. 

Death may occur from the overpowering effect of the poison 
on the system, exhaustion, uraemia, or apoplexy of brain, liver, 
spleen. 

From the beginning to the end of an attack the general indi- 
cations for the treatment of a malignant type of fever should be 
carried out and rigorously enforced : recumbent position ; thor- 
ough ventilation, greatest possible attention paid to cleanliness ; 
bathing and disinfectants. Diet very plain ; arrow-root, barley 
water, broth, iced lemonade. Seltzer water. Watch case closely, 
guard the patient in every particular. Mustard to nape of neck 
and feet ; cloths wrung out of hot water, often relieve that ter- 
lible headache. General bathing as frequent as possible; occa- 
sionally the application of turpentine over spleen and liver is 
good. 

The factor in yellow fever is the germ or fungus ; with a high 
temperature it breeds by millions per hour ; lower the tempera- 
ture in any way, active microbe evolution ceases. The high 
temperature produces dreadful complications; reduce heat by cold 
packs, by an active refrigeration of the body, the germ dies or 
becomes inactive. 

To lower temperature, exalgine is a drug of rare value. It is 
indicated here ; a dose morning and night works wonders, low- 
ers temperature, cuts off germ growth, changes the entire aspect 
of the fever, prevents complications. Its use should never be 
overlooked, as it holds the patient in the best possible condition 
for treatment. 

No direct line of treatment can be laid down, no doses given, 
the physician in attendance must be the judge in all cases. We 
shall enumerate a few of the leading remedies in use. 

Sulphate of quinine is "the great stand-by. There is no doubt 
about the propriety of using it at proper intervals and in suitable 
•doses. 

Warburg tincture, or eucalyptol is worthy of consideration. 



346 



DISEASE GERMS. 



Metria is a term which includes a num- 

Puerperal Fever, ber of affections, which are classed to- 
or gether under the name of puerperal fever. 

Metria. The pathology of metria is still far from 

being perfectly understood. Two facts- 
alone are admitted by all who have studied the subject carefully : 
namely, first, that puerperal women are liable, under certain cir- 
cumstances, to be inoculated with septic matter conveyed to, and 
deposited in, the vagina by the hands of the attendants, as well 
as by other agencies, when, either through carelessness or ignor- 
ance, proper precautions have not been adopted to prevent such 
an occurrence ; and that the disease produced by such inocula- 
tion is not an unfrequent. source of one of the forms of metria ; 
secondly, that puerperal women may be self-inoculated by pois- 
onous matter originating within their own bodies, from the de- 
composition of blood-clots formed within the uterus after partu- 
rition, or of portions of the membranes or placenta which have 
been retained in titero. 

That this state is predisposed to by a depression of the great, 
sympathetic, as struggle for existence, grief, worry, blighted 
affections, shocks of all kinds. 

The exciting causes are numerous (contagion and infection), 
the former carried on the clothes, hair, person of the physician 
from one person to another, etc. ; the latter, hurried labors, re- 
laxed uterus, which is liable to follow a too rapid evacuation of 
the contents of the uterus ; imperfect uterine contractions de- 
pendent upon nervous bankruptcy which interferes with recupera- 
tive powers. 

Auto-infection, self-inoculation, in their own bodies from the 
decomposition of blood clots found within the uterus after partu- 
rition, or of a portion of the membranes, or placenta retained in 
the uterus, owing to imperfect uterine contractions. 

These are the main factors in its production. The mouths of 
the vessels at the denuded site of the placental attachment, keep 
up a slight oozing, which becomes fetid by lying in the uterus 
and along the genital tract. 

Imperfect uterine contractions are due to hard work, struggle 
for existence; sexual congress during pregnancy; and anything 
which would be likely to exhaust the uterine plexus of nerves. 

Symptoms. — The general symptoms are rigors, succeeded by 
fever ; a full, hard, rapid pulse ; occasional vomiting ; distress of 
countenance ; great debility ; suppression of the secretion of 
milk ; usually, not always, pain and tenderness in some part of 
the abdomen, most frequently about the umbilicus, which is in- 
creased by pressure. 



BACTERICIDES. 



147 



Some patients complain of great pain, great tenderness, with 
great constitutional disturbance. 

These coming a few days after delivery, in some high fever, in 
others a peritoneal inflammation preceding the fever. The acute 
stage continues for a few days ; during this time the rigors are 
severe ; the skin hot, at some periods clammy ; abdomen be- 
comes tumid, and susceptible of great pain from the slightest 
pressure ; the tongue is white ; the respirations short and quick ; 
countenance anxious; signs of abdominal inflammation. 

The progress of the disease is rapid, often fatal inside of forty- 
eight hours. 

Prophylactic measures are various. The mortality from this fever 
is specially great among unfortunate women, the depressed 
sympathetic, mental distress, despondency, seriously interfere 
with the recuperative powers which should be active after parturi- 
tion. With a blighted sympathetic, the muscular fibres of the uterus 
do not contract well, the lochia lies long in the genital organs, 
germs are evolved which enter the blood, either slowly through 
the open mouths of the vessels, or are absorbed through some 
crack or fissure. Patient should be re-animated with a new life^ 
new hopes, new aspirations ; uterus stimulated to contract and 
at the same time disinfected by injecting it with solutions of 
boroglyceride, or resorcin. 

The rigid enforcement of all antiseptic precautions, the avoid- 
ance of sewer gases ; all physicians and nurses should be forbid- 
den attending such cases who perform post-mortems, or have 
been for six months previously in attendance upon a similar 
case, or one of boils, or erysipelas. 

Morbid anatomy. — On examination after death, the vessels of 
the omentum and peritonaeum are found to be turgid with blood \ 
there are usually adhesions in many parts of the abdomen, which 
is distended with gases, and effused serum, with flakes of lymph 
floating in it ; and sometimes Ihere is seen on the intestines, the 
puerperal micrococci in the form of zoogloea ; also in the lungs, 
spleen, kidneys, brain, chains of micrococci. The uterus in par- 
ticular is literally covered with a thick coating of the germinal 
matter. The essential and most obvious fact is that the entire 
body has been the victim of the most deadly of all microbes, the 
most tenacious, as it is six months before it disappears from the 
hair of the physician or nurse ; the most deadly, as it often de- 
stroys life in forty-eight hours. In its origin, it usually declares 
itself within ten days after delivery. 

In metria, or so-called puerperal fever, micrococci liave been 
found in the blood in the form of zooglcea in all irritated organs, 
as the mouth, lungs, spleen, endocardium, Hver, uriniferous tubules 



348 



DISEASE GERMS. 



of the kidneys, and in emboli of the blood-vessels and brain. 

Precisely the same state of microbe evolution exists in all cases ot 

puerperal mania ; zoogloea 
and chains of micrococci 
are met with in the brain, 
associated with clot. 

The present illustration 
is taken from a necrotic 
patch of the lochia, which 
affords most energetic cul- 
tivation in beef tea. 

Indications of treatment 
are: if we possibly can 
without injury to the or- 
ganism, introduce into it 
a sufficient quantity of a 




drug 



Chains of micrococci found in a necrotic patch of the 
lochia. Precisely the same state of evoluiion exists 
in brain and heart clot. 



to the 

life and reproduction of 
the micrococci or microbe 
(pathogenic) that may 
either prevent the devel- 
opment of the disease ; 
destroy or sterilize the microbe ; or change it, we may possibly 
limit its growth, and thus retard the pathological process to such 
an extent that the germ may be incapable of destroying life. 

Treatinent, — The treatment of metria must to some- extent be 
governed by the predominant symptoms of each case, and depend 
larcfely on the prevailing type of the fever. 

Under all circumstances must the temperature, pulse, respira- 
tions, be kept normal, whatever the type of the fever, for if the 
germ is not sterilized or destroyed in a week, it will kill the pa- 
tient. It must be treated boldly ; no time must be lost. Select 
one of the following remedies, either anti- 
pyrine, thallin, opium, Dover's powder or pul- 
verized asclepias. 

Administer in such doses and so frequent 
as to maintain an equalized circulation. 

To the abdomen either concentrated ozone 
or ozonized turpentine, or a mixture of the 
two. Kept applied until erythema of the 
skin is produced, then follow with fomentation 
of poppies and resorcin, and repeat the applications persistently 
for several days. The entire surface to be bathed with hot water 
to which some peroxide of hydrogen is added ; this should be 
done thrice daily. 






M 






\ ' 



The pathogenic microbes 
of pueperal fever. 



BACTERICIDES. ^^g 

The next important steps is to administer half a drachm of 
leptandra with one grain of opium, pulverized, and five of quinine, 
this is to be followed in two hours by drinking an infusion of 
senna, and if it does not operate freely, repeat inside of three 
hours, so as to produce five or six evacuations from the bowels 
daily, until the germs are annihilated. Chionanthine, leptandra 
and opium must be repeated every six hours, both have a power- 
ful germicidal influence on this microbe ; a directly destructive 
remedv to the germ. Should violent purging come on, the dose 
of the leptandra can be reduced. As soon as the symptoms of 
germ evolution subside, and the recovery of the patient is secured, 
withdraw the drug. 

Chlorine or ozone water to be given as a drink. 

In addition to these remedies a germicide is to be selected suffi- 
cient to destroy the microbe and adminstered every hour ; resor- 
cin is excellent, carbolic acid and tincture of iodine (as in typhoid 
fever). 

Whatever treatment is carried out, another thing is essential, 
and that is three times daily a copious, warm, intra-uterine injec- 
tion of a solution of boroglyceride or resorcin, or chlorinated 
soda, creolin ; some one is essential. The use of these for wash- 
ing out the germinal matter from the cavity of the uterus is self- 
evident. They are of great utility and should be used with great 
caution. 

One of the most eminent physicians in our country says of 
Metria : 

"The most decided results are obtained by a rigid germi- 
cidal treatment, under which the microbe disappears from the 
blood and tissues. Thus, the most careful antiseptic precautions, 
anti-pyrine in sufficient doses to keep the pulse at 70 ; wash out 
the cavity of the uterus thrice daily with warm solutions of boro- 
glyceride ; concentrated ozone with chloroform over the entire 
abdomen, or ozonized turpentine till erythema appears. Resor- 
cin jelly one-eighth of an inch thick over the redness ; when it 
disappears, a re-application of the germicide. Bowels in all cases 
freely opened with large doses of leptandra and jalap ; then tea- 
spoonful doses of concentrated tincture of kurchicine every three 
hours. In a very few hours no microbe can be detected either in 
the breath, saliva, blood, or lochial discharge." 

Country physicians may say, we cannot procure such remedies, 
appropriate in such cases. Turpentine is always at hand ; in all 
states and conditions it is a good ozone generator and stimulant 
in metria, one which from its action on the microbe, on the skin 
and kidneys, materially aids in the annihilation and elimination of 
the germ ; it is a valuable germicide in puerperal septicsemic fever. 



350 



DISEASE GERMS. 



A peculiar form of coryza, to which a 
Hay Fever, certain class of individuals are liable each 

Bacillus Subtilis. year, at a particular season ; the disease 
is of frequent occurrence among highly 
civilized Caucasians, as the American and English. 

It occurs much more frequently among those who have their 
nervous systems very highly developed, the highly educated, or 
those who perform much mental work. People who live in cities 
are much more obnoxious to the disease than those who live in 
the country. The nervous temperament, or neurasthenia has an 
undoubted influence in predisposing to the complaint. 

The predisposition is often the result of a neurotic inheritance, 
can be traced back for generations in the same family, but more 
commonly acquired under great mental toil, care, worry, strug- 
gle. The liability to the disease is at any period of life, but most 
commonly between twenty and thirty-five years of age. 

The exciting causes are numerous, micro-organisms and irri- 
tating agents in the atmosphere which are much more commonly 
in the summer and autumn months, as the pollen of flowering 
grasses and cereals coming in contact with the periphery of 
nerves in the delicate mucous membrane ; that the rise and fluc- 
tuation of the malady during the summer months corresponds 
with the varying amount of pollen in the atmosphere. Grasses 
most productive of hay fever are clover, timothy ; of flowers, 
roses and violets ; of cereals, rye and buckwheat ; ragweed and 
grapes being most productive of the autumn form. No doubt 
pollen or aroma in the air, annually recurring, acts as an exciting 
cause, but hay fever properly includes a much larger group of 
cases, in which vaso-motor and secretory disturbances in the- 
nasal passage, or along the whole naso-bronchial tract are excited 
by a variety of causes. 

The symptoms usually present are those of languor, lassitude, 
debility, with pain in the back, calves of the legs, rigors, fever 
with coryza ; sneezing ; nasal obstruction ; watery discharge 
from both eyes and nose ; the lachrymation is accompanied with 
smarting. There may be irritation of the throat, tightness and 
soreness of the chest, cough, and definite attacks of bronchial 
asthma. 

In persons with the typical nervous conformation, a train of 
symptoms identical with those of hay fever are extremely com- 
mon, and may be excited by dust of any kind, as the powder of 
ipecac, linseed; or the exhalation from animals, as cats, dogs, 
horses, rabbits, pigs ; or the odor of violets and perfumes ; vio- 
lent exercise ; sudden exposure to great extremes of heat and 
-cold, impressing the sensory nerves of the skin, together with 



BACTERICIDES. 



30 



other psychical causes. Some persons with the pecuHar nerv- 
ous idiosyncrasy are liable to attacks of sneezing coryza at all 
seasons of the year. 

The factors at work are a hypera^sthesia of the terminal nerve 
filaments in the nasal mucous membrane, and an undue activity 
of certain nerve centres. Both conditions combined give rise to 
.a degradation of bioplasm, the evolution being the bacillus sub- 
tihs. This micro-organism, combined with prolonged irrita- 
tion, the result of pathological states, leads to hypertrophy of 
the nasal mucous membrane. 

This bacillus is very common, and widely distributed, as it 
occurs in all nitrogenous compounds which are left to the atmos- 
phere to decompose. The best of 
all material is hay, ragweed, roses, 
grapes. 

Hay is the best. Infusion of hay, 
filtered and covered, and left to 
-Stand in a warm place, speedily 
swarms with this bacillus. 

This microbe consists of cylin- 
drical rods of variable length and 
breadth. Single rods grow to 
double their length and then un- 
dergo division. They at first form 
threads, which become developed 
into rods and cocci. They are 
mobile and are provided with a 
flagellum at each end. Their 
multiplication in any nourishing fluid speedily impoverishes it, 
and their growth by division soon ceases. Spore formation, 
however, will again become active if exposed to the air, as they 
are aerobic ; the deprivation of oxygen causes the growth of the 
bacilli to cease. 

The bacilli from the other nitrogenized bodies mentioned are 
identical in all respects with those from hay, consisting of elemen- 
tary rods of various lengths, with a flagellum at each end. After 
division the individual bacillus remains, as then the germ divides 
and separates, spore formation being independent of nourishing 
material. The hay bacillus bears a strong resemblance to the 
giant bacteria of anthrax, a zoogloea, a swarm, being a special 
characteristic. 

The microbe is pathogenic of hay fever, bears culture admira- 
bly and will grow in almost any nourishing medium, and when 
inoculated into any animal will give us hay fever or asthma. 

Hay fever and allied forms of coryza are in a large number of 




Hay tiaciUu^ . Baciilus Sidytilis), The 
microbe of hay, grape, ragweed, rose 
and other fevers. 



352 



DISEASE GERMS. 



cases associated with abnormal stites of the intra-nasal structure, 
and an improvement or complete cure of the coryza may be 
looked for from treatment directed to the destruction of the micro- 
organism in the nose. Irrespective of the microbe, or often 
associated with them, outgrowths from the nasal septum, hyper- 
trophic rhinitis ; enlargement of the inferior or middle turbin- 
ated bodies, mucous polypi. 

Remedying these pathological conditions, and the removal of 
the microbe, invariably affjrds substantial and durable results, 
the removal of redundant erectile tissue or otherwise, removing 
or excising nerve filaments. 

In the management of all cases, the neurotic element must 
ever be kept in mind, and. remedies like kephaline, avena sativa, 
should be pushed. 

The principal indications are to strengthen the general nervous 
system, soothe local irritation, and remove the microbe. 

The most hopeful remedies are those which give tone to the 
nervous system, kephaline combined with quinine and nux 
vomica; the bromide of potassium or ammonia and hydro- 
bromic acid, glycerite of ozone. 

To allay the irritability of the mucous membrane, various 
drugs have been tried with varying success, as atropine, morphia,, 
aconite, cocaine, peroxide of hydrogen, etc., by spraying in the 
nose, and over the eyes. Of these remedies, cocaine is of the 
greatest value, it may also be administered internally. Locally a 
solution, four per cent, is sufficient. While thus meeting the 
more urgent symptoms, we should select some germicidal remedy 
with which we should literally saturate the system, sterilize the 
blood, so that no microbe can live in it. 

Peroxide of hydrogen, sulphide of lime, comp. oxygen, Chian 
turpentine, one or other administered, will so sterilize the blood 
that no microbe will grow, the patient becomes invulnerable to 
either contagion or infection. Even inoculation is futile. Bi- 
chloride of mercury produces the same effect, thus: Bichloride 
mercury, gr. i or ii ; bicarb, soda, half an ounce ; distilled water,, 
eight ounces Mix. Dose, one teaspoonful every four hours. 

Boroglyceride both locally and internally ; begin early before 
the expected attack. 

The ozonized witch hazel charged with ten volumes of perox- 
ide of hydrogen, administered internally and locally, diluted, 
does good work in sterilizing the micro-organism and lessens the 
hyper-excitability of the nasal and respiratory mucous mem- 
brane. 

The distillation of the pine, of the eucalyptus, are exceedingly 
useful for internal use and also for inhalation ; the pine prepara- 



BACTERICIDES. 



?>S^ 



tions are superior to creosote ; the pinol preparations, rich in 
natural and artificial ozone, are always of the greatest efficacy. 

Syrup of tolu, to which is added con. ozone and resorcin, has 
a magical action. 

The effervescing citrate of caffeine is not to be despised, as it 
will often ward off an attack ; and a w^arm douche of sulphate of 
quinine will kill the entire brood of germs. 

Euphorbia pilulifera, when taken internally, has the effect of 
sterilizing the germ. It has a slight narcotic action, but relieves 
the nasal, laryngeal, bronchial symptoms, and invariably affords 
a good night's rest. As this plant is toxical^ great care should be 
taken in its administration. As it yields its properties readily to 
boiling water, a decoction of the dried plant in the proportion of 
a half an ounce to a pint of water, and when cold a teaspoonful 
of chloroforrn added. This may be administered in doses of 
a wine-glassful three times a day. 

If case does not improve rapidly, medicated bougies should be 
tried, composed of cocaine, resorcin, naphthaline, and butter of 
coca. 

Local cauterization to the special sense of sensation, the sup- 
posed seat of the microbe entrance, is being practiced. 

In all cases of hay fever the diet should be liberal, as the dis- 
ease is of a depressing and exhausting character. Daily exer- 
cise, early hours, very moderate indulgence in alcoholic liquors 
should be advised. A certain amount of moral courage on the 
patient's part is also a desideratum, for the more the affection is 
resisted the less trying does it become. Moreover, as a previous 
unhealthy condition of the mucous membrane is necessary for 
the development of hay fever, it is very advisable, during periods 
of rest, and when the disease lies as it were dormant, that the 
mucous membrane should be maintained or restored to a healthy 
condition. I therefore, as far as possible, treat patients before the 
annual attack shows itself. By this means, in many cases, it has 
been warded off. Careful syringing with alkaline lotions and 
sprays, the use of inhalants and of interrupted currents of elec- 
tricity, with, of course, attention to diet and general medicine, 
will often enable patients to tide over the trying months of spring, 
without any manifestations of the malady. As to electricity, I 
am not aware that it has been tried in the treatment of hay fever 
on any extensive scale. In many cases I certainly have seen 
much benefit derived from mild interrupted currents, adminis- 
tered daily or every second day — act beneficially by exhausting 
the irritability of the part. 
23 



354 



DISEASE GERMS. 



An irritation of the brain and cerebro- 

Spotted Fever, spinal axis, by the presence of a disease 

Epidemic germ, resembling the streptococcus in diph- 

Cerebro- Spinal theria, and having also its pathogenic 

Meningitis. characteristics. 

In all conditions of the human body in 
which the vital force is at a very low ebb, shattered almost irre- 
parably, and this is aggravated by diminished electrical or per- 
verted meteorological states, a degradation of normal bioplasm 
takes place. 

It attacks persons of all ages, with broken-down or devitalized 
constitutions. It is prevalent all over the world, and corresponds 
precisely to the blight in the vegetable kingdom ; contagious and 
infectious. 

It comes on slowly and insidiously, preceded by an undeter- 
mined period of incubation or germination, followed by rigors 
and a fever which last from five to seven 
days. The prostration and coma are ex- 
treme ; head and heels thrown back ; often 
livid or purple spots on the body, some- 
times absent; otherwise the 5kin is re- 
markable for its pallor ; flush on cheeks. 
Often convulsions. 
Streptococcus in cerebro- j^s duratiou is fivc days ; recovery in all 

spinal meningitis. i i r i 

cases very doubtiul. 

There is a tendency for the different types of remittent to ter- 
minate in cerebro-spinal meningitis. 

Its recognition is easy ; its insidious mode of attack, the coma, 
high fever, head and heels thrown back, livid spots on the skin, 
violent and short duration of fever. 

If the case is seen early, the general indications of treatment of 
fever should be observed, as bathing, beef-essence for diet, exal- 
gine in doses sufficient to equalize the circulation. Active stimu- 
lants over the cervical portion of spinal cord, with galvanic 
cautery or ice, followed by hot poultices or a liniment of tincture 
of belladonna, chloroform, and aqua ammonia, equal parts. Se- 
cretions kept active. 

An effort should be made to destroy the streptococcus in the 
blood. 

Internally, the microbe is annihilated by the presence of the 
ozonized glycerite of sulphur. This remedy is administered in 
teaspoonful doses every three hours, and the results obtained 
are rapid diminution in the pulse rate and temperature ; a speedy 
alleviation of all the symptoms ; its duration is shortened ; the 
dangers are overcome. It is one of the most remarkable germi- 




BACTERICIDES. 



355 



cides, greedily taken by any child, and can be utilized in every 
case, and effectually roots the brood of germs from the body. 

Dose after dose can be administered, and so long as there are 
microbes to kill it will not disturb the bowels, but when all 
are exterminated, then it will excite peristalsis, and the fre- 
quency of administration as well as the size of the dose must be 
lessened. 

Hydrogen peroxide should be administered internally in alter- 
nation with the sulphur to sterilize the blood, kill the spores ; 
neutralizes the ptomaines, and thus anticipate the sequelae of 
that dreadful microbial disease. 

In the absence of these two remedies, it should be borne in 
mind that the microbe can be killed by the administration of 
sodium salicylate in acetate of ammonia, by zozodine, chlorinate 
5oda, pyridin, etc. 



A class of continued fevers characterized by a 

Eruptive rash. The principal diseases of this class have 
Fevers. certain features in common. They are each due to 
the presence of disease germ in the blood, and 
each of the respective microbes have a definite period of germina- 
tion, of fever, rash and decline. 

The germination of the microbe corresponds to the old stage 
of incubation, which terminates in each case respectively with a 
rigor; then the microbe is fully developed, actively at work, 
sprouting, breeding in the blood ; using up in its own nutrition 
all the oxidizable properties, which, when completed, the germ 
seeks the skin for the purpose of obtaining free oxygen ; here, it 
produces various pathological changes, according to its peculiari- 
ties and protoplasmic wants. Microbes on the cutaneous surface 
appear in scales, in peeled-off colonies ; in vesicles, pocks or 
scales. The microbes, wrapped up in the dead or effete tissue 
of the body, if not burned up, have an independent property of 
life, unless destroyed by some bactericide. 

The special microbe of each type of eruptive fever, once in 
the body, appropriates to its own use, nutrition and growth, cer- 
tain elements in the blood and nervous system which never, 
except in some rare instances, appear there again, hence the patient 
is subject through life to but one attack ; his blood being sterilized 
to that special microbe ; and this rule holds good, even if the 
germ is killed on the first day of its entrance. 

So that each species of germ can be killed by germicides, and 
all the uncertainties of fever, rash, etc., wiped out, the child's life 



oq5 DISEASE GERMS. 

saved, yet impregnable ever afterwards to the ingress of the same 
microbe : 



Disease. 



Measles . . . 
Scarlet Fever 

Small Pox . 



Gerniinalion. Eruption appears. 



lo to 
4 to 8 days.; 2d day of fever. 

12 days. 3d day of fever. 



Eruption fades. 



4 days. 4th day of fever. 17th day of fever. 
5ih day of fever. 
/ Scabs form on gth day. 
\ fall off 14th to 22d day. 



This continued, highly infectious and often fatal 

Measles, fever is due to a micrococci and dipiococci in the 

or blood, brain and fluids of the body, found most 

Rubeola, abundant in the watery discharges from the eyes 

and nose ; not quite so abundant on the tongue, 

sweat. 

The germ is pathogenic, bears culture v/ell ; cultivations fed to 

animals reproduces the disease perfectly, even to its different 

stages, in the most perfect manner. 

Symptoms. — After a period of germination, varying from ten to 
fourteen days, there is pain in head, back, calves of the legs ; lassi- 
tude, shivering, fever and catarrh, the eyes 
are suffused, lining membrane of the nose 
congested ; mucous membrane of the 
fauces, larynx, trachea and bronchi become 
much affected; eyelids swollen, keep water- 






ing, intolerance of light 



Micrococci of measles. 



runnmg water ; dry cough, hoarseness ; 
difficulty of breathing ; drowsiness ; great 
heat of skin ; tendency to delirium ; fre- 
quent, hard, rapid pulse; tongue white-coated. The eruption 
comes out on the fourth day of fever, usually first on the face, 
then the body, and lastly the limbs, fading on seventh day ; it 
consists of patches, rough, irregular, elevated above sound skin, 
often of a round or crescentic or horse-shoe shape. Between 
the crescentic blotches the skin is of the usual color. Fever 
does not abate on the appearance of the eruption. There is no 
peeling or desquamation of the cuticle, which is a characteristic 
in scarlatina. Diarrhea often sets in on the declining of the 
rash. It is usually salutary. The contagion of measles is 
strong, being powerful through both its latent and active form ; 
often pulmonary complications, especially in winter and spring 
months. 



BACTERICIDES. 35^ 

If the patient is tubercular, or the disease comes from another 
race, there rriay be laryngitis; oancrum oris, severe otitis, epistaxis, 
acute tuberculosis, or acute desquamatic nephritis. In a malig- 
nant form, when powers of life are low, the disease is remarkable 
for its fatality. 

In the treatment of a case of measles, without any complica- 
tions, the patient should be confined to bed, in a warm, airy apart- 
ment either darkened or with buff curtains ; patient must, nay, 
it is imperative that he should be confined to be bed ; he should 
be sponged off thrice daily with a warm alkaline wash, and well 
and carefully dried off Put half a teaspoonful of the tincture of 
aconite leaves into four ounces of water, and give one tea- 
spoonful every hour. Half teaspoonful doses of the compound 
tincture of serpentaria should be administered occasionally to 
maintain some slight degree of moisture on the skin. No cold 
drinks to be given. 

In all cases a bactericide should be given, as there is consid- 
erable lung, bronchial and nasal irritation from the microbe. 
The following is most beneficial, and greedily taken by the child : 
Syrup of tolu, four ounces ; resorcin, three drachms. Mix. 
Administer frequently, so that one teaspoonful will be given 
every two hours. If this is not deemed essential, a few drops of 
glucozone could be given, or the old formula of two drachms 
each of chlorate of potassa and muriatic acid, added to four 
ounces of water. Mix. One teaspoonful, added to a glass of 
sweetened water, taken at repeated intervals, so , one is used 
every four hours. 

Diet should be liquid, but very generous, consisting of beef 
tea, sterilized malted milk, chicken broth. If debility is great, 
brandy and cream, or brandy and ^%^\ cough troublesome, 
increase the tolu and resorcin ; any convulsions, delirium, must 
be carefully managed by the application of mustard to the feet, 
and rubbed over the entire body, with the internal use of the 
bromide potassa. ; - 

Complications .may arise from carelessness on the part of the 
mother, or a want of recognition of the fever being due to the 
presence of a microbe. Those are usually congestion of the 
lungs, bronchi and eustachian tube. 

In such cases there is danger,; treatment should be on general 
principles and active. 

Catarrhal states of the eustachian are often troublesome, and 
are apt to give rise to impairment of hearing. The coryza and 
nasal catarrh, with the large mass of germs, swelling of the naso- 
pharyngeal membrane. A little care and watching are sufficient 
to prevent any permanent injury. 



358 DISEASE GERMS. 

German or French measles has been supposed 

Rubeola to be due to a hybrid germ, the union of the 
or microccocci of measles and the bacilli of scarlatina. 

Rotheln Bacteriologists assert the existence of a distinct 
germ, which is pathogenic of the fever, which is 
essentially contagious and infectious. 

Symptoms. — There are the ordinary symptoms of languor, 
lassitude, debility, rigors, and a fever, which often runs high ; 
tongue is furred ; slight sore throat ; redness of the fauces ; little, 
if any, coryza; loss of appetite; drowsiness; looks heavy; eyes 
may be red, but do not water. The skin is full, tense and raised, 
and a papular rash makes its appearance, which gradually inten- 
sifies in color and becomes of a bright, rosy hue. These patches 
become blotches, and gradually spread over the entire body. 
The rash that comes out first soon fades and other patches 
make their appearance. The rash is followed by dryness of the 
skin. 

In mild cases there is simply the rash without the least con- 
stitutional disturbance ; appetite good, tongue clean, no languor, 
rigor or fever — nothing but a few tiny spots ; larger spots or 
blotches of a rosy hue in one part, at the elbows and knees, and 
spots and blotches on the hands, arms and legs ; the redness 
and soreness of the throat scarcely appreciable ; the rash may be 
gone in a day. Sometimes the cuticle peels, but as the constitu- 
tional vigor is good, he eats and sleeps well. Between a severe 
and mild case, rotheln varies much in character and severity. 
Most frequently it presents no symptoms but the rash, or the 
patient may be quite sick, and the rash varies much, appearing 
like measles ; in other cases diffused, or but a few sparsely scat- 
tered rosy-red minute dots ; in others a perfect aggregation. 

It is highly contagious and infectious, but its stage of incuba- 
tion, fever and eruption has not been defined. The worst case 
seldom lasts longer than three days. One attack protects the 
patient from all subsequent ones. It is followed by no sequelae, 
and most invariably terminates in recovery. 

The treatment consists in the warm bath, rest in bed between 
blankets, warm drinks, sweet marjoram. 

Aconite and compound tincture of serpentaria ; aromatic sul- 
phuric acid and quinine, destroys the germ promptly, and 
should be given as soon as the skin is moist from the action ot 
the aconite. 

The child should be kept at-home a few days, as the affection 
is even more contagious than measles or scarlatina. No after 
treatment is necessary. 



BACTERICIDES. ^^q 

This continued, highly infectious fever is due 
Scarlatina, to the micrococci scarlatina swarming in the 
blood, mouth, throat glands. The micrococcus 
can be found everywhere throughout the body, in the blood, 
breath. The germ is pathogenic of the fever, bears cultivation 
well in beef tea ; cultures injected into animals causes a re-appear- 
ance of the disease, even to the efflorescence of the skin. Three 
grades of activity of the microbe are described, which depend 
solely upon the status of vital force and sanitary sorroundings of 
the child in which the germ exists. If the micrococci enter the 
blood of a thoroughly healthy child, with good vital force, all the 
symptoms of fever and rash will be mild (simplex), but let there 
be depreciated vitaUty, with insanitary surroundings, the germs in 
the blood will be very active ; propagation by millions ; rash 
heavy ; throat badly germ-smitten (anginosa) ; if vital forces still 
more shattered, germ evolution still greater ; cerebral or malig- 
nant symptoms of an adynamic type; rash dusky ; purple, with 
a tendency to general gangrene, ^^ 

manifested by a suppuration from v^'^ ^ ^^ "•> • 

eyes and ears (malignant). ^« ^ 

In Scarlatina Simplex the symp- ^/^ 

toms are a latent period of from 
four to six days, with languor, las- -^ ^/^ 
situde, debility, pain in head, back, ^ ^^ ' 
calves of legs, and also rigors and a ^ 

fever. On the second day the erup- ■ws^ ^ 
tion appears in the form of innu- ^^ ^_^ ~^ jy_^ 
merable minute dots of a bright The Badiii scariatma rfounlir^re 

scarlet color, which rapidly diffuses blood before the germ migrates to 

1 -11 T^i • the skin. 

itself over the entire body. Ihis 

eruption terminates by desquamation of the cuticle, which takes 
place on the fifth day. It is merely a scurf on the face and trunk, 
while on the hands and feet large flakes of denuded cuticle peel 
off. While, or even before the efflorescence is spreading over 
the entire body, the mucous membranes of the mouth, fauces, 
and tonsils become affected ; the tongue at first covered with a 
thick white fur, through which red, elongated papillae project ; as 
the fur cleans off, the organ presents a strawberry appearance. 

In Scarlatina Ajiginosa the symptoms are more violent, very 
much aggravated, and the languor, rigors, and headache very 
great; fever high, vomiting, delirium, and prostration. The 
fauces, palate, and tonsils become greatly swollen and covered 
with coagulable lymph, the nasal mucous membrane, parotid and 
other glands severely implicated, swollen, and often suppurating. 
Sometimes there is a diffuse inflammation of cellular tissue of 



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^6o DISEASE GERMS. 

the neck, which is swollen and of a brawny hardness. The erup- 
tion may be delayed to the third or fourth day, and may then 
come out in scattered patches. With its fading, on the fifth or 
sixth day, the fever as well as the inflammation of the throat be- 
gins to abate. Severe inflammation of the serous and mucous 
membrane is to be dreaded. In strumous subjects it often as- 
sumes quite an aggravated form. Cases sometimes occur, in 
which there is no eruption on the skin at all, and still it peels off 
after recovery. 

In Malignant Scarlet Fever it assumes a malignant or typhoid 
form. Great cerebral disturbance, convulsions, urgent prostra- 
tion, muttering delirium, sordes on teeth, fetid breath, incrusta- 
tions of coagulable lymph on tongue, uvula, tonsils, fauces, gan- 
grene often takes place, and there is suppuration of throat, nose, 
ears, and eyes. The rash, if any, is purple or livid ; if it comes 
out it is late ; more generally it never appears. A fatal termina- 
tion almost invariably takes place on the third or fourth day ; 
few indeed weather the storm. 

The various forms are liable to terminate in ulceration of the 
tonsils ; inflammation of the eyes and ears, glands of the throat 
with suppuration. The ear, next to the kidneys, suffers greatly 
from the bacillus of scarlatina. The microbe penetrates the eus- 
tachian tube to the inner ear, germs and spores by the million ; 
their escape is prevented by the drum head; the bacillus rapidly 
causes destruction of the ossicles, mastoid cells and perforation of 
the membrana tympani itself. A large percentage of post- 
scarlatinal deafness, with perforation, is no doubt the result of 
carelessness. 

The scarlatinal germ excites synovitis, carditis, vaginitis, irri- 
tation of all serous membrane, which terminate in dropsy, and 
acute desquamative nephritis, with persistent albuminuria; 
ursemia is to be feared in some cases. 

The bacillus scarlatina is one of the most vigorous of all dis- 
ease germs, a 'potent spore evolver and ptomaine excretor, most 
destructive to the red discs of the blood, and deteriorates the 
general vital elements of the nervous system. The fact, that a 
patient afflicted with scarlatina is a perfect pest-house of disease 
jjerms should be strongly impressed upon parents, and also the 
fact that in his skin and hair are millions of spores, capable of 
propagating the disease for three months to come. . 

There is ho doubt that this contagious and infectious fever 
can, with care, be greatly modified, rendered so mild that none of 
the tisual complications can take place. When the disease is 
suspected in any locality, alk the children not previously affected 
should be placed at once upon better diet, daily bathing, cleanli- 



BACTERICIDES. 



361 



ness, a removal of all insanitary states, and all deemed suscepti- 
ble should be placed upon a germicidal course of treatment, so 
as to utterly sterilize the blood, to render it unfit for any disease 
germ to grow. Select some active bactericide, such as dioxide 
of hydrogen ; or sulphide of calcium ; or glycerite of sulphur. 

By resorting to such a procedure, there are few germs, and 
what there is are usually greatly attenuated. 

The discovery of the bacillus scarlatina has been the result of 
much study, accurate observation. 

The discovery of this bacillus revolutionizes the treatment 
completely. 

In the general treatment of a case, the general indications for 
the correct management of a case of fever must be inculcated. 
The patient must be confined to bed, in a warm, comfortable 
room; the entire body should be sponged off thrice daily with a 
warm alkaline wash until the eruption appears. The diet should 
consist of beef tea, sterilized milk ; disinfectants should be ex- 
posed in the apartment. The clothing or covering of the patient 
should be the finest possible ; bowels and kidneys looked after. 

The very moment the case is recognized, place the patient at 
once on a germicide, either glucozone, sulphide of lime or gly- 
cerite of sulphur ; one of these remedies should be persistently 
administered, and if so, the case will run very mild. There is 
no use in waiting for symptoms, apply resorcin jelly to the throat 
at once. • Put it on every three hours. 

If too late in beginning with bactericides, and fever sets in, 
keep on with germicides, but at the same time fall back on the 
old remedies, tinctures of aconite, belladonna and digitalis, with 
comp. tincture of serpentaria ; suitable doses to equalize the cir- 
culation and lower temperature. Ears carefully covered with 
laps. 

Mineral or vegetable sulphur is the natural antidote to kill the 
germ and sterilize the blood. Glycerite of sulphur, ozonized 
sulphur water, sulphide of lime are probably the three best 
forms for internal use, whereas lycopodium can be dusted over 
the entire skin, and if this is not handy, the anti-microbe powder 
can be used. 

Everything in and around the patient must be given and per- 
formed to kill a most tenacious microbe, even his drink and food 
should be germicidal. Tartrate of soda and a little lemon juice 
sweetened is an excellent drink ; malted sterilized milk a superb 
food. • • 

In addition to germicides, most cases are benefited with a 
tonic of aromatic sulphuric acid and quinine, small doses added 
to water. , . 



362 DISEASE GERMS. 

Convulsions, an evidence of ptomaine evolution in the intes- 
tines, are best treated with resorcin in the syrup of tolu, and ad- 
ministering salycilate soda in the liquor ammonia acetatis. 

Forthe mouth and fauces: Water, four ounces ; chlorate potassa 
and hydrochloric acid, of each two drachms. Mix. Dose, one 
teaspoonful added to sweetened water; boroglyceride solution ; 
zozoiodol and chlorinated soda. 

If the microbe scarlatina is not either sterilized or annihilated 
in the blood by the glycerite of sulphur, peroxide of hydrogen,, 
or other germicides, in the ordinary course of its evolution, it will 
seek the cutaneous surface to secure free oyxgen. In this pro- 
cess it imbeds itself in the skin and causes desquamation or peel- 
ing of the cuticle. In this process of shedding, the old microbes 
die, but leave their spores. These spores represent the seeds,, 
are capable of retaining life and germinating into bacilli, even 
after the most damaging influences are brought to bear against 

them, even time, drying, heat, cold 
■\s^ ^iS ^^^ chemical agents. The spores of 

^^^ yfi^B scarlatina retain their power to ger- 

^^S^^^^ £^^^» minate after long intervals ; even the 
^^i^^^Si^P^ ^'^^ temperature of boiling water, while 
WaL ^^^^^^^^ ^^ ^^^^^ micrococci, bacteria and the 

^^^^^^^^^^^^^M bacilli themselves, does not affect the 

I^^^^^BHH^^S^^ The determination of the thermal 

**' ' 'C'^^W^V* ' ^ • death-point of the spores of the mi- 

*v S ^ ''^? ' * ^» crobe of scarlatina has a very impor- 

A colony of the Bacillus Scarlatina in taut bearing- UDOU humauity at large. 

the peeling of the cutis; showing , -i 1 r • 1 .^ 

the spores. aud possibly of curative therapeutics. 

Clinical experience has established 
this, that if the entire cutaneous surface is rubbed over with 
resorcin jelly morning and night, that there are neither microbe 
nor spores left on the cuticle to cause desquamation. This jelly 
is easily prepared, thus : add to one pound glycerine heated to 
a temperature of 350° Fahr., one ounce of resorcin, three ounces 
of pulverized starch, and while cooling off, four ounces of per- 
oxide of hydrogen. This makes an excellent bactericide. As 
soon as the case is diagnosed, begin inunctions morning and 
night with warm olive oil, then rub in a portion of this jelly. 

This procedure is effective. It is almost needless to recapitu- 
late that all internal treatment should be germicidal ; sterilize the 
blood (kill the microbe), so that no disease germ can live there ; 
resorcin in syrup of tolu, ozonized glycerite of sulphur, ozone 
water, dioxide of hydrogen are the medicaments of the future. 

The general principles of treatment all through the case is to 



BACTERICIDES. 



3^3 



push bactericides under all and every condition, by doing so, life 
is saved, complications prevented. 

Ear complications are about equally as common as dropsical 
effusions from all the serous membranes. 

Serous infiltration of the cellular tissue, effusion from the mem- 
branes of the brain, pleura, peritonaeum, and sometimes the labia 
and scrotum. 

These dropsical conditions are due to the destruction of the 
red discs of the blood by the action of the germ ; poverty or 
ancemia ; to heart failure, that organ being imperfectly nourished 
by the poor blood; to a blocking of the kidneys with the 
microbe. 

Very nearly the same treatment should be resorted to as inter- 
stitial nephritis. 

Patient should be well nourished and kept warm. 

Remedies like digitalis and strophanthus to stiffen up action of 
heart; mild diuretics, as parsely root, hair-cup moss, asparagus 
tops, with cream of tartar, to flush the tubules of the kidneys ; 
aided with warm baths and dry heat over the loins. 

These, with the strictest attention to the weakened heart, are 
soon effective in promoting a cure. 



The microbial origin of small- pox is now tho- 

Variola, roughly elucidated, and the micrococci variola 

or isolated. The microbe is most abundant in the 

Small-Pox. blood, mucous membrane and pustules. 

The microbe is pathogenic of the disease, 
bears cultivation well, and cultures injected, or eaten by animals 
produce the disease in all its malignancy. 

That eminent bacteriologist, Prof James M. Bunn, M. D., of 
Altoona, Pa., says that the streptococcus of variola appears under 
the microscope in the form of cocci, singly, in 
pairs, and in long or short chains or colonies. /^%''--'": 
They are found in the fresh lymph of human ^'^^"^^C^ 
and cow-pox and in the pustules of true small- ^"5^^:'^^?^ 
pox. They are found most numerous in and ^^^/^^y^ 
around the pustules. Successful vaccinations *-.-3>!^^*%"' 
result from artificial cultivations. The micro- "'' -'^'^ 
cocci of varicella, variola and confluent small-pox ^^lmii"°ox"' ° 
are identical, thus establishing most conclusively 
that these are but one morbid state, that the microbe is patho- 
genic of the disease. 

Living as we do among distinct races of men, in which every 
microbial disease is intensified, variola is the great pathogenic and 
therapeutic question of the day. 



3^4 



DISEASE GERMS. 










Themicrobe variola can be detected in the atmosphere for fifty 
feet around an infected person. All withia that radius are exposed 
to it, and it enters their bodies ; but in order to take hold and mul- 
tiply, there must be particular conditions of temperature and 
chemical media, constituting what is termed receptivity. Just as 
some seeds will germinate only in presence of certain meteorologi- 
cal conditions and in certain soils, so organic receptivity is re- 
quisite, that disease germs be followed by their effects. Once the 
microbe of variola enters our bodies and produces small-pox, the 
solids and fluids of our bodies are so altered or modified, that all 
the essential elements for their further nutrition 
are used up and never appear again. 

If the germ of variola enters the human body 
and finds a medium suitable for its existence, 
it quickly multiplies, with the celerity peculiar 
' to minute bodies, their marvellous facility of 

;o I reproduction compensating for their micro- 

; ^ ' \- scopic size. During the twelve days of incu- 

i 'O '^^V ■ bation millions of ova or spores are evolved, 
i^.r^'^?C'^y-^^ '■'■':^:) so that when the rigors come with the three 
" ^ ^ • days of fever, the microphytes, having used up 
all the oxygenizable material in the body, eager, 
greedy for more, with air and light, accumu- 
'•^^;^ ' ^^^ near the surface; scattered in groups in 
"v/v^J^ the skin and mucous membrane, the microbe 
Section of skin in I'mar- excltcs suppurativc inflammation, which con- 
pox, showing the mi- stitutes " pustulation.'^ 

ciococci seekmg the „, ^ r ^i r • ^i ^ a. 

surface for free oxy- 1 he CaUSC of thc fcVCr IS thc StrCptOCOCCUS 

^"""^ variola. 

Symptoms. — ^^The period of germination in the blood, or latency 
or incubation, lasts twelve days, during which time there is lan- 
guor, lassitude, debility, pain in the head, in the loins, and calves 
of the legs, with persistent nausea and vomiting, tongue not much 
coated and white of eye clear, and as early as the ninth day a 
gritty feel can be detected in the skin. FoUowiag these symp- 
toms a; rigor and fever for three days, during which time pains in 
the head, loins, and muscles continue, but nausea and vomiting 
usually cease. When vomiting is severe, pains in the loins in- 
tense, they may be regarded as precursors of a bad attack. Pe- 
culiar eruptions of pimples or papulae appear at the end of the 
third day of fever, appearing in the following order : first on the 
face, then on the neck and wrists ; secondly, on the trunk, and 
lastly, on the lower extremities. The papulae have first a hard, 
shotty feel, then present vesicles on the summit, which gradually 
expand laterally to about the diameter of a split pea, are flat or 



BACTERICIDES. 



365 



depressed in the centre. On the eighth day of the eruption an 
inflammatory areola or circle forms around the vesicles, and their 
contents become cloudy and then purulent, the vesicles gradually 
ripen into pustules, suppuration being complete on the ninth day, 
at which time finer pustules break and crusts or scabs form. 
In from five to nine days more, longer or shorter, these scabs 
fall off. 

In many instances the rash on the skin is accompanied with a 
similar one on the mucous membrane of the nose, mouth, throat, 
eyes, and ears ; in others by a swelling and inflammation of the 
subjacent areolar tissue; occasionally by marked irritation of the 
nervous system, delirium, and convulsions. 

The severity of the disease usually bears a direct relation to 
quantity of eruption. When pustules are few, and they remain 
distinct and separate from each other, the disease is not severe ; 
when very numerous, they run together, coalesce, and lose their 
regularly circumscribed circular form, it is highly dangerous.* 
This has caused a division of small-pox into variola discreta and 
variola confluent. Former not near so dangerous as the latter. 
Eruption on the face may be confluent, while scanty over the 
body; still if so, the disease is regarded of the confluent kind. 
Sometimes the pustules are so numerous that they touch each 
other, but do not coalesce ; it is then said to be the SQmi-conflu- 
ent form. Sometimes they are grouped in circles or clusters, 
and the name corymbose applied. If in either case symptoms of 
malignancy or putrescence are added, the disease is termed ma- 
lignant small-pox, a most formidable affection. Occasionally 
after the early symptoms, as pain in the loins, nausea, vomiting, 
a rubeoloid or measly eruption, and later minute petechia, which 
increase in number and size, hemorrhage takes place into the 
conjunctiva and from the bladder, bowels, etc., and death occurs 
on the fourth or sixth day ; no characteristic rash, only a few 
scattered papules or vesicles having appeared, it is called hemor- 
rhagic small-pox, which is almost invariably fatal. 

The greatest difference between the distinct and confluent 
form exists from the beginning. All the symptoms in the con- 
fluent form are very aggravated, intense, often proving fatal from 
the blood being surcharged with a living destructive poison. 
During its course, troublesome complications are likely to arise, 
as erysipelas, swelling of the glands in the groin and axillae, 
phlebitis, ichoraemia, glossitis, pleurisy, pneumonia, ulceration 
through the cornea, and suppuration of eyes and ears. No con- 
tagion so potent as the living germ of small-pox ; infection lasts 
all through the case, from the earliest symptom to a little after 
the last crust has fallen off. One attack exhausts the suscepti- 



366 



DISEASE GERMS. 



bility of the system to future attacks, as a rule. The practice of 
inoculation with the variolous matter is illegal. 

Small-pox is easily recognized by the history of the case, the 
period of incubation, fever, and rash ; in the earliest stage by pain 
in loins, nausea, vomiting, and a white or clear conjunctiva. 

The success of treatment in small-pox depends upon the 
early recognition of the disease. With our present bactericides, 
we are not able to break it up, but it can be rendered very mild. 

During the twelve days of incubation of the germ, every pos- 
sible means to allay the irritability of the stomach should be 
resorted to, as the recumbent posture, stimulants over stomach, 
peppermint water, and tincture opii, etc. Then select a ger- 
micide that will take kindly to the stomach, as either thuja or 
sulphide of lime, or the bichloride of mercury as follows : 

15^ Aqua distilled .^viii. 

Bicarbonate of soda, oiv. 

Bichloride of hydrargyrum, grs. ii. 

Mix. One teaspoonful every two or three hours. Either of 
these three agents — thuja, calcium or bichloride — freely given, 
and elaborated in the blood, renders the soil unfit for the growth 
of this microbe. 

The glycerite of sulphur, with the hydrogen peroxide, has 
excellent germicidal properties, diffuses itself well through the 
blood, sterilizes that fluid, combats the invasion of the bacterium 
of variola. 

Push germicides as far ^s possible all through the stage of 
germination, and when the rigor comes and the three days of 
fever preceding the eruption, do not suspend their use, but 
perseveringly administer them. 

When the rigor takes place and fever sets in, it is likely to be 
very mild if the antiseptic plan has been carried out. After the 
rigor the patient must be kept in bed, in a well-ventilated room, 
free from carpets and curtains, and disinfectants freely distributed 
around the apartment. After his long fast the patient often has 
a keen appetite, and the diet should be generous — arrow-root, 
beef essence, milk and lime-water, ripe fruits, warm drinks. 
Sponging the entire body during the three days of fever with 
warm mustard water and soda must not be neglected. After 
rash appears it must be discontinued. All through an attack of 
small-pox, from its incipiency to its termination, no cold article of 
food or drink, such as iced drinks, cream, or ice, should be given or 
applied to the patient. 

Arterial sedatives, as tincture of aconite, veratrum, and bella- 



BACTERICIDES. 



367 



donna, one teaspoonful of each to half a tumbler of water, of 
which a teaspoonful should be given every hour or two. 

During the febrile stage it is often advantageous to change the 
germicide to either lycopodium, ozonized tincture, or to gluco- 
zane or salicylate soda in the acetate of ammonia. The physi- 
cian in attendance will be the best judge. Warm drinks are 
always indicated ; nourishment and stimulants are always of great 
utility. Tincture of cimicifuga racemosa has an excellent effect 
in all cases. Aromatic sulphuric acid and quinine is a good 
tonic in all cases. 

Much has been written of the bactericide properties of pitcher 
plant, wild indigo, siegesbeckie, and other vegetable germicides. 
We might just say that they are of no utility whatever in the 
destruction of this micrococcus. When the pustules appear, 
general principles must guide. The germcides should be admin- 
istered regularly, till every vestige of the disease has disappeared. 

With regard to pitting, there can be none, even if that simple 
thuja alone be given. Far less can it take place when such 
powerful germicides as sulphide of lime, comp. oxygen and gluco- 
zone are given. 

If the physician is weak in faith in the action of bactericides, 
he can bear in mind that under darkness or a yellow light the 
microbe becomes sterilized in the pustules. Hence there is no 
pitting. If his faith is still weaker, resorcin. jelly or ointment 
applied over the face at once destroys every microbe with 
which it comes in contact. 

As far as practicable, disinfectants should be exposed all 
round the apartment ; and if it were possible to move the patient 
on his cot to another apartment, sulphur fumigation for an hour 
will destroy every germ with which it comes in contact. 

The factor in small-pox is the germ. The whole aim and 
object of all treatment is its careful, persistent destruction, and at 
the same time keep up by every possible means the vital forces 
of the patient. We must by all means crowd in germicides with- 
out offending the stomach. All complications are to be treated 
on general principles ; convulsions, delirium, with bromide of 
potassa, belladonna; restlessness, with sulphonal. If the throat is 
seriously implicated, antiseptic gargles of boroglyceride. 

We cannot insist too strongly on the imperative necessity of 
persistent and careful nutrition all through the case ; food often, 
at proper intervals by day and night. Beef-tea, broths, milk 
food, cream, finely-chopped meat, chicken, game, are most 
acceptable. 

The retrograding action of alcohol on all disease-germs must 
not.be overlooked. This property alone renders it an agent of 



368 



DISEASE GERMS. 



infinite value in the form of milk punch. There is no form of 
fever that bears such an amount of careful nutrition in all forms 
as small-pox. 

Does the modern system of vaccination with the cow-pox 
lymph sterilize the blood of the recipient ? Does it render the 
soil unsuitable for the growth of the variola microbe ? Does it 
exhaust the pabulum ? Most assuredly not. 

Modern vaccination is productive in creating a deterioration of 
race, as is seen in widespread neurasthenia and tuberculosis. 

Bovine lymph has in it the oidium albicans from foot diseases 
of the heifer ; the bacillus tuberculosis which affects eighty per 
cent, of all swill-fed and high-bred animals. Actinomyces is 
more common than what is really known, and all are familiar 
with the malignant anthrax which is decimating our cattle, pollu- 
ting our soil. 

Does a father or guardian desire to implant in his offspring 
microbes of disease, factors of crime ? 



In all tropical countries where solar 

Filaria Sanguinis heat ranges from 80° to upwards of 100° 

Hominis. F., there are to be found in the human 

blood during night, millions of ova, of a 

minute, almost structureless, microscopic parasite, which is the 

embryonic form of the filaria, which requires the action of the 






Filaria Sanguinis Hominis in 
human blood X 280. In 
this case Irom 2510 100 were 
found inevery drop of blood 
between 6 p. m. and 5 A. m. 




Filaria Sanguinis Hominis, taken from a lymphatic in tiie scrotui 



mosquito to effect a transition in its scale of being, a sexually 
mature worm. 

The mosquito, ever active during the night, feeds upon human 
blood when those micro-organisms are present ; being a greedy 
feeder it gorges itself, and once in its body grows prodigiously. 
The nature of the mosquito compels it to seek water, into which 
it liberates the developed spores of a trematode. Free in the 
water, especially if it be stagnant, it undergoes further changes, 
progressing onward in the water, in the human stomach, in its 



BACTERICIDES. 



369 



migration from the gastro-intestinal tract to the lymphatic, 
where it is found in a mature state, measuring usually about 
three inches long. 

The passage of this micro-organism into the human body is 
chiefly by the water as a drink, possibly by the skin in bathing 
or by the bronchial mucous membrane. Once the embryonic 
worm is within the body, it has a selective power, to seek out 
the lymph canals as an abiding place. Its aptitude in choosing 
the lymphatics, or lymph scrotum is remarkable. 

Our knowledge of this parasite is very imperfect, so much so 
that we are unable to give, its life history, its original mode of 
development, its duration of life, its habits, its power of repro- 
duction, or how myriads do exist in individuals during rest or 
repose. 

The embryonic filaria in the blood is a microscopic parasite, 
and will remain or die such, unless he finds an entrance into the 
mosquito, thence into water, and finally into the human stomach 
and lymph channels. 

The mosquito has a peculiar and special affinity for this micro- 
organism, and will not suck the blood of those in whom they do 
not abound. . The embryonic filaria are not common in the blood 
of those who lead an out-door Hfe and enjoy the highest possible 
standard of health. 

More is wanting to enlarge our conceptions of the nature of 
this and other blood parasites. 



This usually consists of a narrow crack or lacer- 
Fissure. ation of the mucous membrane, involving the 
sphincter muscle at its coccygeal border. It is usu- 
ally situated at the posterior wall, at the external border of the 
anus, where skin and mucous membrane meet, but it often ex- 
tends up or across the internal sphincter, and even into the rec- 
tum. As a rule there is only one, but it is not at all uncommon 
for two or three to exist simultaneously. The great abundance 
of sensient nerves in and about the sphincters renders it very 
sensitive, and when fissured, the pain is indescribable ; severe, 
agonizing, persistent, after a defecation ; the reflex effect of which 
is most disastrous to the nerve centres, giving fise to collapse, 
chorea, epilepsy, nervous disease. 

It may occur at any age, in both sexes, but most frequently 
•met with in adult females. 

Causes. — Scratches, abrasions, lacerations, due to straining at 
stool, or to excessive stretching produced by passing dry, hard- 
ened faeces, or to fish bones, or cherry stones, polypus, piles, 
24 



370 



DISEASE GERMS. 




tumors, diarrhea, discharges, enlarged prostate, prolapsus of 
uterus and rectum, rectal ulcers, disease germs eating, eroding 
the tissues, the labor of childbirth. 

Symptoms. — There is excruciating, intense, sharp, burning 
pain, at or subsequent to defecation, with mucus or muco-puru- 

lent matter from the anus, but it 
needs to be seen, although the pain 
is an excellent symptom, being of 
an agonizing character, very de- 
pressing, owing to the faecal matter 
lodging in the fissure undergoing 
chemical changes. 

Treatmeiit. — The general health 
must be improved by every possi- 
ble means, alteratives and tonics. 
Among the last the following is in- 
valuable as a rectal tonic : Fl. ext 
juglans ; fl. ext. Virginia stone crop ; 
fl. ext. coUinsonia, equal parts of 
each. Mix. One teaspoonful three 
times daily. 

The sphincter muscle must be 
paralyzed by the local application of 
belladonna ointment, the bowels 
evacuated by oil. After a thorough 
movement, wash out rectum with boroglyceride solution, then 
wipe the parts dry and expose the fissure thoroughly; then 
sprinkle it all over with iodol or the 
solution of nitrate of silver, thirty 
grains to the ounce of water. 

By keeping the sphincter thorough- 
ly relaxeci ; causing copious soft stools 
with the administration of fl. ext. of 
juglans, and the introduction of the 
cocaine suppository, the fissure heals 
promptly. 

Another plan is : after the bowels 
are evacuated, and the parts cleansed, 
introduce within the fissure a frag- 
ment of lint, soaked in a solution of 
chloral hydrate, one to fifty. This 
should be applied every morning. 
The action of the chloral is anti- 
septic, stimulates granulation rapidly. 

Conium ointment is of great utility in all painful affections of 



A form of deep rectal fissure commenc- 
ing two-and-a-half inches above the 
sphincter muscles, usually met with in 
persons that suffer from nervous bank- 
ruptcy, white softening and insanity. 









U 



-^'^Wsf 



Piles, complicated with longitudinal fis- 
sure, high up as well as low down. 



BACTERICIDES. 



371 



the anus and rectum, but it is especially efficacious in fissure 
with intolerable itching", severe tenesmus, with bleeding; it 
.affords marked and speedy relief, after every other remedy has 
failed. 

If the case resists treatment, sphincter irritable, stretching the 
sphincter muscles is of great utility. 

The office of the sphincter ani is to guard the rectum from in- 
voluntary discharges of its contents in health.; this it does easily, 
perfectly, without strain or friction. But let disease supervene, 
ulcer, fissure, fistula, piles— the irritation incidental to which 
gives rise to thickening ; piles are constantly tending to protru- 
sion, ceaselessly warring with the muscle, when faeces are passed, 
they are either protruded, bruised, painful, or agonizing ; whereas 
in ulcer or fissure the irritation is cumulative. 

' In order to effect a cure in the majority of cases, it is impera- 
tive that the muscle be placed physiologically at rest ; to effect 
this, belladonna is the drug to be 
applied ; and this is not at all times 
indicated, especially if there is fis- 
sure. While stretching the sphinc- 
ter ani is neither recognized, nor 
taught, nor appreciated, but scouted 
as unsurgical, nevertheless, infinite 
good is to be derived from it in 
some cases. Digital stretching is 
the best, never lacerating, but suffi- 
cient to destroy its power for a few 
days until recuperation is effected. 

Piles and rectal fissures often 
co-exist — a good illustration. Fis- 
sures running up are best got rid 
of either by rectal bougies of boro- 
glyceride and resorcin, or stuffing 
them on alternate days with iodol ; the external chronic hsemor- 
rhoidal condition best smoothed down by painting them once a 
week with a solution of chromic acid. Another excellent remedy 
is the ozonized distillation of hamamelis virginica ; by two thirds 
of the profession it enjoys absolute precedure over all other drugs. 

This term is applied to a sinus or channel exist- 

Fistula in ing in the tissues surrounding the anus or rectum. 

Ano. Anal fistula is a tube lined with a false membrane, 

which is a secreting tissue and communicates 

with a cavity. It is met with in three forms ; complete, blind 

internal, blind external. A complete fistula connects the rectal 




Fissured rectum, the result of the syph- 
iUtic microbe, cured by rectal bougies 
of zozoidol. 



372 



DISEASE GERMS. 



cavity with the external skin, by a sinus running outside of or 
around the sphincters. If the rectal wall be perforated and a 
sinus extends from the perforation to some point in the tissues, 
but does not reach the surface, it is called an internal, imperfect 




External incomplete fistula 



Internal incomplete fistula. 



or blind fistula. If the sinus extends from an opening on the 
outside wall of the rectum, but does not penetrate the rectal 
wall, it is termed a blind internal. 

Causes. — Constipation, which distends the lower portion of the 
bowel to a great extent, and then a weakened patch gives way, 
or a piece of hardened fasces, fruit seed, fish bone or some other 
hard body excites irritation, inflammation, ulceration clean 
through, or otherwise forming a fistulous ulcer. There may be 
one or more. Fistula does not necessarily co-exist or depend 
upon the presence of the tubercular bacilli, but may be caused 
by a germ-eaten rectum, the microbes eating their way through 
to the external parts. This is frequently the case in ulceration, 
due to the bacilli of tubercle, or to the vibrios of the insane. 

The external tissues of such patients 
are soft, non-vital and disease sperms 
perforate readily. 

Symptoms. — The external aper- 
ture is usually small, and in some 
cases difficult to find. Generally 
it is near the anus, although it is 
not uncommon to find it several 
inches distant ; it may be concealed 
in a furrow, or it will be found in 
the centre of a button-like eminence. 
Complete fistula is most annoying, because gas, intestinal mucus, 
and fluid faeces pass along the tract, causing external irritation 
and painful spasmodic contractions of the sphincter. The blind 
internal is easily detected by the introduction of a blunt probe, 
which does not penetrate through, the discharge from this is 
mucus ; the blind external gives rise to symptoms nearly analo- 
gous to irritable ulcer. By a careful examination with a bent 
probe the orifice can readily be detected. 




Fistula Deverticula. 



BACTERICIDES. 



373 



Treatment. — Before enumerating our modern method of treat- 
ment, which is satisfactory, we will simply enumerate the old 
methods which have fallen into disuse. 

The old orthodox and approved treatment for many years has 
been to cut through the fistulous opening into the rectum, divid- 
ing the sphincter, and permitting it to heal from the bottom, if 
the patient has vitality enough, otherwise an imperfect or non- 
union of the sphincters may take place. This cutting may be 
done with the knife, or crushed by the chain of the ecraseur, or 
by a ligature. Even cutting the false membrane lining the sinus 
has been resorted to. 

Most encouraging success has attended the treatment of this 
malady, by stimulating, cleansing, germicidal injections into the 
fistula. Generally we are successful with this method, but once 
in a great while we meet with a case in which the ligature or 
knife might be necessary. 

Whichever of the methods is deemed best for success should 
be decided on ; but before it is resorted to it is well to improve 
the patient's health by every possible means with tonics, fresh 
air, best of diet. The bowels should be cleansed with oil. If 
the injection method is selected, we append a few formulae, with 
which we have had most gratifying success. Before any of those 
are used, the sinus and rectum should be washed with an anti- 
septic wash, such as one grain of chloral hydrate to one ounce 
of water; or one grain of nitrate potassa to two ounces of water; 
or one grain of bichloride of mercury to four ounces of water ; or 
a few drops of peroxide of hydrogen in water ; or a solution of 
boroglyceride. 

After one or other of those washes have been used, the parts 
dried, then select one of the following formulae to inject, to 
destroy the sinus and stimulate effusion of lymph to block up 
the passage. 

Carbolic acid, three drachms ; glycerine, one drachm ; sperm 
oil, one-half drachm. Mix. Heat to 300° F., and evaporate 
to four drachms ; then use as below. 

Carbolic acid, twenty grains ; corrosive sublimate, gr. i. ; Mon- 
sul's solution, one drachm; glycerine, two drachms. Mix. 

Carbolic acid crystals, forty grains; hydrochlorate of cocaine 
and of morphia, of each respectively, five grains ; glycerine, two 
drachms. Mix. 

An excellent radical cure is as follows: First trace fistula with 
a flexible probe. Wash out the tract with a five per cent, solu- 
tion of hydrogen peroxides. Then inject a ninety-five-per-cent. 
solution of carbolic acid, plus an equal quantity of a ten-per-cent. 
solution of the muriate of cocaine. Draw from ten to fifteen 



3;74 " DISEASE GERMS. 

minims in the syringe. Push the nozzle of the syringe to the 
depth of the fistula, and then inject slowly as you withdraw the 
needle. Within two hours afterwards inject a few drops of 
equal parts of oil of eucalyptus and glycerine. Let the patient 
rest twenty-four hours. Lock up the bowels for a few days, and 
the operation is complete. 



Stricture of the urethra, when old, and not got 

Fistula rid of by absorption or electrolysis, is very apt 
in to excite irritation of the urethra and a gleety dis- 

Urethra. charge ; the obstruction, however small or large, 
causes a rebounding upon the prostate, and invaria- 
bly gives rise to irritation and enlargement of that gland. 

In bad cases of stricture a drop of urine is hable to lodge 
behind the stricture, which will, in time, excite irritation, in- 
flammation, ulceration, and ultimately an opening on the inferior 
aspect of the penis, through which the urine drops or flows in 
micturition. 

There is really only one successful method of treatment,^ 
namely, placing the patient under the influence of an anesthetic, 
and carefully dissect out the fistulous tract ; then forcibly intro- 
duce into the urethra, through the stricture, into the bladder, a 
No. 12 silver catheter; it should be retained for about eight days ;. 
the wound should be carefully stitched up. 

By the time the catheter is withdrawn both stricture and fistula 
are usually wiped out and a good cure is the result. 



This may originate from a laceration of the 
Fistula, perinaeum, which extends back through the 

Recto-Vaginal, sphincter muscle of the rectum, which has 
been stitched up, but left an opening between 
the vagina and rectum ; or it may have arisen from chancre in 
the vagina perforating through, or from stricture of the lower 
bowel; foreign bodies ; from the introduction of knitting-needles, 
whalebones, to induce miscarriage, and like conditions. 

It is easily recognized by the passage of gas, liquid or solid 
faeces into the vagina. If very small, and in doubt, empty the 
bowels from above with castor oil ; after it has operated, put 
patient on her back, knees drawn up, and a crow-bill speculum 
into the front part of the vagina ; have a good light, and the 
index finger into the bowel, and examine it all over for an orifice. 
They are seldom high up, and by bulging the rectum with the 
finger, can be easily seen. If very small, so that a pea would 



BACTERICIDES. 37^ 

penetrate through, it can be closed up without an operation if care- 
fully managed. Every second or third day for five or six weeks 
it can be touched with nitric acid; that is, the edges of the 
fistula and a little beyond ; after it is raw, it will begin and throw . 
out granulations that will effectually block up the orifice. It takes 
time and care, and while it is going on, the patient must keep 
bowels very soluble and free from gas, by eating a proper diet. 
If it fails, or if the opening is large, it should be stitched up. 
Patient's bowels having been well cleansed out, placed under 
chloroform on her back, a crow-bill speculum should be inserted, 
and the part exposed to a good light ; its edges should be freely 
pared, so as to have a good raw surface. If the sore is round, 
like a three-cent silver piece, it has to be lengthened slightly, to 
prevent puckering when the stitches are introduced ; then sewed 
up with lead sutures, and the sphincter muscle on both sides of 
the coccyx must be divided, so that the patient can have no con- 
trol of the bowels, that gas and solid matter may pass without 
disturbing the fistula ; bowels locked up for ten days with opium ; 
and kept perfectly quiet in bed for two weeks. If the patient is 
strong and vigorous, all may go well ; the cut sphincter may 
unite ; if it does not, the patient is a miserable object all her 
future life, not being able to hold or have control over her bowels. 
The original fistula, however, unites perfectly, unless there has 
been some bungling in the paring of the edges or application of 
the stitches. 

To obviate the cutting of the sphincter muscle of the rectum, 
tubes have been tried, with partial success. 

In all cases the best of nourishment should be o-iven, so that 
a high standard of health be maintained. 



A fistulous opening from the bladder 
Fistula, into the vagina. 

Vesico-Vaginal. Its common cause is the use of instru- 

ments during delivery, especially if the 
bladder has not been emptied. A full or distended bladder, with 
hurried labor, or with a bad presentation,; or a crooked or de- 
formed pelvis, may also give rise to it ; and various other like 
conditions. It is often caused by ladies attempting to commit 
abortion on themselves by. knitting-needles, whalebones. The 
dribbling of the urine through the orifice, night and day, gives 
rise to irritation, rawness of the vagina and renders the patient 
very miserable, and an object of great distress. 

It should be treated by getting her into as good health as pos- 
sible, and then stitching it up ; placing her upon her arms and 



3^6 DISEASE GERMS. 

knees, head down, parts well exposed by two crow-bill specu- 
lums, a catheter in the bladder. The edges of the fistula should 
be well pared, and then stitched up with lead-wire sutures; patient 
put to bed, and a catheter kept constantly in the bladder. All 
cases are successful. 

Reflex or functional disorders are 

Functional Disorders extremely common, and embrace 
of the Heart. many of the principal organs of the 

body. 

We have selected two as an illustration of them all. 

Functional disorders of the heart are usually brought about 
in this way : the reflex centre, medulla oblongata, is weak from 
some cause or other, so are the various nerves that supply the 
heart. With a weakened bulb, any irritation in the body, such 
as worms, neuralgia, uterine irritation, or irritation of clitoris, 
penis, kidneys, bladder, stomach, liver, will be easily and promptly 
transmitted to the centre, from thence to the heart, giving rise to 
this functional disturbance ; nervous exhaustion, over-study, 
anxiety, sexual excesses, weaken the nervous centre. Tobacco, 
tea, whiskey not only enfeeble the reflex centre, but devitalize the 
heart. Gout, rheumatism, syphilis, mercury, act on the weakened 
cardiac nerves, circulating through them, poisoning them. 

Symptoms. — In the so-called functional derangement, we may 
have every symptom of organic disease, irregular pulse, palpita- 
tion, fluttering, with a cardiac murmur and subcutaneous anaemia, 
in anaemic subjects. Dull, weary ache over region of heart ; 
occasionally sharp, lancinating, catching pain ; inability to lie on 
the affected side, owing to tenderness ; very great mental depres- 
sion ; often dyspepsia, with heart-burn, flatulence, and eructations 
of gas or acid secretions ; vertigo, faintness, noises in ears, specks 
or spots before the eyes, flushing of face, violent palpitations, 
with pulsations in aorta. In women with uterine or ovarian 
trouble, or young men addicted to masturbation, smothering, 
difficulty of breathing, globus hystericus. 

Treatment. — Cases of this kind require fine judgment, long ex- 
perience and keen observation. Symptoms must be relieved, for 
they are real, not imaginary, until the cause can be reached. 
If patient is intelligent, his case should be fully explained to 
him. He must be told his nerve centres are feeble from some 
cause or other ; that his cardiac nerves have lost their tone ; 
that there is an irritation carried to the weakened, but now 
highly impressible bulb, thence transmitted to the heart ; or that 
the nerves of the heart are starved from poor, or poisoned by 
bad blood. Once the cause can be removed there is usually 



15ACTERICIDES. 



377 



little difficulty in the case, but that must be done. Investigations 
-as to them embrace not a cursory but careful examination of 
lungs, stomach, liver, bowels, kidneys, genito-urinary organs, 
skin, blood, for irritation or disease ; and if no cause can be 
found, the case should be treated with alteratives and tonics, with 
irritating plaster over region of heart, and treatment persevered 
with for months. At the same time every means should be 
adopted to invigorate the nerve centres with cinchona, avena, 
matricura, kephaline, coca wine. 



The terms biliousness and torpid 

Functional Disorders liver are very common, and are ap- 

of the Liver. plied to a variety of symptoms, such 

as constipation, sallow and itching 

^kin, dark urine, headaches, lassitude, furred tongue, bitter taste 

in mouth. . 

Functional derangement of the liver may be due to structural 
disease, as chronic inflammation ; abscess, acute yellow atrophy, 
gastric and intestinal dyspepsia, atony of the bowels, organic dis- 
ease of the heart, lungs, kidneys, to syphilis, tuberculosis, ma- 
laria, to a faulty diet, too much hydrocarbon, ale, beer, sedentary 
habits, a deficient supply of oxygen, insanitary state, breathing 
sewer and other deleterious gases ; poor ventilation, anxiety, pro- 
longed mental labor. 

The prominent symptoms which attract attention are anorexia, 
a bitter taste in the mouth due to taurocholic acid in the blood ; 
flatulency, acidity, pyrosis. The tongue is large, pale, flabby, 
with indentations of the teeth along its edges. It may be white, 
with elongated papillae. 

The faeces are pale, unless they have remained a long time in 
the large bowel, when they are blackish. Constipation and 
diarrhea may alternate ; haemorrhoids very common. There is 
often a weight, fulness, tightness, burning, or even a sense of 
actual pain over the liver. There may be obesity, but emaciation 
is liable to take place from deficient production of bile, or from 
disarrangement of the glycogenic function of the liver. 

Bile may saturate the textures of the body, and yet fail to 
poison, so long as the kidneys are active. A torpid liver, with 
obstinate constipation, gives rise to a deficient elimination of 
cholesterin ; lithiates and pigmented bodies in the urine are signs 
of a dormant liver, and the diathesis lithaemia is usually an ante- 
cedent state. 

Renal derangements may be the result of hepatic trouble, and 
in this way liver disturbance gives rise to congestion of the 
Icidneys. 



378 



DISEASE GERMS. 



After the function of the hver has been interfered with for 
some time, its granular structure is Hable to become diseased. 
Amyloid and fatty degeneration is the most common. Senile 
decay, calcareous, atheromatous arterial changes follow next in 
order. The lactic and butyric are next, due to the non-de- 
struction of fibrine in the liver. 

This modern liver torpor seriously impairs the energies of life. 
It dwarfs ambition, creates debility, gives rise to pains in the 
right side, and not infrequently is the cause of numerous diseases, 
as sciatica, lumbao^o, vertig;o, headache, muscae volitantes, melan- 
cholia, insomnia, hypochondriasis, irritable temper, moodiness.. 
It often gives rise to functional disorders of the heart, a variety 
of skm affections. 

The treatment consists in regulating the diet. Forbid the use 
of all starchy or saccharine food ; also all wines and malt liquors. 
Recommend fresh air, moderate exercise, attention to daily alka- 
line bathing, and abandonment of all severe mental strain. 

The bowels should be kept freely opened. Alkalies, as the 
phosphate of soda, are always of service. 

The remedies of real value are those which act directly on the 
liver. Chionanthus virg. is the most efficacious drug in func- 
tional hepatic disturbance. It increases the biliary secretions ; 'it 
influences the disintegration of albumen, and thus relieves a 
weak or overworked organ. Apocynum, podophyllum and 
taraxacum make a good liver stimulant. 

The use of iron, mineral acids, ;iarcotics is contra-indicated. 



In speaking of disease germs, it is not necessary 
Germs to describe the origin, the growth, the development 
Disease, of the human species ; neither is it requisite to 
delineate the process of nutrition, mode of propaga- 
tion, maturation from the most simple element, a cell, up to the 
most complex and perfect bodies, nor the ingestion and digestion 
of food in the stomach, bowels, and its elevation into a vitalizing 
fluid by the lymph canals and pink marrow of the bones — the 
blood, which is the life, a complex Hquid that nourishes brain, 
bone, muscle, gland — a fluid in which infinitesimally flows the 
sparkling, vivifying elements of the soul. In other words, it is 
not necessary to descnbe the process of evoltitioii, but suffi- 
cient it is to say that evolution is simply an ascending develop- 
ment in a particular order — the passage from the least, the low- 
est, to the most highly organized ; from the most simple to the 
most complex ; from the infinitesimal to the giant species ; from 
a simple cell to the climax of brain development in man's sympa- 



BACTERICIDES. 3-.Q 

thetic ganglia. It is a positive process by which the body is 
built up, put together or constructed ; the negative process is dis- 
solution, one of undevelopment, of taking to pieces, when the 
organized, the complex, fall asunder, come back to simple 
original elements. 

Man originates in a simple cell or germ, and this body, when 
of sufficient vitality, with a favorable location, evolves, grows, 
aggregates from its surroundings, and becomes the most com- 
plex and highly organized of all created beings — reaches the 
highest level, the top layer of evolution. Partial or complete dis- 
solution is downwards, retrogressive ; it is a process of change, of 
alteration, of living matter resuming its most simple form, and in 
this process of dissolution normal living matter is changed, 
altered into disease germs. 

Disease may be defined to be any deviation from health, a par- 
tial death or dissolution — a state or condition in which there 
invariably takes place a degradation of the bioplasm of the blood 
of some special tissue or gland. Thus, for example, if the shock 
affects the nervous system — say grief, worry, anxiety — the mat- 
ter concerned in the nutrition of the great sympathetic will be 
degraded into the disease germ, the vibrios, and there will 
probably be typhoid fever or neurasthenia ; if the organs of 
digestion are impaired or damaged, the nutritive elements con- 
cerned in its nutrition are degraded into the disease germ bacte- 
ria ; if the lining membrane of the nose is depressed by colds or 
otherwise, the nutritive elements concerned in its repair or con- 
struction are degraded into the disease germ, the amoeba. The 
degradation may be local, but its pristine seat is in the blood — a 
fluid in which flows the sparkling, vitalizing elements of our 
being. 

There can be no dissolution without pain, without , altered 
secretion, without disease germs being present. Pain, by what- 
ever name it is called, indicates a deficiency of life, a partial 
death, with its changed secretion and disease germs, calls for 
remedies to promote a renewal ; pain is nature's cry for more 
stimulus, more pabulum. It disappears the moment a renewal 
is established. So long 2iS paiji exists colonies of disease germs 
are being formed or evolved, which are important factors in dis- 
ease, being the degraded living elements of special nutrition. 
Pain, even a neurosis, an increased sensibility, whenever and 
wherever it exists, exhibits a deficiency of life and the presence 
of disease germs. Pain follows ; nay, is an integer, a factor, in 
over-work, exhaustion, enfeebled brain, deficient vitality, disease. 
As a result, the mechanism of the human body is deranged, the 
appetite leaves; tongue coats, becomes bulky, dry, indented; 



380 DISEASE GERiMS. 

complexion muddy; countenance has the stamp of suffering, of 
mental depression ; urine deposit lithates ; the stomach, Hver, 
kidneys work feebly, and the individual feels wretched ; jaundiced 
in all his acts, thoughts, because he is clogged up with disease germs. 

True, persons highly and finely organized, feel pain more 
keenly, more acutely than those of a lower oi'ganization ; the 
higher the development, the less reserve of vital force, the less 
the resistance, the more the susceptibility, and less the capacity 
to bear it. No standard can be laid down as to the degree of 
pain. Men and women are variously organized and experience 
it differently. 

Disease germs may be thus defined : " The blood contains 
every element, when properly supplied with food, for the proper 
nourishment of every tissue in the body, as brain, bone, muscle, 
gland ; here all find their primary elements of nutrition. If the 
inherent, innate, vital force, that presides over the evolution of 
each be degraded by any condition adverse to healthy evolution 
or normal health, those primary elements become degraded into 
disease germs." 

Disease germs then consist in the degradation or change or 
alteration of the primary elements in the blood, into other living 
matter which is capable of independent existence, noxious, with 
prodigious power of reproduction if vital force is low, and if 
much shattered may destroy the individual in whom they are 
evolved or from whom the degradation springs, or of being car- 
ried from the seat of evolution and communicated by contagion 
and infection. 

The diseases of this class are very variable, being often differ- 
ent in one race from another, modified by soil and climate, but 
in all cases giving rise to epidemics, as plague, cholera, small- 
pox, diphtheria, catarrh, fevers, hooping cough, cancer, syphilis, 
tuberculosis. Thus disease germs in their varied forms and 
aspects, influence the fate of individuals, of cities and empires ; 
they decimate armies, infest the habitations of the poor in our 
sewage-sodden cities and are direfully fatal to all in feeble health, 
with insanitary surroundings. They are emphatically the scourges 
of mankind. 

The question how microbes act in disease has long been in 
doubt, but the progress of science tends to clear away obscurity. 
The first idea was that they were the factors of disease, that 
when they were evolved or taken in that they acted like parasites, 
lived upon the blood and tissues of their host. No doubt this is 
the case to a certain extent, that they swarm in the blood, ab- 
stract from the red corpuscles the oxygen they require for their 
nutrition. 



BACTERICIDES. 



381 



It often happens that death is so rapid that the bacilH have not 
time to develop in the blood in sufficient numbers to produce 
fatal results, such as in tetanus, anthrax, rabies, in cholera ; in the 
latter especially, death often takes place before the comma- 
bacillus enters the blood. 

An explanation of this state of things is necessary. 

It is this : all disease germs excrete or eliminate in their growth 
and development a poisonous substance, resembling snake 
venom, an alkaloid, the ultimate product of putrid fermentation 
of organic matter, an alkaloid termed ptomaines. The presence 
of this toxical principle is a natural excretion of all microbes, in 
the blood, intestines, brain, stomach, etc., gives rise to debility, 
rigors, fever, pain in sentient nerves, vomiting, diarrhea, hectic, 
delirium, spasm, collapse. 

Poisoning by tainted meat, fish, milk, wool, water, is due to the 
presence of ptomaines. 

The chief action of all pathogenic microbes, of the most harm- 
less as well as the most dangerous class, is due to their excretion 
(in some part of the body) of the ptomaines. This explains the 
speedy death in snake bite, tetanus, rabies, and cholera ; so rapid, 
so sudden, that the germ has simply localized, never entered the 
blood. Although the germ has not been absorbed by the intes- 
tinal mucous membrane, and carried into the blood, the poison- 
ous alkaloid or ptomaine which it excretes, is certainly present, 
and it is to its presence that the symptoms must be ascribed. 

This alkaloid has been extracted from the faeces. 

The action of pathogenic micfobes on and in the human body 
is complex, and may be thus stated. The action of the germ, 
the factor of morbid action, which is nourished at the expense of 
the blood ; the formation and excretion by this same germ of a 
ptomaine, a highly poisonous alkaloid, which acts on the system 
as an annihilator of vital force. 

A ptomaine is a chemical compound which is basic in its 
character, formed either during the putrefaction of animal and 
vegetable matter, or is an excretion from disease germs, some of 
which are not very poisonous, whereas others are so highly 
toxical that they will destroy life almost immediately. 

Ptomaines are formed in the death of matter, in the transition ; 
in the activity of bacterial life, which is present when structures 
are passing from the organic to the inorganic ; they are formed 
in all microbial diseases as an excretion of the germ ; they are 
pure alkaloids, and differ in their poisonous qualities, according to 
the nature and character of the germ which gave them birth. 

Whereas Leticomaines are altogether different, being a basic 
substance found in the living tissues, either as the product offer- 



382 



DISEASE GERMS. 



mentative changes or of destructive metamorphosis — all basic 
substances found in animal tissue during normal life. The term 
is used in contradistinction to the ptomaine, the basic alkaloid of 
putrefaction. 

The leucomaines embrace two groups of waste, uric acid and 
creatine. 

The excretions of all living things, plants and animals are poison- 
ous to the organisms which secrete them. These poisons are 
formed within the body ; they originate in the changes by which 
the complex organism is split up into simpler compounds, urea, 
ammonia, water, carbonic acid gas. It matters little how these 
changes are effected by organized ferments, germs, or by the un- 
organized ferments of the gastric juices, or by unknown agencies, 
which will induce metabolic changes in all the tissues; in all 
cases poisons are formed. 

At all times, but especially in warm weather, there is a pro- 
fusion of both vegetable and animal germs in the atmosphere, of 
which even the most virulent or active cannot find ingress to the 
blood through the bronchial mucous membrane ; but let the 
mouth be open, they find ingress there. The human mouth is 
an excellent culture apparatus, in which too frequently do the 
broods of microbes enter ; for there they find heat, moisture, 
nutrient fluids, naturally provided for their nourishment and 
growth. Besides, the mouth is really the receptive focus, by or 
through which all disease germs enter the body ; but if there is 
a lesion, even infinitesimal in its character, they merge in freely. 
If a few germs enter, they are apt to perish in the blood, but 
when a large mass enter, the vitality of the blood has not the 
power to destroy them. 

Besides disease germs, the degradation of the primary elements 
of our own bodies, we are liable to take into our blood a giant 
form from animals, most malignant, such as anthrax, rabies, 
glanders. 

The vegetable kingdom also furnishes elements, microbes in 
themselves, which enter the human blood, produce microbic 
changes, such as malaria, yellow fever. The degraded bioplasm 
of fruits, cereals, as borne by the wind or dew drops, give rise to 
fearful ravages. 

Races are distinct and antagonistic to each other, so are the 
degradations of living matter into disease germs as distinct as the 
body in which they originated. The origin of disease in the 
Negro, Mongolian, etc., are dependent on the same condition as 
the Caucasian, but the germs are more active, virulent, if they 
are passed into an antagonistic race. 

Not infrequently are animals and plants similarly affected ; all 



BACTERICIDES. 



383 



the result of a deterioration of original histogenetic elements. 
Besides, a special degradation in our own bodies, and that of ani- 
mals and plants, " disease germs " may come into our bodies 
from other persons, or from animals, or from plants, if our vital 
force is weakened in any way, as that condition only permits of 
the ingress of disease germs from any source. 

Germ diseases are more common in our country than in any 
other, mainly on account of the high development of the people, 
their less reserve of vital force, the necessities of a rising civiliza- 
tion, mixed races living in proximity, mingling with antagonistic 
races, our intensely oxygenized atmosphere, our sudden extremes 
of heat and cold, the mental strain or struggle, or worry, etc. 
The mortality from germ diseases is enormous, especially at the 
present time. 

There is a special degradation of living matter corresponding 
to each disease. The practical difference in the evolution of 
those germs turn chiefly upon the amount, kind, degree, quality 
of expenditures of mental or physical force. Enervation, decrepi- 
tude, altered nutrition of various parts of the body follow a 
prodigal waste of the mental or corporeal energies. The quan- 
tum of germ diseases, contagious maladies, falling to our lot as a 
nation is in direct proportion to the demand upon the tissues, the 
character of the food, housing, clothing, and absence of sewage. 

Taken in the order of their greatest fatality, " germ diseases " 
arrange themselves thus: Tuberculosis, typhoid and scarlet 
fevers. Small-pox, hooping-cough, measles, croup, diphtheria, 
dysentery, erysipelas are the most common. 

Germ diseases vary with the density of population, the charac- 
ter of races, location, sewage. Certain trades are very deterio- 
rating ; whereas others are remarkable for their healthiness. 
Life is longer, the freedom from care, worry, excitement ; the 
better the food and clothing, the fresher the air, the more salu- 
brious and cleanly the house, the less th^ confinement. 

Animals and plants, when their vital elements are deteriorated 
by adverse conditions, have also their vital elements of nutrition 
degraded into " disease germs," as anthrax or cattle plague 
among cows is simply a degradation of primary elements into a 
giant disease germ called bacillus anthrax ; and the foot disease 
of the same animals is analogous to the grape and potato rot, 
both being identical with the disease germ oidium albicans in the 
human race. Again, glanders or epizooty (in which we find the 
giant amoeba) is analogous to the amoeba of nasal catarrh. 

Every deviation from health, every disease, has its special 
degradation, its own disease germ, and all are contagious and 
infectious. As, for example, when nerve nutrition is damaged 



384 



DISEASE GERMS. 



there is a special degradation or alteration of neurine into the dis- 
ease geryn vibrios, the germ of typhoid fever and all nervous dis- 
eases. When the elementary matter concerned in the nutrition 
of the air-passages is degraded by adverse conditions we have 
the amoeba, the disease germ of catarrh, chronic laryngitis, 
eustachian deafness, asthma, bronchitis ; when the fundamental 
elements of nutrition are perverted we have the bacteria, the germ 
of boils, erysipelas, wounds, etc. If the elements concerned in 
the nutrition of the sexual organs are degraded by promiscuous 
coition, the syphilic germ is evolved ; if the typical fissures of 
the brain are partially or completely obliterated by consan- 
guinity, sameness, isolation, solitariness, reflex irritation or dis- 
ease, the tubercular germ or bacilli are evolved ; if the vital forces 
are terribly shattered, a dilapidation, a sterility of vital elements, 
there may be a rot, and the oidium albicans is evolved, and so 
with other diseases. 

The discovery of these and other disease germs has done 
much to alleviate human suffering, prolong human life. It has 
created a new system of medicine, a new cure, founded on the 
presence of disease germs in the blood and the employment of 
antiseptics in the treatment — a class of remedies to kill the germ, 
which at the same time tone, invigorate, elevate the standard 
of vital force, and thus prevent further degradation, which enter 
the blood, and coming in direct contact with the germ, annihi- 
late it, without in the least diminishing the vitality of the 
patient. 

Bacteriology has completely revolutionized the practice of 
medicine and the treatment of all diseases. What are bacteria 
or microbes? simply either the degraded bioplasm of our own 
or others' bodies, or of animals, or vegetable cells, the lowest 
forms of existence. All bacteria possess constancy of form, 
marking its complete development. 

All bacteria have a cell wall and cell contents, and multiply 
or reproduce themselves by division or by the formation of 
spores. The spores are surrounded by a thicker and stronger 
cell wall than the bacteria from which they spring, they are con- 
sequently more vigorous than the original bacteria ; can with- 
stand much greater extremes of heat and cold or vicissitudes of 
atmospheric influences. 

In a favorable environment, carefully nurtured, in a proper 
nutrient material, they grow and multiply with great rapidity, 
and if introduced into any animal will reproduce the disease to 
which they are the factor, and in their process of development, in 
the. vital process so resulting, they excrete a chemical product, 
an alkaloid (a ptomaine), which in the living organism occasions 



BACTERICIDES. 



385 



pathological changes, characteristic of infectious diseases, and 
which are antagonistic to the life of the microbes themselves and 
any vital fluid or tissue with which they come in contact. 

These micro-organisms are cellulose, round globular (inicro- 
cocci) ; short rods (bacteria) ; long rods {bacilli) ; spherical, 
twisted {spirilla). 

The atmosphere, water, and even some articles of food, con- 
tain both animal and vegetable germs, even the mineral world in 
which we have the debris of perished creatures. 

From the vegetable world we have micrococci, bacilli and 
other forms of the great family of bacteria, spores of other fungi, 
pollen, seed, parts of flowers. The air of cities is rich in mi- 
crobes of all diseases, from their sewage-laden emanations. 

The determination of the thermal death point of disease germs 
has a very important bearing in prophylactic medicine and cura- 
tive therapeutics. 

The following table exhibits the death point of a few of the 
microbial factors of disease : 

Organisrr. Thermal Death Point.. 

Fahr. 

Bacillus of typhoid fever 132° 

Cholera-spirillum (comma-bacillus) 125.6° 

Cholera-spirillum 125.6° 

Cholera-bacillus 143-6° 

Anthrax-bacillu> (without spores) 129.2° 

Tubercle-bacillus 111 ir>.sh sputum 212° 

Bacillus of glanders. 131° 

Bacillus of tubercle ) 

Bacillus of cancer \ 140° 

Bacillus of syphdis J 

Bacillus from faeces 143.6"^ 

Bacidus of green pus 132.8° 

Bacillus of so-called pneuniocoLC. In 136.4° 

Bacillus of foul blood ' . 212° 

Staphylococcus pyogenes aureus 136.4° 

Staphylococcus pyogenes citrc'us . 143.6° 

Staphylococcus pyogenes albus 143-6° 

Micrococcus of osteomyelitis 136.4° 

(Identical with Staph, aureus) 

Streptococcus of erys pelas 129.2° 

Micrococcus tetragon s 140° 

Bacillus variola 212° 

The spores of all disease germs require a heat nearly fifty per 
cent, greater to kill, than the mother germ itself; ptomaines, the 
excretion of microbes, correspond chemically and pathologically 
with the cadaveric alkaloids, which are indestructible by any 
known heat, or process of calorification. 

The germ theory of disease has, and is producing a complete 
revolution in the treatment ; it has#reated a new system of medi-^ 

25 



386 



DISEASE GERMS. 



cine, a new cure founded on the presence of disease germs and 
their excreta ptomaines in the blood, and the introduction into 
the materia medica of a class of remedies called germicides. 

Bactericides are a series of valuable antiseptics and disinfec- 
tants now becoming of very general use by the highest scientific 
authorities for the purpose of exerting a detrimental influence 
on the evolution, growth, and multiplication of disease germs, in 
either sterilizing or killing them. 

In order that the remedy be pronounced a germicide, it is ne- 
cessary to bring it in direct contact with the disease germ for a 
definite period of time, then remove the germ to a suitable nour- 
ishing medium; if the germs refuse to grow, the conclusion is, 
that the exposure has either injured, sterilized or destroyed its 
life. 

While thus testing whether the remedy be a germicide or not, 
we must bear in mind that Pathogenic Microbes do not thrive in 
an acid medium, neither do they grow well unless there be some 
degree of warmth about blood heat; a very high heat kills all 
germs and parasites. 

In the case of pathogenic microbes, all remedies are to be pro- 
nounced germicides which have the power, when they are ex- 
posed or brought in contact with the micro-organism, of perfectly 
annihilating them. 

Pathog^enic Microbes * either in the human blood or in a suit- 
able nutrient fluid, acted on by a germicide, are incapable of pro- 
ducing the disease, which the same organism, unexposed to the 
substance in question, does produce. 

A perfect germicide then must be capable not merely of destroy- 
ing the micro-organisms and their spores, but also of destroying 
by chemical oxidation the toxic products which they are capable 
of producing. 

The great scavenger of diseased blood is ozone. 

Ozone exists in the atmosphere and is liberated by friction, it 
is manufactured in the laboratory of the chemist in a method 
analogous to that of respiration. This, then, is nature's antisep- 
tic or germicide, the presence of ozone wards off all contagious 
and infectious diseases, it vitalizes all animated nature ; without 
it there is no higher life, without ozonized phosphorus there is 
no thought, no longings after immortality. 

* Pathoi^enic Microbes. — The pathogenic microbes are those which are capable of 
generating disease ; and the evidence on which their disease-producing powers rest 
is, it must be admitted, sufficiently satisfactory, for no microbe is regarded as the cause 
of a disease imless it is, in the first place, found to be constantly present in that dis- 
ease, either in the blood or in the tissues ; secondly, unless when carefully isolated 
and cultivated, it can, when introduced into the body of a healthy animal, give rise 
to the original disease, and be again fon^^d in quantity in the body. 



BACTERICIDES. 



387 



Ozone, then, chemically pure and in an assimilated form, is the 
most important agent in nature and in medicine. When intro- 
duced into the human body it does its work efficiently as a 
scavenger to diseased blood, it also vitalizes the healthy corpuscle 
and tissue, it kills disease germs and eliminates them when dead 
from the body; thus the important factor in disease is destroyed 
and rendered innocuous. 

All the eminent medical men of this age and country attest 
the suprising virtues of the ozone preparations, and it is only a 
question of time as to its general utilization by the profession. 
It is of the greatest utility in all diseases to which flesh is heir to ; 
good in all maladies, acute and chronic, when disease germs 
are lurking in the blood. We have many and numerous agents 
that are active germicides, but none so intrinsrcally valuable as 
C. P. ozone. 

It is a scandal to our civilization if, with a proper knowledge 
of the uses of ozone, typhoid fever, scarlet fever, diphtheria, 
small-pox are permitted to remain the scourge of our day, the 
terror of any parent, and allowed to run their course by succes- 
sive inoculations or infections from child to child, from man to 
man, when our increased knowledge teaches us that here we have 
an agent able to control and destroy any principle of contagion, 
every disease germ in any location. 

Microbes differ greatly in their chemical composition, and in 
their toxical effects upon the nervous system, and the germicide, 
organic or inorganic, which is prescribed for their complete anni- 
hilation, must meet the requirements of a positive strength so that 
when it comes in contact with the organisms, they ever afterwards 
are incapable of growing or multiplying, even their very existence 
is wiped out. 

Some germicides have a special affinity or chemical attraction 
to certain pathogenic microbes, and will unite with them more 
readily, combine with them and destroy them, than others. 

Witness how silently, how efficiently the glycerite of ozone, 
when administered in pulmonary tuberculosis, annihilates the tu- 
bercle bacilli ; and if additional degradation of bioplasm could 
only be prevented, how rapid the cure. 

See the utter annihilation of the streptococcus, oidium albicans 
of diphtheric, the spherical and cylindrical masses making up the 
diphtheric membrane, the micrococci in the blood and every 
gland, and the pathogenic microbe of scarlet fever, if the ozonized 
glycerite of sulphur be freely administered. 

The microbe variola in or out of the body refuses to grow in 
the presence of thuja occidentaHs. Such germicides kill the germ 
and eradicate all ideas of contagion and infection. 



388 



DISEASE GERMS. 



The comma-bacillus of cholera will not grow in the presence 
of lobelia, resorcin, lactic acid, ozone water, peroxide of hy- 
drogen. 

The cancer germ, of all microbes is undoubtedly the most 
difficult to reach by a germicide, although the practical experi- 
ence of a half of the members of our profession in America 
clearly demonstrates that the prolonged use of Chian turpentine 
mixture effectually kills it in the blood and also in the tumor. 
Administer the glycerite of wintergreen in acute rheumatism, fever 
ceases, all its symptoms disappear, because the microbe, its factor, is 
killed. Brush over a diphtheric patch or colony with the ozonized 
distillation of jequirity and the oidmm albicans die ; sprinkle or 
dust or apply in capsule, the ozonized powdered jequirity. to an 
ulcerated neck of the uterus, and the entire brood of bacteria will 
peel or shell off in the form of a false membrane, leaving normal 
tissue unaffected. When the bacteria of erysipelas migrate to 
the skin for free oxygen, if a saturated solution of boroglyceride 
be applied and kept wet, they entirely disappear. 

Witness the extraordinary action of sambul on the sugar fungus 
of diabetes; if administered it thoroughly annihilates it; the re- 
sult is, the languor, debility, chloroform breath disappear ; every 
function, appetite, excretion, becomes normal, and the affected in- 
dividual, with deranged chemical centre in his brain, assumics a 
new lease of life. 

Old physicians can scarcely realize the fact that the addition of 
resorcin to syrup of tolu, and administered in hooping cough, 
will cause the myceb'a to disappear from the breath and blood, 
that morbid action will cease ; or that resorcin jelly applied over 
extensive, burns, will kill the bacteria ; or over the abdomen in 
peritonitis, inflammatory action ceases the moment the microbe 
is destroyed. 

Bring ichthyol close to any vegetable cutaneous parasites, they 
immediately die. The germicide calculated to do the work 
most efficiently should be selected ; sometimes it is advisable to 
use one and sometimes another. The one best suited to the pur- 
pose is one which will retain the largest amount of positive or 
negative ozone, without causing the decomposition of the remedy, 
most of all the ozonized remedies contain from five to ten volumes 
of C. P. ozone, so that they are capable of yielding when taken 
on the stomach five times their own volume of nascent oxygen. 
They are all available for internal administration. 

The more general use of ozonized remedies exhibits a more 
rapid cure of a class of diseases hitherto deemed incurable, and 
a greatly diminished mortality among all contagious and infec- 
tious diseases. 



BACTERICIDES. 



389 



The following table of bactericides is prepared from the most 
careful experiments. One part in thirty will annihilate the bac- 
teria. The. highest or germicide of greatest potency at top, 
weakening as you descend the scale : 

Peroxide of hydrogen. 

Corrosive sublimate. 

Sulphurous acid. 

Boroglyceride. 

Chloride of lime. 

Bisulphate of lime. 

Chlorine. 

Iodine and bromine. 

Chloride of zinc. 

Menthol. 

Thymol. 

Benzoate soda. 

Creosote. 

Benzoic acid. 

Methyl salicylic acid. 

Salicylic acid, 

Eucalyptol. 

Sodium salicylate. 

Carbolic acid. 

Oil cloves. 

Chloral hydrate. 

Permanganate potass. 

The above list, classified in the order of their activity. Each 
of the above, as a remedy, has more or less affinity for a special 
microbe, the factor of some special disease. 

The dose of a germicide must in all cases be innocuous to the 
tissue of the body, and still must be sufficient to either arrest 
their multiplication or sterilize, or destroy them. 



Wild indigo infusion. 

Glucozone. 

Arsenic solutions. 

Glycerite sulphur. 

Glycerite ozone. 

Glycerite vtantetgreen. 

Glycerite kephahne. 

Bisulphate of carbon. 

Con. ozone. 

Resorcin. 

Solol. 

Chian turpentine. 

Naphthaline, 

Quinine. 

Camphor. 

Ozone vi'ater. 

Alcohol. 

Oil of rue. 

Oil of thyme. 

Oil of peppermint. 

Oil of turpentine. 



Oil of erigeron. 

Oil of sassafras. 

Oil of fennel. 

C. P. ozone. 

Siegesbeckie. 

Essence mustard. 

Pmol. 

Ichthyol. 

Creolin. 

Sambux. 

lodol. 

Thallin. 

Hydrocotyle. 

Arbor vita. 

Saccliarin. 

Comp. oxygen. 

Liquid ozone. 

Chloride of carbon. 

Simabicidia. - 

Distillation of jequirity. 

Distillation of witch hazel. 



Amoebse. 



This microscopical vegetable organism, which 
we find present in all cases of nasal catarrh, oz^ena, 
eustachian deafness,ulcerated 
sore throat, chronic laryngi- 
tis, bronchitis, incipient tu- 
berculosis, has a most won- 
derful tenacity of life, difficult 
to sterilize or destroy. Nasal 
catarrh and its kindred affec- 
tions are predisposed to by 
the presence of the microbe 
of syphilis, the bacillus of 
tubercle and other disease 
creating organisms in the 
blood, but the active excitin<^ 
is the amoeba, which is pathogenic of the disease ; bears cul- 




The amceba of nasal catarrh. 



microbial factor of nasal catarrh 



390 



DISEASE GERMS. 



ture well in any nutrient fluid ; the inoculation of the cultures 
into animals produces the disease. The amoeba looks like 
o^o^d^ ' breed by fusion, distension of their cellulose walls, and 
a shedding off of their embryonic broods, they are aerobic, 
take a thermal heat of over 212° F. to destroy them. 

This microbe is sterilized in the presence of ozone et chlorine, 
boroglyceride, resorcin, creolin, peroxide of hydrogen, myrtol,, 
glucozone. 



Bacteria. 

the stomach, 
is found on 



A general term once applied to all disease 
germs, but now restricted to that present on the 
•tongue in malassimilation, or disordered states of 
It is identical with the bacillus megatherium, which 
spoiled vegetables. It consists of large rods, like 
small sausages, four or five times longer 
than wide, usually somewhat curved. 
Transverse division occurs, each seg- 
ment attaining the length of the origmal 
rod. When fresh, they appear non- 
articulated, but when treated with alcohol, 
they are seen to be composed of seg- 
ments. The rods are motile, and form 
irregular chains of a disjointed appear- 
ance. 

They are pathogenic of malassimila- 
tion, bear cultivation well on nutrient 
agar and nutrient gelatine. Cultures 
injected into animals produce profound 
malnutrition ; tongue coating heavily. 
Spore formation in the usual manner. 
If not sterilized or annihilated, it becomes 
an exuberant breeder, giving rise to 
colic. 

This microbe bacteria is the most 
common of all disease germs, being the 
degraded bioplasm of normal nutrition in 
man and plants, changed or altered under 
some adverse state. It is found in all deranged states of the 
alimentary canal in wounds, ulcers, and all breaches of continuity. 
Like all other disease germs, it has marvellous powers of re- 
production under favorable conditions. 

It is either sterilized or annihilated in the presence of eucalyp- 
tol, Warburg's tincture, matricaria, sulphur water, peroxide of 
hydrogen, and other bactericides. 




The Bacteria — the degraded hio- 
plasm of nutrition, magnified 
600 diameters, in an active state 
of growth and nutrition. Spore 
formation is seen beginning in a 
single cell, spreading in link-like 
sausages, which vegetate and 
divide. These protoplasmic 
bodies are surrounded by a cell 
wall or cellulose membrane so 
thin that they are virtually 
naked ; they move either by 
rotation or oscillation. Present 
in erysipelas, boil, gastric fever. 



BACTERICIDES. 



391 



8 



\\ 



\.> 



>\ 



^ 






i 



H 



% 




Micrococci of the pathogenic ; microbe 
of the pneumococcus seen in different 
stages of growth in the prune juice 
ot the sputum prior to the rigor. 



consist of short, thick rods, ahiiost eUipti- 
Bacteria cal cells ; often two to four linked together, 
Pneumonica forming dark granular colonies. 

The lanceolate diplococcus represents the 
only pathogenic microbe or virus of genuine primary pneumo- 
nia. During the first three or four days of the disease the diplo- 
coccus is present in the patient's sputa ^^ 
in an almost pure cultivation; but 0^' 
later on there may be found, side by ■) "^j 
side with it, either the amoeba sub- "2 
tills, or sometimes various pyogenic 
micro-organisms, such as staphylo- 
coccus aureus et albus, bacillus of 
green pus, streptococcus, etc. The 
lanceolate coccus, however, is in- 
variably detected in such enormous 
masses that a pneumonic sputum 
cannot possibly be mistaken for that 
of any other kind — bronchitic, etc. 
Still, in view of the fact that the 
staphylococci, micrococcus tetragenes, 
and such like microbes may stimulate to a certain degree the 
pneumonic cocci, the differential diagnosis in question should be 
always settled by means of plate preparations and cultivation 

experiments, in addition to a micro- 
scopic examination. The diplococcus 
loses its virulence and vitality with 
III ^^^Jjl W f||, characteristic rapidity, both in the 
It /((^^ w [ill patient's system and on artificial 
11 ^--^ ^/^ \^. nutritive media. In the former case 
I ^ [(\^:\ \'m\-i it becomes less and less virulent day 

by day, to perish altogether just after 
the crisis. In artificial media kept 
at 37° C. the microbe loses its vital- 
ity in a week; in that at 40° or 
40.50° C, even in a few days. How- 
ever, when the medium is daily 
renewed, and invariably kept at 32° 
C, the coccus may survive about 
three weeks. In lower animals, on 
inoculation of its pure cultures ob- 
tained from the sputa or pulmonary 
juice (in cases ending fatally before the crisis), the diplococcus 
gives rise to a typical fibrinous pneumonia. We strenuously 
insist that a bacterioscopic examination of tho patient's sputi 




Perfect adult form, of the pneumococcus 
magnified 2000 diameters ; A and B, 
thread forms : C, D and E, rod 
forms; G, diplococci; H, cocci; 
/, streptococci. The pneumococcus 
consist of cocci, ellipsoidal or round, 
sma:le or in pairs (diplococci), rocs 
and thread forms, all enclosed in a 
cell membrane or gelatinous capsule. 



3^2 DISEASE GERMS. 

should be undertaken ; possibly early. The latter should be 
collected always after a preceding thorough disinfection of the 
oral cavity. 

The microbe is pathogenic of pneumonia; grows vigorously in 
blood serum or beef juice. Cultures injected into any animal 
will give rise to the disease. The microbe is most abundant in 
the prune juice sputum, from Vv^hich it is easily isolated. 

The microbe is either sterilized or annihilated by inhalations 
of comp. oxygen, peroxide of hydrogen, glucozone, etc. ; locally 
by concentrated ozone and chloroform over the microbial- 
smitten lung, followed by linseed-meal poultices and resorcin 
jelly. 

Germicides internally, peroxide of hydrogen, alternated with 
liquor ammonia acetatis and sulphate of quinine ; Warburg's 
tincture, antifebrine, resorcin, creolin. 

Jaborandi, administered before microbes form a colony (red 
hepatization), will cause the micro-organism to leave the lungs for 
the skin ; later on, no good. 

The microbe excretes ptomaines freely, the alkaloid being pro- 
ductive of embolism, and cardiac and intestinal paralysis. 



The microbe of all warts, contagium vivtim, a 
Bacterium minute germ. 

Porri. Bears culture well in any warm nutrient 

liquid (is pathogenic), injected into any animal it 
invariably causes an abundant crop of warts to appear over the 
entire body. 

Microbe is at first sterilized, subsequently annihilated, in the 
presence of thuja occidentalis. Washing them over with salt 
water twice daily, and then sprinkling them with calomel. The 
reaction of the residual sodium chloride and calomel produces 
mercuric chloride, which speedily annihilates the microbe without 
the slightest pain. Lactic or acetic acid efficacious. 



The bacillus of butyric acid — the 
Bacillus Amylobacta. microbe of rheumatism. 

This micro-organism results as an 
evolution of fermentation from starchy and saccharine solutions. 
It takes the form of minute cylindrical rods, rounded at their ex- 
treiiities, usually straight, and either isolated or united in chains 
of two or more articulations. They have a gliding motion, and 
are often curved and present slight undulation, they are repro- 
duced by fission, and like all other germs, excrete ptomaines 
freely. They are found most abundantly in cheese, convert the 
lactic acid in milk into butyric acid. 



BACTERICIDES. ^qo 

This microbe, the evolution of fermentation, is pathogenic of 
rheumatism, bears cultivation well, and its injection into animals 
produces the identical condition of rheu- 
matism which we meet with in the human 
subject. The microbe is anaerobic, in the 
ripening of cheese, in the fermentation of 
sauer-kraut, and sour gherkins ; in a case 
of acute rheumatism, the micro-organisms 
can be detected for at least twenty feet from 
the ferment. Ptomaines are excreted freely, 




and are the cause of the intense suffering. shaped forms inciud 



Bacillus Amylobacta, spindle 
shaped fo 
oval spores. 



■ This microbe can either be sterilized or 
completely annihilated in the presence of the glycerite of winter- 
green ; uric acid solvent; salicylate soda in acetate of ammonia ; 
manaca, cascara sagrada tablets ; tine, cimicifuga racemosa. 



wool-sorters' disease, or malignant pustule, con- 
Bacillus sists of rods, long and broad, and threads, with 
Anthracis, spore formation present and ac- 
tive ; rods are straight, or some- 
timse curved, rigid and motionless ; vary in size 
in different animals. The most tenacious of life 
of ail microbes; and excretes ptomaines in great 
abundance, so much so that it is probably as 
fatal a disease germ as rabies. It has a most 
vigorous growth, literally loads the capillaries 
all over the body, lungs, liver, kidney, spleen, 
^ ^ , , , . skin, mucous 

{t^ J -^ (3 ^^ J^ ^_ membrane. In a 

^■^-^ f-" ^J^^ 'k of^ ^ well marked case 

.T^nO--., ^J^^ O 'Serous _ as to 

/7)\.^_^g> G) ^ ©"q"^ ^ cause infraction 

O G)®^ J (^ Q ''^'^'"x-Pq^ of the kidneys, 

" Q) ^ ^^3^ ^ G> pN ^- ^^*^ \oQ>k under a 

'©; -D'?./-;©«l0'o.--'- small power as if 

/ (^ ^^""^--^^^^r- kidney was 

'rZ7% ^ (!) '^ (b rZr. ^ an injected speci- 

,y f.\C) ^ /^ ° . ^^O men. Amhrax, giant bac- 

^nvt,-" .,, r r\ ri.1- leria magnified 6oo 

i.ucillus Anthracis, as seen lu th3 biuud of a (JnC OI the diameters; from 

wool sorter. ^ , . foreis-n wool 

most contagious foreign wool. 

and infectious of all malignant microbic diseases. . Pathogenic 
in the truest sense of the term. 

The sterilization and de.structIon of the germ is most difficult, 
because when a man, woman, or child, or an animal die and are 




394 



DISEASE GERMS. 



buried, the worms bring the germs to the surface and deposit 
them. The excrementary discharges from infected animals find 
a nourishing soil in decaying vegetable and animal matter; and 
their spore formation is active in marshes, rivers, ponds ; inhala- 
tion of spores, ingress by the pulmonary or intestinal mucous 
membrane, or direct inoculation are thus being constantly 
kept up. 

Various theories have been proposed as to the mode in which 
the anthrax bacillus causes death — by embolism, by a ferment 
which decomposes the tissues ; by the evolution of ptomaines. 
From pure cultures of the bacillus, a most deadly alkaloid is ob- 
tained. The same in the blood of the affected individual is so toxi- 
cal that death often takes place before the symptoms of the dis- 
ease appears. 

Bacteriological demonstrations on malignant or 
Bacillus cancerous growths have arrived at the following 

of conclusions : 

Cancer. i. The disease is caused by a special pathogenic 

red-shaped microbe. 
2. The bacilli have slightly ovoid outlines, and are arranged 
most1)^ in pairs and little heaps, their length amounting to one- 
fourth of the diameter of 
a red-blood capsule. 
^ a\ (ST^Njs^^ \ j/^ 3. In a pure cultivation 

vSv J^^ J ^ I ^^^ ^^^^ grow best on 
O £^1^^ ^ if coagulated blood-serum at 
the body temperature. 

4. When inoculated un- 
der the skin in animals, 

The microbe of Cancer. .1 • u • ' t. 

the microbe gives rise to 
a cancerous degeneration, commencing in the nearest lymphatic 
glands, and subsequently spreading to the internal organs, 
especially to the mesenteric glands, omentum, liver and pericar- 
dium. In all the organs genuine cancerous nodules are formed. 

5. Of the lower animals, rabbits and cats prove to be most 
sensitive in regard to the bacterium. When inoculated they die 
in one or two months from cachexy, with generalization of can- 
cerous foci all over the body. 

6. All cancers (of any variety and any organ) seem to be 
caused by one and the same bacillus. 

The microbe is pathogenic of all forms of cancerous growth. 

It is sterilized and annihilated in the presence of Chian turpen- 
tine, saxifraga, sulphate of lime resorcin, thallin, compound saxi- 
fraga and phytolacca ozonized ; siegesbeckie, hydrocotyle. 




BACTERICIDES. 



39S 



This microbe consists of very short rods, with 
Bacillus rounded ends. They are round, ovoid, or spindled 
Indicus. shaped, and have characteristic granular margins, 
having a strong resemblance to the microbes of 
pneumonia and rhinoscleroma, both of which are capable of 
giving rise to the formation of indigo blue, and to indigotic fer- 
mentation. It is pres- 
ent in Addison's dis- 
ease. 

This microbe plays 
an important part, and 
determines the forma 
tion of indigo in varioi s 
diseases. 

Indigo is a fermen- 
tation product, due to 
the action of this m - 
crobe, and not to sin.- 
ple oxidation. 

This indigo bacillus 
is pathogenic ofvarious 
affections, due chiefly 
to non-aeration of the 
blood, bears cultivation 
well. If injected into any animal gives rise to embolism, hepa- 
tization of lungs, cardiac apoplexy, visceral congestion and 
fibrinous exudation. 

This microbe is sterilized in the presence of compound tincture 
kurchicine, eucalyptol, sulphate of quinine, compound oxygen, 
ozone water, liquor ammonia acetatis, belladonna and acro-nar- 
cotics generally ; peroxide of hydrogen. 




Microbe of Indicus, as seen in the liver, magnified 1500 di- 
ameters ; found in pneumonia, Addison's disease, asph^ xia, 
cyanosis, valvular heart disease ; excretes ptomaines freely. 



Bacillus Mallei : 

The Microbe of Glanders 

and Farcy : 



A giant form of bacteria trans- 
mitted to man from the horse. 
The nasal discharge placed in 
the field of the microscope ex- 
hibits the micro-organisms in the 
form of fine rods, about the size of the tubercular bacilli. They 
appear in the form of minute, transparent drops, consisting en- 
tirely of characteristic bacilli. 

When this microbe enters the human blood it takes one or 
other of two forms, either excites by its presence irritation, in- 
flammation of the lining membrane of the nose, which speedily 
passes into ulceration, round, scooped-out ulcers, elevated edges,. 



39^ 



DISEASE GERMS. 




with a central granulation, profuse micro-purulent discharge 
(glan iers), or the microbe causes a germinal blocking up of the 

lymph canals, with en- 
gorgement (farcy). The 
microbe excretes pto- 
maines freely. 

The microbe is the es- 
sential cause of the dis- 
y^^y^ ^_^^%^^^ '"' ^y ease, and is pathogenic. 

Bears most excellent 

Bacillus Mallei,,he microbe of Gla.clers and Farcy. ^^^^^^^ -^ ^^^^ ^^^ ^^ 

meal extracts. 
To Sterilize or Annihilate the Germ.- — It will not grow in the 
presence of peroxide of hydrogen, glucozone, sulphate of lime 
and other bactericides. 

Rods, very fine, like thread forms, mostly col- 
Bacillus in lected in irregular masses, with characteristic 
Tetanus. spore-formation. 

Inoculation of garden earth subcutaneously 
into rabbits induces tetanus. The bacilli found in their blood is 
identical with the microbe in man. 

The germ is pathogenic of the disease, bears cultivation well, 
and is as active after several generations of culture as in its primi- 
tive state. Pre-eminently contagious and infectious, it has an un- 
certain period of incubation, depending upon the status of vital 
force of the inoculated. Cases occurrino: 
twenty-four, thirty-six or forty-eight hours >'<*/ ^\ ^':^t ^^ 
after injury rarely survive the third day, but '%0^*^ ^t 'i'V 
comparatively few are lost when it comes on % ' \ ^ ^*^'^ 
the ninth or eleventh day. "•/;^'o« ' 

The excretion of ptomaines is most active 
in and around the medulla, death often takes Microbe of Tetanus, 
place from them before they have time to enter the blood. 

Sterilized and annihilated by the administration persistently 
every few minutes of a combination of lobelia, capsicum, valerian, 
resorcin and sozoidol, aided with con. ozone and chloroform to 
nape of neck. 

Three rod-formed organisms, which 

Caries and Necrosis, give rise to and are invariably asso- 

Bacilliis saprogciies. ciated with a gangrene of bone and 

putrefactive processes generally. The 

microbe is readily procurable from necrosed bone or from otitis 

media, grows very readily on blood serum. All cultivations 



BACTERICIDES. 



397 



yield the microbe with the pecuHar odor of rotten kitchen 
refuse. 



The bacillus bears in- 
oculation well. 

The microbe becomes 
sterilized in the pres- 
ence of either of the fol- 
lowing remedies: 

Peroxide hydrogen ; 
glucozone ; chloride of 
gold et soda; baptisia ; 
siegesbeckie ; distillation' of jequirity 




\ 






m 



Bacillus Saprogenes, the microbe of Caries and Necrosi 



etc. 



Caused by a tissue-starved brain ; hot 
Caries Dentalis. and cold fluids; indigestion, formation of 
lactic acid degrades the elementary mole- 
cules into a polymorphic bacillus, which is pathogenic of the dis- 
ease, bears cultivation well in beef tea to which some phosphate 
of lime is added. 

Inoculation into animals gives rise to tooth caries. So infec- 
tious is it that one carious tooth will 
contaminate a mouthful. 

The microbe becomes sterilized in the 
presence of the anti-microbe powder ; 
concentrated ozone ; distillation of je- 
quirity ; solutions of boroglyceride ; 
soap-tree bark and hydrogen peroxide ; 
infusions of wild indigo ; fennel ; rue ; 
and nearly all the aromatics. 




Microbe of tooih caries. 

consists of rods, occasionally long, very thin, 

Bacillus and rounded at the ends. They are both 

Tuberculosis straight or curved, and frequently beaded ; 

occur singly, in pairs, or in bundles. They 

are found in the cells of tubercles, especially in the interior of 

giant cells. Propagate by spore formation. 

A tubercle bacillus consists for the most part, of a very deli- 
cate sheath, with protoplasmic contents which have a great 
tendency to be broken up, or coagulated into little segments or 
roundish granules. 



398 



DISEASE GERMS. 



The best medium for cultivation is solid blood serum of cow 
or sheep, with or without the addition of gelatine. The most 
favorable temperature for their development is 98^ F. They 
grow slowly in cold latitudes. 

The bacilli are found in all tubercular deposits of man, animals, 
and birds. The bacilli can be detected in the sputum and 
excretions. 

Strictly contagious and infectious ; food, such as milk, flesh- 
eating, inhalation, close contact ; the bacilli or their spores are 
inhaled from the air, or taken in with food, find ingress by the 
pulmonary or intestinal mucous membrane. 

Morphologically identical bacilli are seen in lupus, tabes, etc. 

The tubercular bacilli is pathogenic of all forms of tubercular 



li% ^Viiix 



^4i: 



.{('.:->, 



^:".: 










Bacillus tuberculosis in the blood. 



Bacilli tubercle in lung structure. 



disease, its inoculation into animals, reproduces the diseases, and 
vice versa into man. Ptomaines excreted give rise to fever, diar- 
rhea, and other symptoms. 

The microbe is both sterilized and annihilated in the presence 
of germicides, of which the glycerite of ozone is the most reliable 
and definite, but distillation of pine, tar, creosote, chlorinated 
soda, comp. oxygen, creolin, peroxide of hydrogen, are of utility. 
The great difficulty in tuberculosis is, there is a nervous blight 
or wreckage, which keeps on degrading normal bioplasm into 
new crops, and until this is overcome the cure is difficult. 



Bacillus in Typhoid Fever 

and 

Nervous Diseases. 



Rods, broad and forming 

filaments, rounded at their 

ends, and constricted in the 

middle like small feathers or 

yarrow leaves, exhibiting 

spore formation. These bacilli are found in the sordes on the 

gums, in Peyer's glands, the spleen, mesenteric glands, lungs, in 

typhoid and in the insane. 



BACTERICIDES. 



399 



Spore formation occurs at the ends of the rods, and is most 
active. 

The microbe is pathogenic, bears cultivation well in any nutri- 
ent broth. Inoculation in all cases reproduces the disease. 

The germ is sterilized and annihilated in the presence of either 
of the following germicides : mixture of carbolic acid and tincture 
of iodine ; or resorcin ; iodol ; lactic 
acid; creosote, salol ; sozoiodol; creo- 
lin ; kaki ; siegesbeckie. 

The microbe of typhoid breeds, ex- 
cretes its ptomaines in the intestines, 
found abundantly in' the stools. Dur- 
ing its growth and multiplication in 
the intestines, the ptomaines are thrown 
off, which form the poison that gives 
rise to fever. The toxi-ptomaine is 
termed typhotoxino. The viiality of this 
germ is so great that freezing will not 
destroy it, and it takes a high heat to 
kill it. Communicated by contagion 
and confection, also by air, food, water, milk. Stools of the 
germ-stricken should be destroyed by fire, as they live in earth, 
water, etc. 






t, 






c 

4^ 






The bacillus of typhoid fever. 



Hay Fever or Asthma. 
Bacillus Subtilis. 



of cylindrical rods of variable lengths and breadths. 



they 



appear as threads, 



The bacillus of hay, rag-weed, 

roses, grapes and other nitrogenous 

bodies, resembles the giant bacteria 

of anthrax, the microbe consisting 

Originally, 

which become developed into rods and 

cocci. They are motile, and are 

provided with a flagellum at each 

end. They are easily obtained 

from any infusion of hay, and 

will grow prodigiously in almost 

any nourishing medium, by 

spore formation and division by 



The microbe is pathogenic of 
hay fever or asthma ; bears cul- 
ture well in any vegetable infu- 
sion. The inoculation of the 
BaciUus Subtilis, the microbe of hay fever. ggj-m into aoy animal produces 
the disease. The excreted ptomaines often give rise to violent 
constitutional disturbance. 




400 



DISEASE GERMS. 



To sterilize or annihilate the microbe, a combination of lobelia, 
stramonium and belladonna (crude) inhaled, or administered in 
tincture form, will sterilize; glonoin, nitrate of amyl ; sulphate 
sparteine, have the same action ; euphorbia piluliform. 

The microbe is annihilated in the presence of pyridin. 



Bacillus in 
Syphilis 



consists of rods, very minute. Two or more 

ovoid points are visible in the course of the rod, 

which are spores. They are best observed from 

the secretion or discharge of the indurated 

chancre, or from the uldfers in the mouth. When the blood is 

searched for them, they are, when present, found in the interior 

of the nucleated cells. The microbe is pathogenic of systemic 




The bacillus in syphilis as seen in the blood. 



syphilis. Bears culture well ; reproduces itself in all red-blooded 
animals when injected subcutaneously. 

The ptomaines excreted by the syphilitic germ are peculiarly 
toxical to skin, mucous membrane, bone, brain, lungs, etc. 
When the atmospheric electrical influences are low, germ breeds 
most actively. Thence the nocturnal pains in bones, etc. 

The micro-organism is annihilated in the presence of saxi- 
fraga, kalmia, phytolacca, stillingia, irisine, sulphur water 
ozonized, sozoiodol. 




BACTERICIDES. ^01 

appears in the form of a rosette of pyriform. 
The Microbe or club-shaped elements. The little masses 

Actinomycosis are arborescent, pure white, of a yellowish 
tinge, visible to the naked eye. 

The microbe effects an entrance to the mouth through an 
abrasion, wound or carious tooth. Then the living organism 
sets up an inflammation, which results in the formation of a 
neoplasm, composed chiefly of round cells, resembling a tuber- 
cular nodule. These may break down or go on increasing in 
size. Fibrous growths may develop between the nodules, and 
these latter into purulent excavations or cavities. The microbe 
has a special affinity for the mouth, gums ; if it does not localize 
there, it may select the lungs. There it pro- >><r'Vr- 
duces great havoc, destroying tissue, forming ^^^SlSl 
fistulae and sinuses, giving rise to fetid expecto- ^ ' 

ration ; often causes caries of the spongy bones. 
The fungus has been detected in the tonsil. 

The fungus bears cultivation well, pathogenic 
of the disease ; extremely contagious and infec- 
tious. Cattle drivers are most generally affected. The microbe of Acii- 
The absence of antiseptic precautions among nomycosis. 

dentists aids greatly in maintaining and propagating the disease. 

The microbe is sterilized and completely annihilated in the 
presence of concentrated ozone, ozonized jequirity, anti-mJcrobe 
powder, peroxide of hydrogen, and other germicides ; but before 
these are applied, free incisions, openings and counter-openings 
into the diseased parts should be made, so that the remedy 
may reach the microbe. 

Bacteria abound in the intestines even irt 
Microbe health, and some have thought that they might 
of Diarrhea, even aid the digestive juices in breaking up 
the food. It is quite likely that they aid in 
breaking up the food, but whether they do so with any advan- 
tage to the organism may be somewhat questionable. They tend 
^^ ^ to split up the products of pancreatic digestion 

,'^^tfi^'\ farther than the pancreatic ferment would, and 
'*!«.*«.y/;r7 one of the substances to which they give rise 
VT.^'«:*-ir5'/- is indol. This body has an antiseptic action, 
'k\ S^^L, and belongs to the aromatic series, members 

*'"iC* " of which, as I shall afterwards have to^show. 
Microbe of d,;.rrhea. ^^^^ ^ ^^^y marked action upon the liver. In 
the intestine it becomes converted into indican, which is absorbed 
and excreted in the urine. 

Diarrhea may depend either upon special microbes or their 
26 






.Q2 DISEASE GERMS. 

ptomaines. These are numerous, but not completely isolated ; 
but that due to cholera and typhoid fever acts to a great 
extent upon the organism by simply producing poisons in the 
intestines. 

To sterilize the entire crowd of germs which produce diar- 
rhea, intestinal disinfectants have been proposed. Naphtha- 
line, which has been recommended by eminent authors, is very 
sparingly soluble; so much so that it passes to a great extent 
unchanged through the whole of the intestinal canal. It cer- 
tainly destroys the disagreeable odor of the motions in infantile 
diarrhea, but it does not appear satisfactorily to check the dis- 
ease. Salol is the phenyl ether of salicylic acid. It passes 
through the stomach unchanged, but in the duodenum it is split 
up by the pancreatic juice into salicylic and carbolic acids. 

Although the carbolic acid 
is set free at the point 
where its action is wished, 
yet there is still the dis- 
advantage of its being 
poisonous, and so betol has 
been recommended. The 
constitution of this sub- 
stance is similar to that of 
salol, but it splits up into 
salicylic acid and beta-naph- 
thol, which is much m.ore 
sparingly soluble, and which 

Microbe ofsummer diarrhea, magnified 2000 jg |^gg poisonOUS thaUCar- 

bolic acid, while it is much 
more powerfully antiseptic. Resorcin, thymol and benzoate of 
soda are among the antiseptic remedies which sometimes are 
useful, but these are either weak or subject to the same objec- 
tions as carbolic acid. 

Direction in wliicJi to look for Intestinal Disinfectants. — When 
we consider the enormous number of aromatic compounds which 
have an antiseptic action, we may expect almost with certainty 
that amongst them most useful remedies are to be found for 
diarrhea, and .Pellicani has found that substances containing a 
diphenyl nucleus are less poisonous, and at the same time more 
powerfully antiseptic, than those containing a single phenyl 
nucleus. 

But there is another class of sulpho compounds — the sul- 
phonic compounds — in which the atom of sulphur, instead of 
being united by means of oxygen to the aromatic nucleus, is 
attached directly to one of the carbon atoms in that nucleus. 




BACTERICIDES. 403 

One such compound — ortho-phenol-sulphonic acid, or aseptol, 
as it has been christened — has been introduced both as a local 
antiseptic and as an intestinal disinfectant. The commercial 
aseptol is a solution containing one part in three, and it is 
administered internally, in the same dose as salicylic acid, in cases 
both of gastric and intestinal catairh, and apparently with good 
results. 

The comma-bacillus. Curved rods 
Microbe of spirilla and threads. The curved rods 

Epidemic Cholera, or commas occur isolated or in masses, 
or attached to each other forming; S- 
shaped organisms or longer screw forms. The commas are 
actively motile, rapid in development, excrete ptomaines abun- 
dantly in the superficial necrosed layer of the 
intestine, in the mucous flakes and liquid con- 
tents of the intestinal canal of epidemic chol- 
era, and often cause death before the germ has 
time to enter the blood. 

It is pathogenic of the disease, bears arti- 
ficial cultivation well in broth, and reproduces 
itself by either being injected or fed to 
animals. 

The microbe is either sterilized or com- 
pletely annihilated in the presence of salol, The comma wiiius of 
creolin, sozoiodol, lactic acid, naphthaline, tercbene. 




when isolated from the ordinary excremen- 
The Microbe of titious matter of the lower bowel, appears 
Dysentery, in the field of the microscope as a germ, 
slightly elongated and oval, or short and 
cylindrical, with rounded ends. They divide by fission ; like the 
micrococci, the individual elongating and becoming constricted 
^ in the middle, capable of spontaneous locomo- 

^-•^y^ -^ tion, having a flagellum at one or both ends, 

with which they perform active spinning or 
darting movements. They are capable of 
forming zooglcea, in which the interstitial 
gelatinous is more copious. The microbe is 
^V*f pathogenic of the disease, bears cultivation 

•^ well in any broth, the cultures when injected 

The microbe of dysentery. -^^^ animals give US all the virulcnce of the 
original disease. The micro-organism is indigenous to the rec- 
tum and colon ; breeds and multiplies there, excretes ptomaines 
^hich give rise to the tenesmus, fever, furred tongue. 




404 



DISEASE GERMS. 



The micro- organism is either steriHzed or completely annihi- 
lated in the presence of ozonized stone crop ; creolin, peroxide 
of hydrogen; naphthaline; resorcin; essence of mustard ozonized; 
salicylic acid in acetate of ammonia. 



The Microbe of Influenza. 

Asthmatus Ciliaris, 



Infusorial catarrh, epidemic 
influenza, very common during 
the winter months. The mi- 
crobe is a flagellated infusoria, 
It is pathogenic, bears cultivation well in 



with body and cilia, 
any nutrient fluid. 

While in the body it excretes ptomaines so freely that they 




Microbe of iiifluenza; infusorial catarrh. 

are to be found in great abundance in the urine, and often cause 
sudden death. 

The microbe is sterilized and completely annihilated in the 
presence of jaborandi, and peroxide of hydrogen internally ; 
inhalation of either glucozone, or menthol, or nascent chloride 
of ammonia, or ozonized sulphur water, or benzoate of soda. 






Identical with that of erysipelas. 
The Microbe of Boils. The pus from a boil contains bac- 
teria, analogous to those in the 
lymphatics of erysipelas, bearing culti- 
^^^^10^^^^, vation well. Pathogenic. 

The local application of equal parts 

^^ .,-... either ozone ointment and resorcin, 

^^^^M^^i^^^f'^^^^''^!^^ or citrine ointment, applied before posi- 
tive suppuration occurs, kills the mi- 
crobe. A thick coating applied gives 
" '^*K\%'J ,- rise to a drawing sensation, followed by 

Staphylococcus pyogenes aureus ; complctc ccssation of pain and tcndcr- 

the microbe of boils. npQC 

Carbuncles may be well treated by applying a cerate made of 
ichthyol, four parts ; camphorated cerate, fifteen parts. Apply 
on lint. The pain is relieved and the disease is arrested or modi- 
fied. 




BACTERICIDES. 405 

Salicylic acid and extract of belladonna ; or ichthyol, one 
drachm to a half ounce of water sterilizes the microbe ; whereas, 
internally, either brewers' yeast, ozone water, iodol, one-fourth 
<^rain doses sulphide calcium, lycopodium and other germicides 
have a remarkable action in sterilizing the germ. 

A most excellent method is to inject a few drops of the per- 
oxide of hydrogen into the centre of the boil. 




This unpigmented amoeboid body makes 

The Microbe of its way into a red blood corpuscle, and 

Malaria. lives and increases in size at the expense 

of the latter. It becomes pigmented, the 

pigment-granules being changed to haemoglobin. It has been 

demonstrated that the granules contain iron. 

Having come to occupy the entire, or almost the entire, cor- 
puscle, it enters upon a cyst stage, during which the pigment- 
granules make their way to the centre, and segmentation of the 
periphery takes place, thus forming spores, which are subse- 
quently set free. Each spore then begins again 
the same life circle. 

The biological relation of the crescentic and 
flagellated forms to the others has not been made 
out. But there are, among the lower animal 
organisms, many polymorphic varieties, which 
at different periods of development exist as 
spores, amoeboid bodies, cysts, and flagellated 
organisms. Among the protozoa, some forms The badiius of malaria, 
develop falciform spores which in appearance resemble the 
■crescents. 

The paroxysm seems to be the period at which the segmenta- 
tion and setting free of spores takes place. This is now tolerably 
definitely settled. The discovery in the blood of the segmenting 
bodies, justifies the positive prediction that the patient will have 
a chill at some time within two hours. Immediately after the 
paroxysm one finds free spores and unpigmented amoeboid 
bodies. During the day of intermission the pigmented amoeboid 
forms gradually increase in size till six or eight hours before the 
chill, when the cyst stage is met with. Immediately before and 
during the chill, one finds the segmenting forms. 

The germ is pathogenic of the disease, will grow in almost 
any nutrient fluid. 

Inoculative experiments on human beings are almost uniformly 
successful. Intravenous injection of malarial blood into a 
healthy individual is followed by typical intermittent fever, with 



4o6 DISEASE GERMS. 

the appearance in the blood of the second person of the various 
forms of the organism described. 

The germ is steriHzed by the administration of quinine ; com- 
pletely annihilated by comp. tine, kurchicine; Warburg's tincture 
alternated with green root tincture of gelsemium. 

The more atoms of carbon a drug contains, the more pov/erful 
is its anti-malarial effect, kurchicine and eucalyptol each contain 
twenty atoms of carbon, and are distinctly germicidal to this germ. 



Poverty of nerve force invariably gives 

The Microbe of rise to the evolution of a pathogenic mi- 
Neurasthenia, crobe, which bears cultivation well in a 
broth of wheaten grits. It can be readily 
isolated from the tongue of an insane individual, and can be 
found in all states of nervous exhaustion, languor, headache, neu- 
ralgia, spermatorrhea, impotency, suicidal mania; most com- 
monly met with among males. The presence of this microbe 
explains why suicide and spermatorrhea are epidemic, impotency 
endemic, insanity contagious. 

The first appearance of this microbe in a man strikes at the 
origin of life, saps his sexual vigor, causes the disappearance of 
spermatozoa in the prostatic secretion, and in their stead sper- 
matic crystals appear, which are devoid of all vitalizing or ferti- 
lizing elements. 

Kill this microbe with bactericides, languor, headache, suicidal 
mania disappear, the ravings of the insane will cease, impotency 
and sexual callousness be wiped out. 

The remedies to sterilize this microbe and cause its disappear- 
ance from the nervous system are : cerebin, glycerite of kepha- 
line, avena sativa, electricity and vitalized massag^. 



Pathogenic of all chronic bronchial 
The Conferva of affections, found in greatest abundance 
Chronic Bronchitis, in the slate-colored sputum. 

Bears cultivation well in liquid gela- 
tine ; cultures injected into animals give the cadaverous cough^ 
with its decided prostration so peculiar to the disease. 




The conferva of bronchitis. 



The micro-organism being difficult to reach, even by inhala- 
tion, renders the malady essentially very chronic ; however, it is 
sterilized in the presence of creosote, peroxide of hydrogen. 



BACTERICIDES. ^0/ 

glycerite of kephaline, lobelia, senega, ammonia, and completely- 
annihilated by resorcin in syrup of tolu ; salicylic acid, and acetate 
of ammonia. 

A streptococcus massed upon the thickened 
Micrococcus valves of the heart, small chains, three or four 
Endocarditis, linked irregularly together, later on they as- 
sume the form of zooglcea and are found con- 
gregated together and form plugs in the vessels of the muscular 
tissue of the heart. In the detritus of the ulceration which fol- 
lows, they are found in chains. 

The micrococci are also found in the spleen, kidneys, liver, 
lungs, lymphatics, blood. They bear cultivation well in beef 
tea. This microbe is pathogenic of the disease. 

The changes in the heart after death give evidence of great 
microbial growth, the muscular structure is engorged, red ; later 
it assumes a grayish, mottled, opaque, buff color, and finally 
changes to green. 

The microscopical appearances vary much, but simply eluci- 
date different stages of germ proliferation, a degenerative pro- 
cess, a breaking down of tissue and formation of abscess ; muscu- 
lar tissue, in chronic cases, is replaced by a new formation or cal- 
careous deposits. 

This micrococcus is most difficult to steriHze or annihilate; 
quinine, strophanthus and other drugs of no avail. 



The gonococcus, cocci, singly, in pairs, 
Micrococcus groups. They are found in great abundance 
Gonorrhea. in the muco-purulent dis- 
charge from the urethra, in 
the pus of a soft chancre and buboes. The 
microbe bears cultivation well in nutrient 
broth, and the pathogenic character of the 
cocci is established beyond all doubt by inocu- 
lation. 

The micro organism is sterilized and com- Micrococcus of gonor- 
pletely annihilated by the ozonized distillation houfs^^afteP^lts^'dis^ 
of eucalyptus, by the introduction of the thai- tc^Zl'n s^verli foTms 
lin ozonized bougies into the urethra; inter- of fission of their nu- 

,- , • • 1 1-111 clei. and micrococci 

nally by germicides which dodge or are un- moving in the proto- 
affected by the gastric juice, and are excreted p"'" ^^ '°° '^"'"^ 
by the urethra in molecules, which coming in contact with the 
microbe, kill it. Those embrace balsam copaiba, oleum tere- 
binth, petroleum, sandal-wood, cubebs, kava kava, etc. 




4o8 



DISEASE GERMS. 



Micrococcus 
in Haemophilia. 



Neonatorum, a coccus characteristic of 
this disease, has been found in hemorrhage 



of infants and 
pathogenic. 



young persons, which is 



Micrococci 
Scarlatina. 



Blood germ-laden with the micrococci ; mouth 
and. glands of the throat swarming. The germ 
is minute, seeks the skin for free oxygen, where 
it will breed (if not smeared over with olive oil 



^•s— ~» 







.^^ 


h 


5* % 


J. 



-<--<5k -i'^Ss 



^? 



'<^ 



Streptococcus of scarlatina and magnified 
50Q diameters ; lound on the mucous 
membrane ot the mouth, tongue, tonsils, 
mvula. These, during the fever, prior to 
their appearance on the skin, form or 
grow into large diplococci and cocci in 
ctiains. and thick zoogloea are found on 
the larynx. The capillaries and inter- 
lobular spaces are blocked with cocci. 



and resorcin or ozone ointment) in 
the scales of the desquamating epi- 
dermis ; will continue this in colo- 
nies if not smothered out for two 
weeks or more. 

It is the deficiency of vital force, 
amount of germs present, with their 
ptomaine excretion, which give rise 
to the three forms of this fever. 

Pathogenic — Sterilized and anni- 
hilated in the presence of glycerite 
of sulphur, sulphide of lime, per- 
oxide of hydrogen, sulphur water. 
These also destroy spores and check 
the evolution of ptomaines. 



'j:s$:^ 



Round cocci and diplococci have been found 
Micrococcus in the watery discharge from the eyes and, in 
in the sweat, eruption, ca- 

Measles. pillary vessels and blood 
of patients affected with 
measles. After the stage of incubation, 
ten days, and of active sprouting, four 
days, the micrococci leaves the blood and 
migrates to the skin for free oxygen. 

The germ is pathogenic, bears culture 
well. The disease is reproduced in 
animals by either feeding or injecting the cultures. The germ is 
easily sterilized and destroyed by either the administration of 
jaborandi or resorcin. 

We find, in a small-pox pustule, micrococci, either 

Variola, isolated or united, which may be seen on a section 

of the skin. The same microbe may be observed 

on the pustules of the mucous membrane of the mouth or 

1 xrynx, in the liv^er, kidneys and blood. 



^mm.:^:^ 



Micrococci of measles. 



BACTERICIDES. .qq 

The micrococci are pathogenic of the disease, bear cultivation 
"^well in any warm, nutrient broth ; cultures, injected or fed, will 
reproduce the disease in either man or animals. j^^^ 

The micrococcus, found in small-pox pustules, --5*'''%:':'j::*.;*,.. 
does not differ in its form from that of the cow- -^v^^usffi^i 
pox in cows ; chemically, morphologically and ^t$'^J:A^'- 
microscopically, they are the same ; they are " i'-:^^^^<>^. -.■, 
completely sterilized and annihilated by the /''^''^v..'"-" 
same remedies, to wit, thuja, sulphide of lime. The micrococci of 
dioxide of hydrogen and bichloride of mercury. smaii-pox. 



This microbe is found in the sputum of pa- 
Micrococcus tients suffering from pulmonary tuberculosis 
Tetragonus. and in the walls of the cavities in the germ- 
eaten lung. 
They are found in groups of four (tetrads) surrounded by a 
hyaline capsule. Present invariably when the actinomyces are 
I ^ in lung structure. They 

^ \^ %. I V ^^^ pathogenic of vomica, 

^ Vw'>ily,^^\ %% caverns in the lung; bear 

^^^^_^f I V^^ML. ^1 cultivation well; reproduce 

" " *" ^ ^^%w ^^^ disease in animals. 

Groups of the charac- 
teristic tetrad are found 
in the capillaries, lungs, 
spleen and kidney after 
death. 
^ \^ ^ ^ When present, urine 

V" i^^-^ I ^ usually loaded with pto- 

Micrococcus tetragonus; from the walls of a vomica mainCS. Thc prCSCnCeof 

'" '^^ ^""^- those deadly alkaloids ex- 

plains the sweats, diarrhea, hectic fever that are present. 

The microbe is sterilized in the presence of glycerite of ozone, 
tar syrup, peroxide of hydrogen; completely annihilated by kepha- 
line and toluene. 






Actively motile, dumb- Qr^t:!^ t^ 
Micrococcus bell cocci are found in the o o&«^SB< 
in blood, lymphatics, in all ^ \^^^^^^ 
Typhus. cases of typhus, ship or g © ^^j|fo 
jail fever. /T)!^^^^^ 
They are isolated from the breath, ;^ ' 
saliva, sweat, the eruption. They are <> Vo ^ 
pathogenic ; easily cultivated in any nutri- 
ent medium The microbe of typhus fever. 



(Sy o J^J* 



410 



DISEASE GERMS. 



An injection of the cultures into animals reproduces the disease. 

A course of ordinary germicides effects a destruction of the 
micro-organisms in the blood. 

The same class of remedies, act also as prophylactics, by steril- 
izing the blood. 



Micrococcus 
Urea. 



*=»C!,, 






"^Ofl*- 



The transformation of the urea (the nitro- 
genous principle of urine) into ammonia and 
carbonic acid, under the influence of a microbe^ 
appears in the form of free globules of articu- 
lated filaments, or of chaplets, resembling those of the lactic fer- 
ments. So long as the bladder is perfectly empty, that is per- 
fectly evacuated, no residual urine, there is 
no microbe in it, but let there be some little 
retention, probably owing to an enlarged pros- 
tate, then this microbe is evolved. True it 
is often carried into the urethra by bougies^ 
catheters, sounds, but very generally found 
in the bottom of the chamber. This microbe 
is the true cause of ammoniacal fermentation 
and intense uriniferous odor. 

The germ is positively sterilized and anni- 
hilated by boroglyceride internally and locally. 



-e«* 



,oo<S^^^ 



<£C30©« 00^2252, 



"^^ 



Micrococcus urea, mag- 
nified 1500 diameters, 
as found in the bladder 
of all patients wiih pros- 
latorrhosa, catarrh or 
ulceration of the blad- 
aer, with dribbling 
urine; a germ of rapid 
growth. 



Micrococcus in Hooping 
Cough. 



Elliptical cocci, having a strong 
resemblance to the oidium albi- 
cans or its mycelia, are constantly 
present in the breath, expectora- 



tion and secretions of all individuals suffer- 
ing from pertussis. In the sputum of 
patients affected, in their blood, micrococci 
resembling figure 8. 

The microbe bears culture well, and is 
pathogenic of the malady. Culture in- 
jected or fed to animals reproduces the 
original disease in all its virulence and 
precision. It is an active ptomaine elimi- 
nator, to whose toxic presence is due the em- 
bolism of blood, fever, vomiting, convulsions. 

The micrococcus is either sterilized or annihilated in the presence 
of either of the following remedies: Syr. tolu, with resorcin and 
thymol ; bromide of sozoiodol ; ozonized tar syrup and creolin ; 
tincture of iodine, siegesbeckie, and in all cases the apartment 
in which the child is domiciled should be fumigated twice a week. 




Micrococcus of hooping- 
cough . 



BACTERICIDES. 



41 r 



for half an hour on each occasion, with burning sulphur. Local 
stimulation to nape of neck of value as a means of raising the 
standard of vitality, on that part of the cervical portion of the 
cord upon which the microbe feeds. 



Cells partly round, oval or cylindrical, 

Oidium Albicans, all sizes. The bud colonies consist of 

rows of cylindrical cells ; from the ends 

oval or round cells sprout; spores 

form singly in roundish cells. They 

are found on the mucous membrane 

of the mouth, tonsils, dorsum of the 

tongue ; very common in children 

in the grayish-white patches, sore 

mouth and on the nipple. 

Bears cultivation well in sweetened 

water and tartrate of ammonia. The 

cells germinate according to its rich- 
ness in sugar. 

The oidium albicans is sterilized. The oidium Albicans. 

completely annihilated, in the presence of a solution of boro- 
glyceride, resorcin, creolin, naphthaline. 




Within a distance of five miles from 
the emptying of any sewer into a river,, 
this microbe is found, few, and at some 
distance at the five mile point, but more numerous as the point 
of egress of the sewer is reached. As found it consists of thin 

threads, with numerous narrow 
windings. The threads have pri- 
mary and secondary windings, 
very irregular ; their ends cut off 
bluntly, and they exhibit rapid 
movement. Besides being com- 
mon in rivers into which sewage 
empties, they are abundant in 
marsh water, and can be obtained by allowing algae to decom- 
pose in water. On cultivation, the threads break up into long 
rods, short rods, and finally cocci. 

Progressive cultivations finally produce the microbe of typhoid 
fever. 

The spirillum plicatile in water can be sterilized either by the 
addition of a few drops of dioxide of hydrogen, or comp. oxygen,. 



Spirillum Plicatile. 



Spirillum Plicatile [Marsh Spirochaite). 
From sewage, contaminated water ; 
magnified 1200. 



412 DISEASE GERMS. 

ozone water, aromatic sulphuric acid, sulphur water, or com- 
pletely annihilated by passing the fumes caused by dropping sul- 
phuric acid on permanganate of potassa, or by the addition of 
lime. 



This germ consists of threads, 
Spirillum of Relapsing with screw curves. They move 
Fever. rapidly and exhibit peculiar wave- 

like undulations. They are found 
in the blood of patients suffering from relapsing fever. They are 
to be found only during the relapses, and are absent during the 
non-febrile intervals. Their number is usually great, excessive 
as it nears the fifth or sixth week. 

They are pathogenic of the disease, bear cultivation well in 
blood serum or broth highly salted. 

Cultures are inoculated successfully into all animals near to 
man in the scale of being ; lower grade of quadrupeds, negative 
results. The prodigious ptomaine excretion occurs every seventh 
day, at which time the multiplication of the germs are enormous. 
The microbe is either sterilized or killed in the presence of con. 
tincture of kurchicine, or Warburg's tinct., avena sativa ; euca- 
lyptol. 



The cells lie singly or in pairs, or in 
Streptococcus in rosaries, or in spherical or cylindrical 
Diphtheria. masses. 

A microbe of easy cultivation on blood 
serum, or veal or lamb broth. A small piece of the membrane 
, j ^^ affords the best bacilli. So far successive 

generations have not been attained. 

Its malignancy is due to its very rapid 
excretion of ptomaines, a very toxical alka- 
loid. 
-inL-''^^^ '^^^ germ is pathogenic. 

\ri^^^^i^^^^ I^ maybe sterilized in the presence ot 

M'ij'j^^0j:f%^ i the glycerite of sulphur, resorcin, carbolic 
-'' r^y'^fh"-''' acid and tincture of iodine, and com- 
streptococcus of diphtheria. ^j^^^j^^ annihilated by brushing it over with 

a distillation of jequirity bean, lactic acid, hydrogen peroxide ; 
solution of salicylate soda. 

From the cultivations of diphtheria microbe, an exceedingly 
soluble alkaloid has been obtained, which induces embolism, 
■paralysis and rapid death (ptomaine). 




BACTERICIDES. 



415 



resembles that of diphtheria ; in well-marked 

The Microbe cases the blood and kidneys are thoroughly 
of Croup infiltrated with the micrococci. They often 
unite or are agglutinated in small masses, 
forming zooglcea. Found in all the tissues, even in the marrow of 
bones. 

They bear cultivation well, and the cultures injected in animals 
give rise to the disease. 

The germ is sterilized or annihilated in the presence of acetic 
or lactic acid ; sulphide of calcium ; either of these remedies 
checks the evolution of microbes in the blood and tissues. 

Here, as well as in diphtheria, too much cannot be said against 
the misuse of emetics. The administration of such an agent 
may remove the false membrane in which the micrococci are im- 
bedded, and leave an irritated or bleeding mucous membrane 
behind, which is a most attractive and luxuriant pasture field for 
an additional multiplication of the micrococci, which are sown 
there afresh, and reproduced with fearful rapidity. 



Streptococcus 

in Cerebro-spinal 

Meningitis. 



Cocci, diplococci and chains are found 
in the cerebro-spinal fluid, base of brain,, 
around the medulla oblongata, spinal 
cord ; zoogloea in 




spleen, liver, kid- 
neys. In all cases excretes ptomaines freely, 
hence its remarkable fatal character. 

The microbe is pathogenic of the patho- 
logical state ; bears cultivation well in bar- 
ley broth. 

Difficult to sterilize or annihilate ; best 
remedies are those which induce a quasi- 
suspension of the activity of the brain and 
cord, such as scull-cap, lobelia, calabar bean, gelsemium, alter- 
nated with either peroxide of hydrogen, resorcin, sulphur water. 

Recent bacteriological investigation reveals a micro-organism 
morphologically and biologically identical with this streptococcus 
in inflammation of the brain-substance. 



Streptococcus in cerebr 
spinal meningitis, 
(bpotted fever ) 



The bioplasm of normal nutrition,. 

changed, altered, degraded by adverse 

conditions into other living matter, which 

acquires an independent form of existence^ 

with prodigious power of growth and multiplication ; a disease 

germ. The micrococcus erysipelas is very small, consisting of 



Streptococcus 
Erysipelatosus. 



414 



DISEASE GERMS. 



s. 



•n^ 



Streptococcus of erysipelas. 



tninute cocci in chains, found in the mouth, breath, blood, faeces, 
kidneys, and by millions in the erysipelatous blush. They occupy 
the lymphatics of the skin, and as they 
sprout and multiply, spread along these 
just at the margin of the erysipelatous 
zone, where the microbes are multiplying 
by millions, marked by the characteristic 
redness and swelling ; the lymph glands 
-are filled with zoogloea of micrococci and the injection of these 
vessels keep pace with microbe growth ; contagious and infectious. 
The germ is pathogenic of the disease ; artificial culture suc- 
ceeds well on nutrient base ; inoculation into animals gives us the 
characteristic. 

To sterilize or annihilate the microbe, solution of boroglyceride, 
kept constantly wet, over the microbic patch ; internally emetic 
of lobelia, followed with either ozone or sulphur water, or resorcin, 
or sozoiodol ; peroxide of hydrogen. 



Streptococcus 

of 
Foot Disease. 



Cocci, singly, in dumb-bells, and in curved 
chains, essentially identical with the oidium 
albicans or rot, with the exception that they 
grow well in milk, in alkaline peptone broth, 
in almost any nutrient fluid. Very common 
among cows which feed on marshy pasture, or insanitary condi- 
tion; found in their milk, and by or through that fluid give rise to 
diphtheria, scarlet fever and malignant stomatitis in children. 




Streptococcus of foot disease, magnified 50 diameters. 



The microbe is pathogenic of the disease, bears cultivation 
well for ages. Cultures injected into animals gives rise to diph- 
theric effusion and death. 

Same remedies sterilize and annihilate as in diphtheria. 



BACTERICIDES. 



•415 



Pathogenic, and the cause of amyloid 
Streptococcus degeneration; microbe can be isolated from 
Pyogenes. pus or muco-purulent matter, most abundant 
when greenish colored, whether pure or from 
bandages. The bacillus consists of slender rods, linked two or 
three together, or collected in irregular masses. Multiplies rap- 
idly by spore formation on 
liquid gelatine. In twenty- 
four hours culture exhibits a 
greenish pigment or coloring- 
principle "• pyocanhiP The 
p-erminal mass is soluble in 
acidulated water, which it 
colors red; neutral solution 
is blue. The microbe crys- 
talizes in chloroform in long 
needles, and in some cases 
form lamellar prisms. 

To sterilize or annihilate the microbe, iodized* oil, saxifraga 
■ozonized, phosphated tincture of oats, kephaUne, glycerite of 
ozone, matricaria, comp. siegesbeckie, iodide potass, ozone water, 
peroxide of hydrogen. 




Streptococcus 
in Puerperal Fever. 



Cocci in zoogloea, and sometimes in 
chains, have been found in all organs 
affected in puerperal fever, and espe- 
cially in the lochial clots or discharge 
in the blood, brain, heart, lungs, spleen, kidney. 

The microbe bears cultivation well, and is pathogenic of the 
fever. 

It is sterilized and completely annihilated in the presence of 
either hydrogen peroxide, or resorcin, or creolin internally, 
with intra-uterine injections of either boro- 
glyceride, creolin, chlorinated soda, peroxide 
of hydrogen, and locally over the entire 
abdomen either ozonized turpentine, followed 
by resorcin paste, or concentrated ozone, with 
chloroform and creolin. 

The production of ptomaines in the blood 
and tissues plays an important part in the 
gravity and fatality of the disease. So very 
great are they in this affection that they can be readily isolated 
from the urine. 






/ 






The pathogenic microbes 
of puerperal fever. 



4i6 



DISEASE GERMS. 



Cocci, microscopically minute, are found 

Streptococcus in in the blood, brain, vomit, stomach, spleen, 
Yellow Fever. liver, kidneys. They occur in chains, 
aggregate into masses, distend the capil- 
laries of the organs enumerated, exciting inflammation, with 
acute fatty degeneration of liver, kidneys, spleen. 

The microbe is pathogenic of the disease. Difficult of cultiva- 
tion so far. 

Ptomaines cause the vomiting, acute inflammation of stomach,, 
liver, spleen, kidneys ; the intense prostration, fever. 

It seems to be sterilized in the presence of dilute hydrocyanic 
acid, comp. tincture of kurchicine, ozone water, Warburg's 
tincture. 

The microbe, or fungus of yellow fever, has (up to the present 
date) not been isolated. A paludal germ, probably originating 
in the delta of the Mississippi, spread by maritime commerce 
over the whole inter-tropical zone of the globe. Centres of 
infection, the sea-boards and mouths of great rivers. The scien- 
tific researches of Prof. McFall, in Galveston and Jacksonville, 
show that in the liver, spleen, kidneys, intestinal canal, chaplets 
of micrococci exist, visible under a high power. New and sus- 
tained researches are necessary to elucidate the germ. 



much resembles that of yellow fever, micro- 
The Microbe scopically. Growth is not so rapid ; neither 
of Dengue has it the faculty of exciting acute fatty degen- 
eration in the liver, spleen and kidneys. It is 









•< ••• • 


/ ' •^^•' 


:»; 


The germ as found in 


the blood 


seventy-two hours after rigor. 



The appearance of the microbe of 
Dengue at the time of rigor. 

much more easily sterilized than the streptococcus of yellow 
fever. 



Whitlow, felon; chains of bacteria or micro- 
Periostitis, cocci are always present prior and subsequent to 

suppuration. 
The microbe is pathogenic, an inoculation of the cultures gives 
rise to periostitis of the small bones. 



BACTERICIDES. 



417 



The micro-organism can be sterilized and annihilated by the 
local application of either of the following remedies : a saturated 
tincture of lobelia, or citrine ointment, if the tincture is applied it 
must be kept constantly moist for twenty-four hours or more ; 
if the ointment is applied, a thick layer. Neither application is 
painful, causes a drawing sensation, followed by a complete cessa- 
tion of pain and tenderness. 



The Glucose Fungus 
of Diabetes. 



When the co-ordinating chemical 
centre in the brain is damaged, an 
irritation is transmitted to the liver, 
grape sugar is elaborated in such 
abundance that the ozone-forming faculty of the lungs is incap- 
able of burning it up, hence the presence of this agent in the 
blood and tissues necessitates the for- 
mation of a living breeding fungus, 
which is pathogenic of the disease. The 
fungus is m ost easily isolated from the 
urine, capable of culture in any saccha- 
rine or starchy liquid at a temperature 
between 80° and 90° F. 

Injected into animals, gives rise to 
the disease, with all its symptoms of 
thirst, voracious appetite, prostration, 
chloroform breath, cataract, etc. This fungus is sterilized and 
annihilated by the administration of a five-grain pearl of sambul 
after meals, glycerite of ozone before meals. Antipyrin is often 
of value. 




The saccharine fungus of diabetes. 



as a canine disease, is evolved in dogs by a degrada- 
Rabies, tion of the primary elements of their nervous sys- 
tem, under adverse states or conditions, communi- 
cated to man and other animals by or through the saliva, in some 
crack or fissure or indentation of a tooth, or bite, so as to reach 
the true slcin. 

The microbe is essentially an outcome of perverted nerve nu- 
trition, consisting of small globular cocci, single or united into 
characteristic colonies; they are most abundant in the brain 
juices, especially in and around the medulla oblongata and spinal 
cord. 

The microbe of rabies must never be confounded with the viru- 
lent saliva evolved in man under rage, passion. The exceptional 
virulence of this micro-organism is due to its vital and reproduc- 
27 



4i8 



DISEASE GERMS. 



tive energy, to the rapidity with which it multiphes, and the ex- 
cessive amount of ptomaines excreted by the germ. 

No germicide has yet been discovered that will either sterilize 
or annihilate the germ. 

Ptomaines of the most toxical character are found in the brain 
and medulla oblongata. 



This germ is round, oval, occasionally 
The Microbe of elongated. It is pathogenic. In artificial 
Mumps. cultivations they appear as white dots, and 

as they grow larger, become of a grayish 
color. They bear culture- well in gruel or any nutrient fluid, and 
if injected into any mammalia will reproduce the original dis- 
ease, either in the parotid, mammas, ovaries, testes or cortical 
substance of the brain. 

The microbe is sterilized in the presence of either resorcin, 
thallin, ozone water, aconite, phytolacca, belladonna, or avena. 

Locally, concentrated ozone, to which a small amount of chlo- 
roform is added, applied over the parotid, testes, mammse, ovaries, 
is instant death to the microbe, there is neither contagion nor in- 
fection left. 



Cocci, cubes or packets, with rounded off 

Sarcinae corners in groups of four, or multiplies of four, 

Ventriculi. united in families of eight, sixteen, thirty-two, 

sixty-four. Contents of the fungus, greenish or 

yellowish red. It occurs in the stomach of man, and is detected 

in the vomit, on the fur of the tongue. 

The germ or fungus bears cultivation 
well on albumen or liquid gelatine. 

Pathogenic of catarrh of the stomach 
communicated to water, thence to poultry 
and animals. The nervous symptoms 
which accompany gastric catarrh are due 
to the peculiar ptomaines excreted by 
the fungus. 

Fungus starved out by either drinking 
freely of bayberry, or stone crop, or 
collinsonia ; sterilized by mineral acids, peroxide hydrogen, 
kaki ; annihilated by sulphide of lime, saccharated sulphur, 
lactic acid, creolin, sulphur ozonized, sozoiodol. 




€0 

h 



Sarcinae ventriculi, in different 
degrees of devel6pment : 
strongly magnified. 



tJACTERICIDES. 



419 



Cocci, or packets, in groups of four or eight, 

Sarcinse very small in size, but very regular in form, oc- 

Intestinalis. cur only in the intestines in cases of chronic 

diarrhea and catarrh of the intestines. 
Sterilized by the use internally of Virginia stone crop, alter- 
nated with salol, naphthaline. 



Extremely small cocci united in families of eight 
Sarcinse to sixty-four, present in the bladder in vesicle 
Urinae. catarrh. 

Sterilized by either boroglyceride or uric acid 
solvent ; the insertion of either a papoid or trypsin bougie into 
the bladder, permitting them to dissolve. 



Cocci very small, but forming large packets, 
Sarcinse common in intra-uterine catarrh. 
Uterinous. It is sterilized by the aleteris far. comp., and 

the insertion of papoid or salix-nigra bougies 
into the uterus. 




Yeast torula consists of spherical or oval 
Yeast Fungi, cells, very much larger than the largest micro- 
cocci; each cell consists of a membrane and 

contents. The contents are either 

homogeneous, or finely granular 

protoplasm ; in the latter case there 

are generally present one, two or 

more vacuoles. 

There are a great many species 

of torula, varying from one another 

morphologically, chiefly in their 

size, and physiologically by their 

action on different fluids. 1^ ^^ 

The cells of ail of them multiply S ^@ 

in suitable media by gemmation, 

a minute knob-like projection ap- Tomla, or Saccharomyces. In the lower 
a. xxlll^ul.^- i^xiwi_» ^ ^1 11 1 P^ of the figure an acospore and four 

pearing on one side of the cell and isolated spores are shown. Magnifying 

keeps enlarging till it reaches nearly ^°'^^'' ^ """^ ^°°' 
the size of the original mother cell. It finally becomes con- 
stricted, or exfoliated off from this latter, or having reached its 
full size remains fixed to the mother cell, and each cell again 
producing by gemmation a new cell. In this way, aggregations 



^20 DISEASE GERMS. 

of four, six, eight, or more cells are formed, which may be 
arranged either as a chain, when the production proceeds in a 
hnear manner, or otherwise, or as a group if the gemmata takes 
place laterally. 

Under varying conditions of nutrition or growth, yeast cells 
enlarge twice, thrice, and more times ; form in their interior two 
three, four, or more cells by endogenous formation. 

These new cells are regarded as spores, the mother cell being 
an acospore, and finally becomes free by bursting the membrane 
of the mother cell. 

Classifying them according to their physiological function, 
there are various specious of torula or saccharomyces ; all of them 
possess the power to split up sugar into alcohol and carbonic 
acid, but this power is not possessed in the same degree. 

Torula cerevisiae, ordinary brewers' yeast, is found in the human 
stomach in gastric catarrh; in the bowels in intestinal catarrh ; in 
the uterus arid bladder in catarrh of both organs. Their pres- 
ence in those organs gives rise to intolerable uneasiness and pain, 
and results of a fatal nature are due to their presence in the hol- 
low viscera. The yeast fungus, in the uterus in intra-uterine 
catarrh, grows well as the catarrhal secretion is slightly acid and 
little saccharine matter present, cells elongate when the case is 
chronic into cylindrical elements, a linear series, separated from 
each other by a thin septum, a mass of filaments, resembling a 
mycelium or elliptical torula cells.* 

Chronic cases of gastric and intra-uterine catarrh thus have 
tlie fungus changed or altered into the oidium albicans, hence 
ulceration of the mouth, stomach, uterus, vagina. 

Artificial cultures prove the same thing ; the fungus after re- 
peated cultures on and on, becomes spherical or cylindrical, taking 
on another type in the series of evolution. 

The yeast fungi is easily sterilized and completely annihilated 
in the stomach in the presence of peroxide of hydrogen, sulphide 
of lime, ozone water ; in the bowels by the ozonized Virginia 
stone crop ; in the uterus and bladder by the occasional intro- 
duction of a thallin, iodol, resorcin, creolin bougie. 

The nervous symptoms which accompany dyspepsia are due 
to the ptomaines excreted by this germ. 



This hybrid germ consists of fine slender 

The Microbe of rods, occasionally pointed at both ends. 

Leprosy. some clearly motile, others not. In the 

secretions from the tissues, they have a 

beaded appearance. They are best cultivated artificially on blood 

serum or meat juice. 



BACTERICIDES. 



421 



The microbe is pathogenic of the disease, just the same as that 
of syphilis or small-pox. The micro-organism demonstrates the 
true nature of the disease. Not 
a single sporadic case has ever 
occurred in our country. Every 
case we see here is imported, 
coming from some portions of 
the world in which the disease is 
prevalent. 

In some cases the microbe is 
sterilized in the presence of the 
Chian turpentine mistura ; chaul- 
moogra and gurjun oil in the form 
of an emulsion have also been 
found useful. 




.•^^^ 



The full-fledged bacillus of leprosy, 
magnified 1500 diameters. 



are rod shaped, one and one- 
Bacteria of Rhinoscleroma half times longer than they are 

broad. • Their location is the 

nose, skin and mucous membrane and contiguous parts, the colo- 

^^ nies of neoplasm form either flat or elevated 

f^^^^^^^:^^ dense ivory nodules. 

^^ The microbe is pathogenic of the disease, 

they bear cultivation well in any nutrient fluid, 

the cultures injected into animals give rise to 

the same ivory nasal deposit. 

The germ and its broods are sterilized in 
the presence of the peroxide of hydrogen and 
Chian turpentine emulsion. 

Locally, ozone ointment and resorcin; 
boroglyceride and creolin; benzoated oint- 
ment and naphthaline. 



(g> 



^m 






Bacteria of rhinosclero- 
ma; rods surrounded 
with their capsules; 
group of bacteria sur- 
rounded by a single 
capsule; bacteria seen 
from above and resem- 
bling a coccus. 



In the culture of the various 

Dual, Triple and other pathogenic microbes we have found 

Complex Organisms. by careful culture that the union or 

junction of microbes in the culture 
glass gives us most remarkable results. For example, an equal 
quantity of the cultures of the bacillus of tubercle and the mi- 
crobe of syphilis will produce the microbe of lupus ; an equal 
quantity of the micro-organisms of syphilis, tubercOlae and scar- 
coma, will give us the microbe of leprosy. The bacteria of malnu- 
trition, the germ of erysipelas and the vibrios of typhoid fever, 
unite to form the microbe of puerperal fever. 



422 



DISEASE GERMS. 



If we take a lupus nest, or a scraping from the skin of a leper's 
face, or a drop of lochiai discharge, this statement can be imme- 
diately verified. 

In neurasthenia in both sexes there is an evolution from the 
blighted or weakened embryonic elements, which assume various 
forms of microscopic life. In gynecological practice in the 
maladies peculiar to women, as a neurosis of the womb or 
vagina, either affecting the mucous membrane or body, a 
damaged uterus is followed by a relaxed or altered state (acid), 
mucous secretions, yeast fungi and other microbes. This natur- 
ally gives rise to more microbes in women than men, and 
explains why those latent discharges are so common in men. 
From puberty to the cessation of the menses the uterus has a 
rich, nervous, arterial connection, and the organ is liable, from 
very slight causes to suffer a neurosis or get out of gear. 

Can we wonder at the number and variety of female disease 
when we look at modern society, and our women, with this 
maundering, wandering activity and great fluctuations of animal 
spirits, gay, fascinating in society ; brisk, orderly, thorough in 
business, but at home dejected and fretful ; a small eater, light 
sleeper, worn worker, an heir of any true neurosis, from insanity 
to toothache; perturbations of intermarriage, with great mental 
power, with eccentricities agonizingly painful, when affected with 
any disease, instead of single disease germs being present, we 
have them dual and complex, as in peritonitis we have both the 
bactarian and vibrios. 



Microbes of all 
Cutaneous Diseases. 



There is 
no lesion of 
the skin 
without a 
degradation of its living matter into 
a disease germ. No damage done, 
no depression of its vital elements, 
without some fungi, or mould, or vege- 
table parasite appearing on its sur- 
face. 

All skin diseases are indicative of 
poor health ; all have their special 
microbe, which is pathogenic of each 
cutaneous affection, which bears cul- 
ture in some nourishing broth. 

As an infallible result, all cutaneous 
affections possess in their innate ele- 
ments contagion and infection ; even 
microbes. 




the 



Fungi from Favus. — Patch. 

sweat is loaded with 



BACTERICIDES. 423 

All cutaneous diseases must be treated with bactericides 
chemically adapted to the utter annihilation of the germ, as thy- 
mol, menthol, ozone ointment, . ^ ^ 
sulphurous water, creolin, per- ^ , _^ / ' L5V"^ / 
oxide of hydrogen, sulphide of ^^ii^ - -^"-^-^'^^^ 
lime. f '5pv1_-^*, S. -• . ^- ^ 



Very favorable results have been 



6^ 



.^-J*^,^ JL^« 



,<:^ /\ e ^ ^ 



obtained by creolin, chrysophanic }-^ I'^Vll^- 

acid, ichthyol, resorcin. "^^^^Vj^^^^T ^ " ^^ 

All vegetable parasitical skin ^-^^ - ^J^^^i 

affections should be treated with ^^^i ^ ^ s^ " ^"^ 

a course of internal germicides, ®^o " > 

such as the peroxide of hydrgen, - ^ 

compound Saxifraga and phytO- Photograph of the micrococcus versicolor 

^ '-' , '■ / — small COCCI which are seen form irides- 

laCCa, CaSCara Sagrada, lyCOpodlUm. cent colomes-growing in the form ot 

yellowish beads. 



Cocci, singly or in pairs, seen in the roots 01 
Bacterium the hair in cases of alopecia areata. Microbe is 
Decalvans. pathogenic; bears cultivation in rich soup ; in- 
jected into animals, reproduces the disease. 
It is completely sterilized either in the presence of ozone oint- 
ment or turpeth mineral, gr. i. to xv. gr. benzoated ointment ; 
ozonized boroglyceride. 

Trichomycosis nodosa, a peculiar condition, nodose in char- 
acter, affecting the hairs of the axilla and scrotum ; due to the 
evolution, growth and encapsulation in the cortical layers of the 
shaft of a small, red-shaped bacterium. 

In the various forms of bacteria occurring in sweat, there 
exists in the secretion numerous granular bodies, the number of 
which is increased according to the hairiness of the part, the arm- 
pit and between the thighs. They are micrococci ; they attack 
the hairs, causing small, knotty swellings. These are composed 
of bacterial elements, cause clefts, spindle-shaped projections; 
hairs are friable : affect the hair shaft. 



of sumac, ivy, poisoned vines, stings of 
The Microbe wasps, bees, gnats, are pathogenic. 
or Living Poison The bacterial germs can be annihilated 
either by solution of chloride of ammonia 
or concentrated ozone. 



424 



DISEASE GERMS. 



The oidium albicans (rot) often attacks the 
Onychonycis. roots of the nails of man as well as the hoofs 
of animals, as the horse, ass, mule. The par- 
asite fungus is readily transferred from one person to another, 
introduced into the cracked, superficial layer of the hoof through 
the fissures. 

Pathogenic of the disease; bears culture well in any nourish- 
ing broth. The cultures injected into any mammal produces 
the original disease. 

Germ sterilized and annihilated in the presence of ozone oint- 
ment and resorcin, or resorcin jelly, hydrogen peroxide, and the 
use of comp. saxifraga ozonized, avena sativa, glycerite of kepha- 
line ozonized. 

In the three different stages of burns, 
The Microbe of erythema, vesication, ulceration, we have 
Burns and Scalds, a degradation of the primary elements 
of the different coats of the skin in a 
bacterium, so that whatever application is made to a burn of any 
degree should be a powerfully stimulating application, as car- 
bolic acid and olive oil, glucozone, creolin, resorcin, thymol, sul- 
phide of lime, balsam of fir, tolu, siegesbeckie in ozone ointment, 
or in olive oil, or oil of boroglyceride, resorcin and cocaine in 
olive oil. 

A malignant, very contagious, microbial disease, 
Glanders, which appears in the nasal organ of the horse, ass, 
mule, or in the lymphatic glands. It is termed 
glanders, when in the nose ; farcy, when the lymphatics are infil- 
trated by the microbe. 

The predisposing cause of glanders in animals is depressed 
nervous and physical energy, such as is produced by hard work, 
overcrowding, isolation, sameness of diet, exposure to air cur- 
rents, privation, depressed and vitiated states of the atmosphere, 
endemic conditions, air loaded with germs, abnormal meteoro- 
logical ■ states, dispersion of germs over large areas, very fatal to 
man and animals, destroying the red discs of the blood, and is 
death to that fluid ; besides, it causes immense hypertrophy of 
spleen, starchy degeneration of liver and kidneys and general 
dropsy. 

Like all germ diseases, it is propagated by contagion and infec- 
tion. It is very prevalent in all sections of the country, and it 
exists to such an alarming extent that it is becoming a serious 
and growing evil. It makes occasional epidemic attacks under a 
form named epizooty. 



BACTERICIDES. 



425 



The gathering together of several hundred horses in one stable 
is not conducive to their health, and the slightest catarrhal condi- 
tion when present is likely to be disseminated. It is well known 
that the disease-germs are not only abundant in the nasal dis- 
charge, but that the breath, sweat, urine and other excreta are 
loaded ; and where have we the least sanitary arrangements 
made for its suppression ? In the stalls, blankets, feed boxes, 
water troughs there is the living contagion. The public drinking 
troughs are a source of danger to animals, as the germs pass into 
the water and the glandered horses are allowed to quench their 
thirst at those valuable conveniences. In the act of drinking 
by the horse, a certain amount of saliva and nasal discharge 
always escapes into the trough, so that one glandered horse may 
infect all that drink subsequently from the same trough ; for, 
although the discharge is heavier than water, and as we would 
naturally suppose, sinks to the bottom, the fact of its being alive 
and the germ growth increased by water, myriads and millions 
.are grown light enough 
not only to float in the 
water, but also to float 
through the air. ^ 







A microbe communi- 
cated from horses to man 
caused by the presence 

of a giant bacterium, the " Badiius of glanders. 

degraded bioplasm of nu- 
trition of the Schneiderian membrane of the horse, evolved by in- 
sanitary states, exposure, over-crowding, bad or meagre food and 
other adverse states. The microbe as found either in the dis- 
<;harge from the nose (glanders) or from the contents of a lym- 
phatic (farcy) appears in the form of very fine rods, about the 
size of the tubercular bacilla. When this germ is cultivated 
either on blood serum or extract of meat, it affords magnificent 
results, appearing in the form of minute transparent drops, con- 
sisting entirely of characteristic bacilli. Pure cultivations, after 
several generations, when inoculated into horses, asses, rabbits 
and other animals, give us genuine glanders. 

It takes place as follows : a spreading ulcer with an indurated 
base first makes its appearance at the site of inoculation, while a 
crop of smaller ulcers break out in close proximity. There is a 
general state of languor, debility, rigors, fever ; lymphatics be- 
come engorged with the microbe ; general infection follows, 
nodules of microbes are thrown out on all internal organs, and 
on the inner lining of the nose, these eminences of the nasal sep- 
tum break, form characteristic ulcers, round, sCooped-out, with 
granulations in the centre. 



426 DISEASE GERMS. 

Glanders is fortunately a very rare disease, and is met with, 
almost exclusively, among grooms, coachmen and others occu- 
pied with horses. The salient feature of the disease is the forma- 
tion of pustules, followed by ulceration of the skin, nasal cartilages 
and bones. The earliest symptoms are secretion of a thin, tough 
mucus, followed by swelling and redness. The mucous mem- 
brane is covered with scabs and ulcerations. There may subse- 
quently be ulceration of the throat, larynx and tongue. The 
discharge from the nose, which is sometimes limited to one side, 
only, becomes, sooner or later, sanious and fetid. The majority 
of cases go on to perforation of the septum, necrosis, glandular 
enlargements and death from pyaemia and exhaustion. The com- 
plaint may run a very chronic course, but in the acute form may 
terminate life within a week. 

If the history of the case is clear, the diagnosis is easy ; if not 
the microscopical examination of the nasal discharges will 
decide it. 

The ulcerations bear a strong resemblance to those of syphilis, 
and are apt to be mistaken for them. 

The microbe is pathogenic of the disease, bears cultivation 
well ; cultures injected into animals reproduces the disease in all 
its malignancy. 

It is resident in the nasal secretions of the infected animals 
and in the ulcers which form upon their mucous membranes, 
also in the so-called " farcy buds " and in the large lymphatic 
glands of the infected animal. There seems some probability, 
also, that it is occasionally present in the urine. The rod itself 
bears a strong resemblance to the ordinary tubercle bacillus, but 
it is more uniform in size. It can be readily seen when stained 
with fuchsine or methyline blue, and certain appearances have 
led people to believe that spores are present in the bacilli. The 
infective material does not appear to be capable of living for any 
great length of time outside the body, and never develops after 
the bacilli have been exposed to a temperature of 130° F. for ten 
minutes. Exposure for five minutes to a five-per-cent. solution 
of carbolic acid, or to corrosive sublimate of a strength of one 
in five thousand, is quite sufficient to destroy all possibility of 
infection. Practically there seems not the smallest doubt 
that any suspected article can be readily disinfected by being 
boiled for, say, a period of half an hour in ordinary water, whilst 
any article that will not stand boiling can be readily disinfected 
by carbolic acid or corrosive sublimate. The exposed parts of 
the stable should be thoroughly disinfected by burning sulphur 
in them, with all the doors and windows closed, after which the 
walls should be thoroughly washed down with carbolic acid of 



BACTERICIDES. 



427 



the above strength or with perchloride of mercury, and the vari- 
ous troughs, etc., should be thoroughly scrubbed out, so as to 
remove all trace of the disinfecting materials. After the walls 
are carefully lime-washed there seems to be no possibility of in- 
fection taking place. 

TJie treatment of glanders, either in the horse or in man, is the 
same. Remedies calculated either to sustain the vital powers, or 
sterilize the blood or allay pain, should be given internally. 

Either the sterilization or destruction of the germ should be 
effected by either peroxide of hydrogen or sulphide of calcium 
in the form of an aqueous solution internally and locally ; these 
two remedies kill the microbe, stimulate the blood currents and 
have a special vitalizing action upon the mucous membrane and 
lymphatics. 

Other bactericides which have met with success are resorcin, 
creolin, pyridin, creosote, naphthaline. 

The nostrils should be douched out thrice daily ; all enlarged 
or painful lymphatics immediately opened. 

Exalgine is a good remedy for both pain and fever. General 
principles as to bathing, diet, nursing, hygiene, should be carried 
out. Scrupulous cleanliness, immediate destruction of all dress- 
ings and discharges. 

The Epizooty, the epidemic form of glanders, is due to insani- 
tary states existing in stables, to overcrowding, to a sameness or 
meagre or insufficient food. 

Pink Eye is simply the same disease germ colonizing in the 
eye instead of the nose or lymphatics. 



A form of blindness, attended with disorgani- 
Glaucoma. zation of the various tissues of the eyeball, in 
which objects are surrounded by various colors, 
especially blue and green. 

Causes. — It seems to depend upon extravasation of blood in 
retina and choroid ; serous effusion between retina and choroid ; 
retina raised in folds ; and clots in vitreous humor, and changes 
in the optic nerve. What induces such changes, aside from 
shocks, jars, concussions, it is impossible to say. 

Symptoms. — It may be acute or chronic, that is, it may come 
on suddenly, or more slowly ; take months to do so. In both 
there is a rapid and irreparable loss of vision ; begins with in- 
tense pain in the ball of eye during night, with throbbing in both 
eye and temple. Pain continues, and the eyes become congested. 
Iris of a dusky hue, and motionless ; cornea becomes dim ; 
pupil widely dilated, and sometimes of an oval shape ; eyeball 



^28 DISEASE GERMS. 

unusually hard. Everything looks as if surrounded with pris- 
matic colors ; often bright flashes of light before eyes ; both eyes 
are affected. 

In the chronic form the symptoms are the same ; perhaps 
more congestion of iris and cornea, and more fulness of eyeball. 
Opacity of the lens is comfmon in chronic form, as a result of 
deranged nutrition. 

Treatment. — So far there is no known mode of treatment that 
avails. The improvement of general health and relief of pain is 
about all that can be done. Any depressing treatment, anything 
that weakens the patient, aggravates the trouble, so that the care- 
ful administration of sulphate of quinine, ozonized glycerite of 
kephaline, and other elements to invigorate the brain, should 
have a trial, with change of scene, and a sea voyage, etc. 



At the present day, when science is slowly ferreting 

Gout, out the secrets of nature, both under normal and ab- 
normal conditions, it is a matter of great interest to 
trace out the origin of uric acid and the presence of urate of soda 
in the blood of gouty patients. 

What gives rise to the liberation of vast quantities of this salt 
in the blood has never been clearly explained. 

Special typical conformations of the body which are hereditary 
give rise to it, and an excess of certain kinds of food, by supply- 
ing an over-abundance of nitrogenized material, for the blood 
creates an excess of urea and uric acid. Besides certain special 
agents as malt liquors, wines, sedentary habits, want of exercise, 
irregularities, lead poisoning, excessive mental strain, worry, 
give us urate of soda or uric acid and soda, which exist in the 
blood in a separate state, but a depression of the nervous system 
causes their union. The morbid state is aggravated by gastric 
and intestinal disorder, impaired appetite, furred tongue, acid or 
bitter eructations. 

The disease cannot be developed unless the blood contains a 
considerable quantity of uric acid and soda in some form. They 
never exist in the blood in combination before an attack of gout, 
but the moment they combine the disease is produced. Nerve 
force in health keeps them separate, so that they can be elimi- 
nated by the skin, kidneys and bowels, but as soon as nerve force 
is lessened or impaired these two unite. Good nerve force keeps 
them apart, but in shocks or debility they unite and crystallize 
as urate of soda. In lessened nerve force the uric acid seizes the 
urate of soda, and this is deposited in the tissues generally most 
remote from the heart and brain. This union generally arouses 



BACTERICIDES. 



429 



the nervous system, and a febrile effort takes place and it is 
warded off, but in subsequent attacks the febrile effort fails. In 
youth, before care, anxiety and disappointment have well-nigh 
worn out the brain, the nervous system is active, and in spite of 
dissipation and indulgence, gout is rare, but as soon as age and 
care stamp their mark upon the great nerve centres, gout too 
often appears. 

In the gouty diathesis, without local manifestations, are to be 
found neuralgia, dyspepsia, palpitation, syncope, congestion of 
liver, piles, anaemia, pains in head, toothache, tonsillitis and 
asthma ; besides it is a common cause of disease of heart, arte- 
ries, kidneys, and, indirectly, of apoplexy, etc. Gout presents 
itself in so many different forms that it is often difficult to recog- 
nize it when we meet with it, and 
many cases are overlooked be- 
cause the disease is not found in 
its accustomed seat. 

One patient may suffer from 
bronchitis, another from psoria- 
sis ; one may have gravel, another 
asthma, or, again, neuralgia of 
the face. One may be alarmed 
by his having to be treated for 
an apparent gonorrhea, while 
another may have piles or tenes- 
mus ; all of which are but local 
exhibitions of the constitutional 
affection. 

The morbid anatomy of gout 
shows the brain cells to be feeble, 
exhausted, the red blood discs 
greatly impaired by the presence 
of the urate of soda, and the de- 
posit of that substance on the cartilages of joints, and valves of 
the heart, or wherever vitality is lowered. This consists of the 
urate of soda in the form of needle-shaped crystals. In the early 
stages the articular surfaces are granular, form a thin incrusta- 
tion, which, as the uriates increase in the blood, becomes thicker 
and thicker, the deposits becoming large concretions. 

Symptoms. — The attack may be preceded by debility, heart- 
burn, flatulence, dull pain in left side of chest, irregularity in 
heart's action, dry skin, urticaria, urine loaded with phosphates 
and urates containing albumen. It may come on suddenly in 
the night with acute pain in the great toe, heel, instep or wrist ; 
rigors, followed by fever with great irritability and restlessness^ 




The appearance of the cartilages of a gouty 
subject, showing a deposit of urates of 
soda— dense deposits of uric acid. 



430 



DISEASE GERMS. 



tenderness and swelling of the affected part. The attack passes 
off, an interval elapses of length proportionate to the care taken, 
and then another attack follows. 

The local affection takes place in weakened parts, then the in- 
flammation and exudation take place, so there is liable to be a 
change of location according as the vital forces of a part are 
strong or feeble. In this manner a metastasis occurs from the 
joint to some internal part, as the heart, stomach, lungs, brain, 
etc. When the kidneys act imperfectly, and there is a retention 
of the urate of soda in the blood, it is taken up and deposited in 
other structures to which it has an affinity, as cartilage, bones, 
fibrous tissue, forming topha or chalk formations, or stones con- 
sisting of urate of soda. . They are found in innumerable situa- 
tions in chronic gout, in the eyes, ears, heart, joints, etc. 

Treatment. — The general principles of treatment consist in per- 
fect rest between blankets, attention to the condition of the 
skin, kidneys and bowels ; to the forrfier, warm baths, to the 
latter, with salines, so as to relieve the overloaded heart and 
blood vessels. For any irritation about the heart, mustard ap- 
plied and to be repeated. The following is to be given at re- 
peated intervals, so that the sensorium experiences no sensation 
of pain : 

Pulverized opium, ten grains ; Dover's powder, thirty grains ; 
pulverized nitrate potash, sixty grains. Mix and make twenty 
powders. Dose, one, as indicated. 

If there is fever, aconite and veratrum viride. To cut short 
an attack, nothing excels the phosphate of quinine in alternation 
with the wine of the root of colchicum. These two remedies 
act quickly and meet the indications most promptly. As to the 
dose, from one to three grains of the quinine every three hours, 
with colchicum enough in alternation to slightly move the bowels, 
the dose necessary being usually from fifteen to thirty drops. If 
the evacuations from the bowels are too frequent, diminish the 
quantity, but do not discontinue. 

As soon as the acute stage is over, the same remedies may be 
continued, although it is often advisable to change to some of the 
following drugs : 

The uric acid solvent, highly ozonized, has a marked effect in 
causing the urate of soda to disappear from the blood, and a dis- 
solution of the incrustations in the joints. This remedy has per- 
manently cured the most aggravated form of the disease. In the 
present state of medical science there is no longer obscurity 
about what gout is ; a bankrupt brain and a perversion or mal- 
assimilation of the secondary process of digestion, with deficient 
elimination of waste products through functional disorder of the 



BACTERICIDES. 4^ I 

l<idneys ; a disease always attended with danger on account of 
the tendency to metastasis. 

In order, therefore, to effect a radical cure, and get rid of the 
urates in the blood and joints, we must administer this solvent in 
all cases ; because it never fails to neutralize this morbid product, 
increases the secretions from the kidneys and skin, and with the 
elimination, pain and irritation cease. It acts first as a chemical 
solvent, then as an alterative in absorbing and lemoving deposits 
in valvular disease of the heart. 

It is best used in small doses, frequently repeated, say from ten 
to thirty drops, added to a glass of cold water. 

Cascara sagrada lozenges, two after each meal are most effica- 
cious in preventing the elaboration of the acid ; they are of great 
utility. 

Carbonate, or bromide of lithia, possesses remarkable chemi- 
cal properties, being, next to the uric acid solvent, one of the most 
soluble salts of uric acid known. 

Salicylate acid, administered in the acetate of ammonia, is most 
efficacious in preventing the formation of the urate of soda ; best 
administered in alternation with sulph. quinine. 

Iodide of potassa, chlorate of carbon are of utiiit}'. 
Benzoic acid administered after meals prevents the formation 
of the tophaceous deposits. 

Phosphate of ammonia decomposes the insoluble lithates of 
soda and leads to absorption of them when deposited. 

In chronic gout, or a state nearly allied to gout, or half gout, 
there may be no local inflammation, pain or obvious swellings, 
or the gouty paroxysms, but it works more silently and is char- 
acterized by the abundance of lithates in the urine. There is 
apt to co-exist signs of ill-assimilation of food, with aches 
and pains, unaccompanied by any perceptible change in the 
aching part. 

A very common and prominent symptom in these cases is 
vertigo, associated with dull headache, occipital pain, occasional 
irregularity of the heart, oppression about the heart, memor\^ 
fails and an exercise of the mind is laborious. Frequently the 
gastric derangement is not well marked, so that the patient is apt 
to believe that the trouble is all in the head. 

According to the most recent views on the subject it is due to the 
liberation of a certain amount of this salt by certain special agencies. 
Once the urate of soda ceases to circulate in the blood the attack 
of acute gout passes off, only again to reappear whenever another 
exciting cause appears to liberate a further amount of the stored- 
up urate of soda. It is not our purpose at the present moment to 
go into the various views which have recently been expressed on 



432 DISEASE GERMS. 

the pathology of the uric acid diathesis. Whilst one set of writers 
put down the formation of uric acid to insufficient oxidation of 
the various products of digestion, others are inclined to ascribe it 
to some deficiency in the action of the liver. This much, how- 
ever, at least, is certain in the treatment of the disease, that all 
gouty patients do not do well upon a similar diet. 

It is certainly impossible to say that gout is in all cases the 
product of a nitrogenous diet, as opposed to one which is formed 
mainly of starchy food. But in addition to acute gout, which 
we have considered so far, there is the more chronic form of the 
disorder which supervenes when the urate of soda is deposited 
round about the joints and in certain of the other fibrous struc- 
tures, thus mechanically, interfering with the function of those 
particular parts. Such a condition may go on for a great length 
of time, interrupted occasionally by an acuter attack of the dis- 
ease, whilst the same patient will be the subject of various forms 
of dyspepsia, heartburn, and other similar forms of indigestion. 
The heart will be very irregular in its action, and chronic inflam- 
mation may take place later on in the walls of the arteries and 
veins. There is perhaps nothing which more readily helps us to 
understand the* affections of the circulation of the system than 
watching the effect of an infinitesimal amount of urate of soda in- 
troduced into the blood of an excised frog's heart. If the beats 
of this heart are registered on a revolving drum, they will be 
seen to be rendered most remarkably irregular when the blood 
contains certain poisons, such, for example, as uric acid ; whilst 
they resume with equal speed their regular rhythm when these 
impurities have been removed, In the case of the respiratory 
organs, pneumonia, pleurisy, and bronchitis are all affections of 
the gouty diathesis, and in many instances, as inflammation of 
the pharynx and the larynx, hardly any of these affections exist 
without some associated irregularity of the heart's action. It 
was ascertained years ago by Berthollet that the skin of a part 
affected with gouty inflammation instantly gave to litmus paper a 
deep red color, owing to the large quantity of acid which was 
passing off by exudation from the inflamed surface. A very 
similar observation may be made in the case of many of the 
acuter forms of gouty affections of the respiratory organs. The 
gouty affections of the genito-urinary tract are too well known 
to need any very lengthy description here ; but those who have 
had any prolonged opportunities of observing the course of the 
attacks of gout which are acute or chronic will easily call to 
mind the large amount of irritability which often exists in the 
bladder and other portions of the urinary tract in such patients. 
In children occasionally so great is the irritation caused by the 



BACTERICIDES. 403 

highly acid condition of the urine that the interior of the bladder 
is irritated and caused to secrete an alkaline mucus which makes 
the urine alkaline when it is voided; whilst if it be drawn off from 
the bladder with a catheter, and the bladder is washed out, the 
urine which is drawn off a quarter of an hour later will be found 
to be strongly acid, owing to the fact that it has not yet had time 
to be converted into an alkaline condition b}' the irritable mucus 
from the surface of the bladder. . Of nerve affections it seems 
certain that we are only just beginning to appreciate the way in 
which gout is able to affect the various portions of the nervous 
organization. Opinions are rapidly gaining ground that many 
forms of epilepsy and other obscure discharging lesions of the 
brain are due to excess of uric acid in the system. It is curious 
that in some cases epileptiform seizures are preceded by hemi- 
crania, and are readily kept in check by those medicines which 
should be given in the case of the uric acid diathesis. The 
treatment of a gouty patient in the future must be directed to- 
wards ascertaining what these particular conditions are, whether 
mental or bodily, which are liable to provoke the formation of a 
large amount of uric acid in the body, and to ascertaining how 
far the formation of this acid is dependent on the particular forms 
of diet which are ingested, and how far it is brought about by 
the surroundings of the individual. Until we are in a position to 
answer these questions it will be quite impossible to arrive at a 
scientific treatment of the gouty diathesis. Whilst much is to be 
hoped from a preventive treatment in the early stages, we seem 
to be as far as ever from the removal of urate of soda from the 
body, when it has been deposited in large quantities in the vari- 
ous tissues, and has already set up pathological changes there 
which are spoiling the tissues in question. 

On examination of the urine in these cases, we find the lithates 
in great abundance, urine scanty, highly colored, specific gravity 
greatly increased, and readily deposits urates of a pink or brick 
color, and crystals of uric acid. 

In the treatment of these cases, rest from mental labor, a 
plain, rather spare diet, free exercise in the open air, and the 
bowels kept regular with salines once a day. The remedy from 
which most satisfactory results are obtained is the uric acid sol- 
vent, in small doses, barely enough to move the bowels. 

The diet in gout should be nutritious, as milk, arrow-root, 
tapioca, fish, oatmeal, fruit, vegetables, avoiding animal food as 
much as possible. 

Women are comparatively free from gout. This immunity is 
due to sexual causes, the character of her nervous system, and 
the rudimentary condition of her great sympathetic. A gouty. 



434 DISEASE GERMS. 

bald-headed woman may be said to have left her sex, cast off the 
woman and become the man. 

Among males whose nervous systems are exhausted by any 
kind of drain, or worry, or study, the gouty diathesis is very 
prevalent, and it lies at the basis of nearly all cases of Bright's 
disease of the kidneys. 

Man, endowed with both an instinctive and moral 

Habits, nature, is easily moulded by habit, more especially 
' by the love of stimulants, which is an inherent ele- 
ment in the organization of all men, barbarous as well as 
civilized. 

The most extensive and. devitalizing of all habits is the alcohol 
habit. 

In no country in the world does the use of whiskey and malt 
liquors produce such direful results as they do in our climate. 
Our dry, clear atmosphere is highly oxygenized, vivifying and 
stimulating, causing great activity of muscular movement and 
cerebral thought; add to it another fuel, it actually burns up the 
tissues. The use of alcohol in small quantities produces chronic 
inflammation of the stomach, arrests normal metamorphosis ; 
that is, checks elimination by liver, kidneys and other excretory 
glands, and tends to the production of fatty degeneration in 
muscles and glands. Besides, it coagulates, indurates, atrophies 
the cineritious or cell-producing structure of the brain ; at the 
same time, it paralyzes the motor elements. Its use in large 
quantities so coagulates and shrivels up the abode of Deity in 
man that every vital function is destroyed, or at least impaired. 
As an illustration : should the drunkard impress his damaged 
spermatozoa upon the living healthy ovum ; that is, if there be 
progeny, it will be tubercular, of a brain type, weak-minded, im- 
becile, idiotic, or the victim of nervous disease. Habitual inebri- 
ation is not even necessary to produce this result. One dose of 
this poison will prevent the brain elements from developing in the 
embryo, foetus, child or adult. Brain-growth is retarded, and 
incapable of habitation by the soul ; idiocy of a congenital type 
is impressed; judgment, reason, memory are defective. 

The tobacco habit is one of great importance to our people, to 
whom from mere babies to a short old age it is of very general 
use. It relaxes and enfeebles the muscular system, especially 
involuntary muscular fibres, like the heart and stomach ; it 
exhausts the base of the brain, gives rise to aphonia or paralysis 
of the cerebral faculty of speech. Take alcohol and tobacco in 
their joint action, they dwarf and atrophy the brain, cause tuber- 
cular in the user and his offspring. They fret, whittle down the 



BACTERICIDES. 



435 



over-stimulated American ; and, under these two habits, it is diffi- 
cult to say what new forms of degradation and disease may not 
be produced. 

The general method of use is by smoking, chewing, snuffing ; 
ladies are often addicted to it in the form of eating snuff. We 
are unable to account for so many ladies using it, as it is ruinous 
to their nature, hostile to their happiness. How disease-creating, 
nauseous, disgusting tobacco ever became a habit to our ladies 
is an enicrma to be solved ; its use constantly indicates dep;en- 
eracy and corruption. The use of tobacco in all cases is inimical 
to health. Snuff-eating is confined to ladies, and they generally 
begin by using snuff as a tooth powder. The habit gains, and 
the nervous system craves the stimulant, but it soon destroys the 
rosy hue of health and subverts and ruins digestion ; following 
that the complexion becomes pale, sickly, yellow ; the cheeks 
lank, faded and hollow; eyes lose their brilliancy, and become 
jaundiced, sunken, hollow, beamless. It destroys the vital ener- 
gies, gives rise to languor, debility, tremors, disturbed sleep, and 
gives the eater the sepulchral shade of death. In the form of 
minute subdivision of snuff, its action is more destructive than 
by smoking or chewing, and how young, blooming girls can 
bear its use is most unaccountable. 

The opiuvi habit is generally created by the physician prescrib- 
ing opium or morphia for the rehef of pain; but ladies have 
found out that it gives unusual brilliancy to the eyes, and have 
got in the way of using it too extensively. Its use at first is not 
incompatible with great intellectual efforts and brilliant thought, 
but by and by, when it makes its dreadful ravages into the brain, 
muscle and gland, it is, without a doubt, the most persistent, irre- 
sistible and destructive of all habits. It over-stimulates, and thus 
exhausts, giving rise to the most feeble form of languor and 
despair ; it atrophies the brain, so that the consumer is dull and 
stupid ; it causes sterility, drying up the very fountains of life, 
and causing a human wreck often fearful to behold. 

The tea and coffee habit ; the characteristics are : anorexia, dis- 
turbances of sleep, trembling of the lips and tongue, attacks of 
gastralgia, different kinds of neuralgia, dyspepsia and leucor- 
rhcea, often profuse. Slaves to tea and coffee suffer from great 
mental disturbance, vertigo, impaired vision, poor memory, 
insomnia ; their deleterious action upon the brain is bad, but upon 
the liver and bowels even worse ; all the symptoms of functional 
liver trouble are present, as brown-coated tongue, want of ambi- 
tion, yellow conjunctiva and skin, with obstinate constipation or 
diarrhea. The evil effects of coffee are especially observable in 
children. The coffee drunkard is described as thin, pinched 



436 



DISEASE GERMS. 



features, pale, wrinkled face, and a grayish-yellow complexion. 
The pulse is weak, frequent and compressible. The sleep is 
troubled with anxious dreams. 

No doubt coffee does on the whole far more good than evil. 
But it is important that the medical profession constantly bear in 
mind the evils that it is able to produce under favorable circum- 
stances. In a general way it may be said that indoor brain work- 
ers do not bear coffee as well as outdoor muscle workers. Per- 
sons of nervous temperament bear coffee badly. 

The chloral hydrate is another very destructive cerebral stimu- 
lant, exhausting more especially the ophthalmic tract and causing 
impaired vision. Much used. 

Arsenic, belladonna and- other cerebral stimulants are not much 
used in this country. 

The arsenic habit is not so common in our country as the 
others; still, isolated cases are met with now and again. It is 
generally found in ladies, first inaugurated by ignorant doctors 
prescribing arsenic for some roughness of the skin. Its use 
gradually wears on the patient, stimulating both brain and heart 
until the habit is acquired, when the patient can tolerate large 
doses of the drug in solution as well as in a crude state. Still, 
the lady, in order to procure the smooth, enamelled white skin, will 
persevere, until some day an over-dose is reached, which will 
terminate the case, and some one else suffer from her reckless 
indiscretion. 

Although these and other habits are thus acquired, it must 
ever be borne in mind that in all cases the working faculty of the 
brain is thrown out of gear. Brain and nerve tissue are of the 
highest possible organization ; they play in the organism the part 
of primary activity. They are the centres of all energy, they 
generate all force. They do not live for themselves but for the 
whole body, and when a habit is created, their nutrition is im- 
paired. We see this well illustrated in the dwarfing and whit- 
tling down process when any of those habits are acquired by 
children or young persons in arresting their growing brain. It 
is positively certain that those habits never strengthen the brain, 
but it is too true that they impair its activity, retard its progres- 
sive tendency. That higher organism, the brain of man, certainly 
requires a better stimulus than what can be supplied with alcohol, 
tobacco or opium. None of these elements impart nutrition or 
growth. No ; they are fatal to the growing brain of man ; they 
cripple its organization ; they do irreparable structural mischief, 
the effects of which are permanent. A well-fed and properly 
exercised brain free from those iiabits works without tension or 
friction of any kind. The knit brow, straining eyes and fixed 



BACTERICIDES. 



437 



attention of the tobacco or opium slave are not a token of 
power but of weakness. When the brain is not crippled by those 
debasing, deleterious habits, its intellectual faculties work easily, 
without tension or jar. 

Treatment. — In the treatment of one or all of these or other 
habits, we must bear in mind that the brain is out of gear, bank- 
rupt, and that all the secretions as well as excretions are vitiated. 
There must be a new era of existence commenced, a complete 
change ; moral and physical restraint ; daily shower and plunge 
baths ; secretions stimulated ; massage as laid down in the (arti- 
cle Neurasthenia) morning and night. General alteratives and 
tonics are always of utility and should be insisted on. 

The only two drugs, however, of real permanent value are the 
erythroxylon coca and the phosphated tincture of oats. 

They produce an effect which is difficult of explanation, but 
they are the remedies in opium, alcohol and chloral habit and 
dipsomania. They are safe, reliable nerve tonics, acting rapidly 
as diffusible stimulants, leaving no unpleasant effects. They act 
promptly upon the nerve centres, causing mental quietude and 
satisfaction, with easy respiration and excellent digestion ; acting 
upon the cord, relieving anaemia of that structure. They have a 
most wonderful effect in relieving that undefinable sensation of 
languo**, weariness and mental unsteadiness. They are very 
exhilarating, which is followed by ease and comfort, relieving 
all mental misery and distress. 

After using coca alone for five to six weeks it should be alter- 
nated with the oats. 

This remedy should be commenced in small doses and 
gradually increased. 

The avena seems to correct and deepen the cerebral fissures 
and imparts tone and vigor to the entire nervous organization. 

After continuing both remedies for about three months, they 
should be gradually decreased and by and by discarded. 

The coca, of all known remedies, is specially adapted to usurp 
the place of alcohol, tobacco, opium, chloral ; the drug habit must 
be at once discarded and the coca substituted in its place, and ad- 
ministered at proper intervals. 

In a few days the patient relishes the substitute well, his appe- 
tite for food becomes keen, and then he should be fed upon the 
very best ; his sleep also becomes refreshing, and it should be 
prolonged by the administration of sulphonal. 

His strength physically and mentally increases, and he is the 
being of sl new existence, free from the slavish action of the habit 
and capable of wonderful powers of endurance and fatigue. 

Its wonderful action on the nerv^bus system in causing its recu- 



438 DISEASE GERMS. 

peration under the most adverse conditions ; its stimulating power 
in perfectly supplanting the most inveterate habit, the person 
feeling better with it and having the power of discarding it at 
any time after six or eight weeks. 

The best preparation is the orange wine coca. This wine ex- 
tracts altogether different properties from that extracted by alco- 
hol. This wine subjected to the dioxide of hydrogen gives us a 
remedy of marvellous power in all habits, by appeasing the desire 
or craving. 

In individuals of a sanguine tempera- 
Hemorrhagic meat there exists in the blood, irrespective 

Temperament, of any special disease, a peculiar constitu- 
tional defect which gives rise to a micro- 
coccus haemophilia, which is pathogenic of hemorrhage. This 
micro-organism impairs the fibrine of the blood, and weakens its 
cohesive property, so that on the slightest irritation, or wound, 
there is apt to be hemorrhage, and especially so from mucous 
membranes, as the nose, bronchi, stomach, kidneys, uterus. 

Patients with light hair, white skin, and highly sanguine tem- 
perament are its victims. 

It may be hereditary or acquired. It may be suspected if there 
be debility, vertigo, hemorrhages or ecchymosis. 

The treatment to overcome this diathesis should consist in the 
best highly animalized diet, rich in blood elements, beef, poultry, 
eggs, cream, etc., mineral acids, preparations of cinchona, etc., 
and all surgical operations on this class of subjects should be 
carefully avoided. 

Loss of blood, or the escape of blood from 
Hemorrhage, the blood-vessels, in which it is naturally con- 
tained, constitutes a hemorrhage. 
It is variously classified and designated ; as for example, it is 
terrried traumatic, when due to a wound, injury or incision, and 
if a middling large vessel is cut or torn, it will escape in jets, 
corresponding to the contractions of the heart ; idiopatJiic, when 
there exist a peculiar germ in the blood, which destroys the cohe- 
sive faculty of the blood, as in the sanguine temperament ; migra- 
tion, localization of disease germs, as well as their destructive 
action on the red discs of the blood, give rise to hemorrhage, as* 
the bleeding from the nose in typhoid fever. 

\\.vi\^.yh^ active ox passive. y^/r/zW hemorrhage is present in 
operations or injuries when vessels are torn or cut ; passive when 
it depends on the presence of disease germs in the blood, or 
poverty of that fluid. Hemorrhage is sometimes periodic, as in 
cases of vicarious menstruation. 



BACTERICIDES. ^^q 

The seat of hemorrhage will depend upon the location of the 
lesion, weakness, or partial death. 

There are general principles which must be observed in all 
hemorrhages. 

The recumbent posture must be rigidly maintained ; perfect 
freedom from excitement. 

The circulation must be perfectly regulated by keeping the 
action of the heart below seventy contractions per minute, this 
can be effected either by the administration of veratrum viride, or 
exalgine, or both. 

Plain, simple, nourishing food ; elevation of the bleeding part ; 
and the application of stimulants and styptics. 

Remedies to arrest hemorrhage will depend greatly upon its 
location and cause. All bactericides are active styptics, as car- 
bolic acid, creosote, creolin, peroxide of hydrogen, mineral acids; 
the various preparations containing tcrebciie, gallic acid, etc. As 
soon as arrested, great caution is to be observed in diet and 
movement. 



Bleeding from the nose or sinuses connected 

Hemorrhage, with it is quite a common occurrence ; owing to 

Epistaxis. the exposed position of the nasal organ and 

its richness in blood-vessels, to its possession 

of erectile tissue, the organ is liable to severe hemorrhages. 

These may be either traumatic or idiopathic. 

Among the commonest traumatic causes are blows, falls, frac- 
tures, entrance of foreign bodies, violent blowing, catheterizing 
the eustachian tube, and other surgical operations. Spontaneous 
or idiopathic hemorrhage is more rare, but may be met with in 
both sexes at the age of puberty. It may also occur from en- 
gorgement, hypersemia, and presence of disease germs during 
hooping cough ; from diseases of the heart, lungs, and liver ; in 
acute affections, such as scarlatina, measles, typhoid fever or 
diphtheria, and in recurrent fever. In some of these cases, the 
primary cause is increased arterial tension, resulting in the rup- 
ture of small and badly-supported blood-vessels. Habitual 
hemorrhage is also met with, without disease of the mucous 
membrane, in unhealthy conditions of the blood, such as haemo- 
philia, anaemia, chlorosis, pregnancy, leucaemia, and, according 
to some authorities, in scurvy, but that at least appears doubtful. 
There may also be nasal hemorrhage in cases of general plethora 
in children or adults. Small varicose vessels, angiomata or ero- 
sions of the septum, naso-pharyngeal polypi, malignant tumors, 
and ulcers may also be causes. Vicarious epistaxis occurs at 
times, and may take the place of habitual discharges from the 



440 



DISEASE GERMS. 



anus or uterus. Free hemorrhage occasionally takes place under 
the mucous membrane, where the blood collects and forms haema- 
tomata, or blood tumors. 

The symptoms, apart from the flow of blood, are chiefly those 
of cephalic congestion, such as giddiness, throbbing, noises in 
the head and sleeplessness. The actual bleeding may be in a 
stream, or drop by drop from one or both nostrils. When it 
comes from the posterior part the blood flows through the nasal 
fossae into the pharynx, and is swallowed. The quantity lost 
may vary from a few drops to several quarts. After these severe 
attacks patients remain pale and anaemic, and if often subjected 
to them may gradually succumb. 

Diagnosis. — The first point is to establish the origm of the 
hemorrhage, which may come from the lungs, stomach, or 
pharynx. Sometimes the bleeding point can be seen. The ab- 
sence of vomiting will preclude haematemesis, and the history of 
the case, together with physical examination, will eliminate dis- 
eases of the lungs and heart. Hemorrhage from the pharynx 
may be recognized on inspection. If the hemorrhage ceases on 
compressing the nostrils, it comes from the anterior third of the 
nasal fossa. 

Treatment. — Epistaxis in some rare cases may be beneficial, as 
in plethora, hemorrhoids, heart disease, and vicarious menstrua- 
tion, but must always be looked upon with some degree of sus- 
picion. In a large proportion of cases the bleeding stops of itself; 
this of course can be aided by a few simple manoeuvres, such as 
placing the patient in the erect posture, holding both hands 
above the head ; the application of cold to the nape of the 
neck to cause contraction by stimulating the olfactory at its root 
in the medulla ; the application of spirits of turpentine over the 
liver ; by snuffing cold, or, better still, very hot water ; the in- 
sufflation of alum, tannin, matico-leaf, or injections or sprays by 
a cold atomizer of tannic acid, perchloride of iron. 

Sometimes these methods fail, and recourse must be had to 
plugging the nose with cotton or Hnt saturated with perchloride 
of iron. In no case should the plug be permitted to remain in 
over twenty-four hours. 

Constitutional treatment will often improve the condition of the 
blood ; rid that fluid of microbes, and thus lessen the predisposition 
to hemorrhage. For this purpose such remedies as iron in the 
form of syrup of quinine and aromatic sulphuric acid, avena 
sativa, kephaline, peroxide of hydrogen; whatever may improve 
health and vitality may be prescribed. Ergot here is a remedy 
of jTreat value. 



BACTERICIDES. 



441 



Hemorrhage 

From the Kidneys. 

Haematuria. 



Bloody urine, hemorrhage from the 
mucous membrane of the urinary pas- 
sages, the kidneys, bladder, urethra. 
It may be a symptom of acute or 
chronic nephritis ; to the presence of 
the microbe of malaria in the kidneys, or to parasites, or calculi ; 
morbid states of the blood, strains, blows, cancer in the 
kidney. 

It is easily recognized by the smoky or port- wine tint of urine ; 
albumen invariably present. When from the kidney, it is gener- 
ally diffused through the urine ; when from bladder or urethra, 





Renal hemorrhage ; illustrating renal 
infarction, as olten occurs in mala- 
rial hsemauiria. 



Renal hemorrhage ; 
diagram showing 
hemorrhage from 
the vascular tutts 
of the glomeruli. 



blood comes away after passing clear urine. Blood-casts of 
renal tubes, cancer-cells, or renal calculi. 

H?eraaturia very often present in Southern ague ; it may occur 
paroxysmally with the fit. 

Strong liability to haematuria in purpura, scurvy, or white cell- 
blood ; comes on from the slightest cold or exertion ; also a 
symptom ii bilious, remittent, and yellow fevers; and in or 
among the inhabitants of those localities where such prevail, it is 
endemic. 

The treatment must be varied according to cause ; but in all 
cases rest, and stimulants over kidneys. In all inflammatory 
forms, turpentine ; when passive without inflammation, hama- 
melis; con. tincture of kurchicine, when due to the malaria mi- 
crobe; gallic acid in infusion of uva ursa best astringent. 



442 DISEASE GERMS. 

Hemorrhage from the lungs is invari- 

Hemorrhage ably an essential symptom of bronchial 

From the Lungs, tuberculosis ; not at all so common where 

Haemoptysis. the substance of the lung is infiltrated by 

tubercle. It is also a common symptom 

in congestion of the lungs, due to the presence of the pneumo- 

coccus ; periodic in vicarious menstruation ; lifts, blows, running, 

jumping. 

TreaUnent in all cases, according to cause, common salt, exal- 
gine, comp. tincture of myrrh, erigeron, iron, are good remedies, 
when the bleeding is due to the tuberculae bacilli, causing ulceration 
of small vessels ; cannabis indica, if there is much nervous irrita- 
tion ; turpentine, ipecac,- cricus lanceolatus, witch hazel, ergot, 
sulphur water, peroxide hydrogen, all excellent remedies. At 
the same time enjoin rest, recumbent posture, cold drinks; keep 
heart's action under control with exalgine. 



Hemorrhage from the bowels may 
Hemorrhage be due to the lesion produced by the 

From the Rectum, germs of typhoid fever in the glands of 
Bruner and Peyer ; to the germ-eaten 
rectum of tuberculosis ; or the presence of the vibrios in the 
insane. It may be due to congestion of inflammation, as in 
dysentery ; to the rupture of the pile sacs (varicose veins) ; to 
the eating of the cancer germ through the vessels invaded by it. 
Foreign bodies, large or hardened masses of faeces, calculi or con- 
cretions may rupture a vessel and considerable loss of blood may 
take place ; polypoid growths. 

From whatever cause it has occurred, it should be promptly 
checked by rest in the recumbent posture, heat over abdomen ; 
either green root tincture of gelsemium or antipyrine should be 
administered freely to bring the action of the heart to sixty. 
Enemata of witch hazel or stone crop, or a teaspoonful of Mon- 
sul's solution of iron to an ounce of water, or aromatic sulphuric 
acid and water. Internally, our best styptic is the bursa pastoris, 
or shepherd purse, a tincture from the green or fresh herb is the 
best rectal stypiic in the materia medica, always reliable, ever 
efficacious; and the general treatment of the disease which gave 
rise to it should be carried out. 

It is well for all individuals who have rectal trouble, or who 
have had any operative procedure about the rectum which may 
have rendered them liable to hemorrhage, to avoid all straining, 
lifting, or violent exertion for some time. 



BACTERICIDES. 



443 



The escape of blood-stained fluid 
Hemorrhage from Skin, from the cutaneous surface is a very 
or rare disease. Most frequently met 

Hsematidrosis^ with in young ladies suffering from 

vicarious menstruation ; still, it occa- 
sionally occurs in young men after puberty. 

The treatment must be upon general principles, chiefly directed 
to stimulating the uterine function by caulophyllum and uterine 
tonics. 

A general course directed to improving the general health by 
tonics and stimulants. ______ 

Hemorrhages into the skin may occur 

Hemorrhages under various conditions. They are not 

in Skin. uncommon in the specific fevers and allied 

affections, occurring especially in typhus^ 

measles, variola (hem.orrhagic variola), diphtheria and pyaemia. 

In erythema and urticaria slight hemorrhages may occur. In 

scurvy, cutaneous and subcutaneous hemorrhages are prominent 

symptoms, while in one disease (purpura) cutaneous hemorrhage 

may be said to be the only symptom. Hemorrhagic spots in the 

skin are variously described, according to their size. Those 

which do not exceed a line in diameter are termed petecluce ; 

when somewhat larger, they are described as vibices ; while large 

patches are denominated ecchymoses. 

Purpura, an unclassified affection, doubtless from the difficulty 
of deciding where to place it. Its cause is not known. Occa- 
sionally it occurs amongst those depressed in health, or subject 
to insanitary conditions, but it also attacks those in perfect 
health. May occur at any age, but more common in children. 
Sometimes preceded by lassitude, pains in the limbs, etc., but 
frequently the hemorrhagic macules appear suddenly, without 
any premonitory signs whatever. They are mostly closely aggre- 
gated together, and vary in size from mere points to spots a 
quarter of an inch in diameter. They are circular, purplish in 
tint, not raised, and not attended with any abnormal sensations 
whatever. Most common on lower limbs and lower part of 
trunk, but also occur in other parts. Also seen on mucous mem- 
branes and beneath conjunctivae. Fade away in the same man- 
ner as bruises do, but successive crops may appear for weeks. 
Larger extravasations may also occur; these are generally more 
deeply seated, and gradually manifest themselves in the same 
manner as deep-seated bruises. Very often purpura is attended by 
no symptoms whatever. Sometimes weakness and lassitude 
accompany the attack, or the temperature may be elevated. In 



444 DISEASE GERMS. 

some cases hemorrhages from the various mucous membranes 
may occur. If these be severe, symptoms due to loss of blood 
will be developed. In severe cases death may ensue from asthe- 
nia or syncope. In fatal cases hemorrhages have been found 
beneath the mucous and serous membranes and into the 
substance of various organs, especially the heart, lungs and 
kidneys. 

The treatment should consist of rest; digitalis or strophanthus, 
mineral acids and quinine, with the best blood-forming diet. 

Scurvy is characterized by cutaneous hemorrhage, caused by 
a want of vegetables ; limited to seamen or people who live on 
heights. 

The skin symptoms resemble, to some extent, those of purpura, 
but the other symptoms should prevent all possibility of a mis- 
take in the diagnosis. There is marked and rapidly-increasing 
anaemia, accompanied both by bodily weakness and mental 
apathy. Hemorrhage is very common. The gums swell and 
bleed, and the teeth become loose. Ulcers are apt to form on 
various parts of the body, and old wounds often re-open. 
In severe cases death may occur from syncope or from some 
complication. 

In the treatment rest is of essential importance ; digitalis, 
abundance of fruit, vegetables, speedily effect a cure. 



Vomiting of blood by the stomach 
Hemorrhage from the is due to a large variety of causes. 
Stomach. It is often but a symptom of some 

Hsematemesis. disease, as acute gastritis, of yellow 

fever, of abdominal disease, as a 
morbid liver, or cancer, or ulcer of the stomach ; morbid 
states of blood, as purpura and scurvy ; or vicarious menstrua- 
tion. 

The vomited blood may be either a pure red, or mixed with 
the gastric juices, or it may be dark, frothy, like coffee grounds, 
or changed to black by the acids of the stomach. 

In the treatment enjoin rest, recumbent posture, heat over 
stomach. Try first green root tincture of gelsemium ; that 
failing, tincture of ipecacuanha, in four to ten drops if there be 
much vomiting. If the blood is dark, grumous (venous), hama- 
■melis tincture; oil of turpentine if there is great debility; ergot 
hypodermically ; other astringents, as sulphuric acid, iron, tannic 
and gallic acid, etc. 



BACTERICIDES. 



445 



Various terms are used to express the idea 

Hemorrhage, of uterine hemorrhage at different periods and 
Uterine. conditions. For example, it is called menor- 
rhagia ,\v\\Qn menstruation is copious or profuse, 
or prolonged ; inctrorrJiagia, when there is a copious, excessive, 
continous flow of blood during the interval, not necessarily asso- 
ciated with menstruation, but more frequently blended with tu- 
mors, warts, disease germs, polypus, cancers and retained pro- 
ducts of conception. 

The uterus is the only organ in the body from which blood 
flows at stated intervals, and so long as it does not exceed in 
quantity over four ounces, and does not occur more frequently than 
every twenty-eight days, it is to be regarded as normal. 

Causes. — Among Caucasian ladies, the uterus is very freely 
supplied, nay, its anterior portion literally covered all over, with 
branches of the great sympathetic nerve ; hence in that class of 
patients violent emotions, desires, affections, passions, as in- 
tense grief, sorrow, worry, etc., give rise to relaxation of uterine 
tissue and congestion; sedentary occupations, repeated abortions, 
devitalize the uterus, cause it to lose its contractility ; wearing 
sponges, rings, pessaries, excessive sexual congress, all impair 
its vitality and aid in bringing about an excessive flow. Debility 
is a common cause, whether it be directly from disease, or the 
presence of disease germs in the blood ; long continued or ex- 
cessive lactation, over work, lifts, strains, inordinate excitement ; 
poisons in the blood due to sewer-gas ; defective sanitation. 

The excessive flow, with debility, anaemia are the symptoms ; 
and these, outside of the causes enumerated, may be essential 
landmarks of metritis, uterine or ovarian tumors ; of placenta 
praevia ; uterine cancer ; polypus, moles, etc. 

Treatment, — During an attack, enjoin rest of body in recum- 
bent position in bed, head low, foot of bed somewhat elevated. 
With this horizontal rest, ease of mind, no hot drinks or hot 
food, and the patient is not to get up for either urination or defeca- 
tion, for the blood pressure is greatly increased by stooping or 
straining. Diet to be nourishing : beef essence, milk and lime- 
water, eggs, toast. 

The judicious physician will select remedies and administer 
them according to their indications. 

In the menorrhage of young ladies, ovarian hyperaemia, no 
drugs excel fluid extract salix nigra, aleteris farinosa, digitalis, 
bromide of potassa. These are unfailing remedies. 

Ergot, ustilago maidis, terebene, are useful in hemorrhage due 
to chronic metritis, pelvic hyperaemia. These drugs cause con- 
traction of the pelvic vessels. 



446 



DISEASE GERMS. 



Strychnine is useful when the flow is associated with general 
debility and loss of muscular tone. 

Witch hazel is indicated in venous or passive hemorrhage. 

Sulphuric acid and spirits of turpentine, oil of erigeron, hy- 
drastin, gallic acid, etc., best adapted to cases of hemorrhage 
after lingering labor. 

Ergot in combination with compound oxygen as follows: 
Fluid extract ergotae, three drops ; compound oxygen, two 
drachms ; dilute muriatic acid, ten drops ; infusion of gold thread, 
one ounce. Administer in four doses, half an hour apart. 

Local treatment of utility, if there be a thick, heavy, congested 
state of the neck of the uterus, even hypertrophied ; pack the 
vagina nightly with boroglyceride till removed. 

The hot vaginal douche is always a valuable auxiliary to treat- 
ment. 

One of the most powerful local means of aiding a renewal of life 
in the uterus, and inducing contractility, is dry heat, in any light 
vehicle, as camomile flowers, bran, hops in bags or pillows, ap- 
plied over the uterus and vulva hot. The old doctors swear by 
cold, but cold water, or ice either, over pubes, or up vagina and 
rectum, is positively injurious. If these means fail, resort at once 
to a plug ; in the" unmarried it is difficult sometimes to insert, but 
in married women there is no difficulty. A sponge answers the 
purpose most admirably, or several small ones ; they may be 
saturated with a solution of carbolic acid, or tincture of iron, or 
vinegar. 

Of intra-uterine applications (used with great care and judg- 
ment), boroglyceride, resorcin, creolin, etc., and the positive pole 
of the continuous current are of chief importance. 

Bleeding from a cancer or polypus is always mitigated by 
rest, brushing the diseased surface with lactic acid ; their 
removal. 

In all cases, 7io matter zvhat the origin may be, strengthen the 
7Ltenis, induce contraction of its vessels by the alternate adminis- 
tration of the sahx nigra ; aleteris farinosa, compound syrup of 
partridge berry, stylosanthus, etc. 



Hemorrhoids or piles are terms applied 
Hemorrhoids, and restricted to small, vascular tumors, or 
excrescences situated either within or on the 
verge of the anus. They consist of folds of mucous and sub- 
mucous membrane in an inflamed, infiltrated or permanently 
thickened condition, and usually contain enlarged varicose 
veins. 



BACTERICIDES. 



447 




External pile. 



Certain distinctions are admitted, and these are engrafted into 
all our literature on the subject, as blind and bleeding, according 
as they are or are not accompanied by hemorrhage ; and into 
external and internal, as they are without or within the 
sphincter ani. 

Hemorrhoidal disease is essentially one of debility — a true vari- 
cose condition of the veins of the rectum, involving altered nutri- 
tion, with dilated, tortuous vessels, surrounded by 
tissue thickened by inflammatory products. Those 
tumors may in some cases consist of erectile tissue, 
formed by the abnormal condition of the vessels of 
the mucous membrane. 

In order to appreciate the subject thoroughly, 
the anatomy of the rectum must be reviewed. 
Here we see that it is very freely, nay, largely, sup- 
plied with blood. The vessels on its outer side are 
large, and send branches at intervals through the 
muscular coat, which ramify between it and the 
mucous membrane. The arrangement of the coats 
of the bowel is not the same throughout ; over 
the greater part the arteries and veins, take the same 
course, penetrate the muscular coat at short inter- 
vals, and at once divide into small branches, and go in a trans- 
verse direction, forming a network by their communication with 
the subdivisions of other smaller vessels. Towards the lower 
end of the bowel, for the length of about six inches, the arrange- 
ment is quite different. Here the vessels have 
considerable length, and their direction is 
longitudinal. Penetrating at different lengths, 
they merge in parallel lines towards the end 
of the gut. In their progress downwards 
they communicate with each other at inter- 
vals, and are still more freely connected near 
the orifice of the bowel. Here the arteries 
all join by transverse branches of good size. 
The veins form loops, inosculate or anastomose 
with great freedom. 

At an early stage of hemorrhoidal disease 
the blood may circulate through the dilated 
veins ; but as they advance dilatation becomes greater, and they 
are still further enlarged, and when so, they are found to contain 
clotted blood or fibrinous matter. From the aggregation of 
veins, thus dilated in different ways and degrees, loaded with 
blood or one of its elements, more or less solidified, the hemor- 
rhoidal tumor is formed. The rounded masses which fringe the 




Internal and external 
piles. 



448 



DISEASE GERMS. 



end of the rectum, soft, pulpy, are simply coagulated blood 
which is confined there. When ravelled out and inspected with 
a magnifying glass, those swellings are simply varicose veins, 
loops dilated, enlarged, tortuous, thickened by inflammation. 

The dilatation of the terminal loops, from their dependent posi- 
tion, the weight of the column of blood, the want of valves in 
those rectal vessels, gives us an uninterrupted flow from heart and 
Hver, the large size of the vessels at the lower end of the rectum 
and of their terminal loops favor varicosity. 

The predisposing causes are inherent, or c^cquired debility, or 
weakness of the veins, which permits of their alteration or 





This wood cut affords an excellent illustra- 
tion of both external and internal hemor- 
rhoids in a full stage of development, 
three protruding through the external 
sphincters, three higher up in the bowels. 



A con-piete stale in which a hemor- 
rhoid protrudes externally with an 
eroding ulcer high up Very com- 
mon in pulmonary consumption. 



change into a hemorrhoidal tumor. This change takes place in 
the loops into a species of gradual dilatation, usually in the form 
of a round pouch, fusiform, or abrupt, or elongated. 

The exciting causes are any thing that give rise to congestion 
of the lower bowel, as luxurious living, sedentary habits of life. 
The use of alcohol, carbonaceous food, overcrowding, solar heat, 
render the liver sluggish, and this inactivity rebounds upon the 
rectal plexus of vessels; causes turgescence. A germ-smitten, 
malarial liver and spleen retards the formation of bile, embarrasses 
its function, gives rise to inertia or inactivity of the bowels. 
Whenever the portal circulation is slowed, vascularity of the rec- 
ta) vessels take place. Constipation is the most common 
cause ; it operates in producing hemorrhoids by pressure of the 
accumulated and hardened faeces upon the veins ; the straining 



BACTERICIDES. ^^g 

and irritation such alvine evacuations produce in their passage ; 
drastic purgatives, as aloes, dysentery ; inflammation of the 
prostate ; uterus ; all persons habituated to diarrhea. 

T/te ordinary symptoms of hemorrhoids are very variable, but 
may be embraced in a few sentences. The patient, after experi- 
encing for an uncertain length of time a feeling of itching, heat, 
fulness, throbbing about the lower portion of the bowels, be- 
comes conscious of a sensation, as if there was a foreign body in 
the anus. On an examination, after an evacuation of the bowels, 
he discovers a small tumor, usually about the size of a small 
marble, which either remains outside or is retracted inside, 
according as it originated, without or within the sphincter. The 
tumor gradually increases in size, and others form around it, 
until a mass of them may form, or the original one remain soli- 
tary. Whichever be the case, they gradually increase in size, 
reaching about the bulk of a pigeon's ^%^ or larger. In its ordi- 
nary indolent state it has little sensibility, and may occasion little 
annoyance ; but when inflamed from strangulation of the 
sphincter muscle, or any other cause, it is exquisitely tender to 
the touch, and is the seat of burning and stinging sensations, 
rendering the evacuation of the bowels, and sometimes the blad- 
der, difficult and very painful. In men those tumors may give rise 
to leakages, prostatorrhaea ; in women, to irritation of the uterus, 
ovaries, vagina, with mucous or muco-purulent discharge, anaemia, 
loss of flesh, debility, and many other anomalous symptoms. In 
severe cases patient can neither sit nor walk with comfort, and 
only finds relief in the horizontal position. 

The reflex symptoms are numerous, as pain in the back, 
albuminuria, headaches, prostration, chorea, epilepsy, nervous 
disease, and general derangement of the vital forces. 

Itching piles, as they are termed, present no distinct elevation, 
but great irritation of the anus and puffiness of the surrounding 
parts, often accompanied with an eczematous eruption ; usually 
disappear under an alterative and tonic course of treatment, with 
a lotion of boroglyceride to the part. 

Hemorrhoids are liable to be aflected by attacks of general ill 
health, or irregularities of the stomach, liver and bowels. 

Cold, damp, carelessness in the selection of article for cleansing 
the parts after defecation, often excite an irritation, a little red- 
ness, with slight tenderness and oedema. Any thing which irri* 
tates the delicate integument about the verge of the anus, an 
obstruction to the circulation, preventing a return of venous 
blood, high living, alcoholic drinks, mercury, malaria, use of 
tobacco, act in the production of piles by obstructing the liver. 
29 



450 



DISEASE GERMS. 



The diagnosis of piles is very simple ; the history of the case, 
their appearance are most significant. 

Treatment. — The general management of a case of either ex- 
ternal or internal piles is simple and most effective. In all cases 
the patient should be placed upon an alterative and tonic course, 
generous diet, free from carbonaceous material, daily alkaline or 
acid baths, and rest in the recumbent posture inculcated ; all pre- 
disposing and exciting causes as far as possible removed. 

Remedies that will efficiently stimulate the liver should be ad- 
ministered, and all alcoholic drinks or conditions of life which 
will cause torpidity of that gland removed. For this purpose the 
following formulae are excellent : tincture of nux vomica, and 
tincture of belladonna, of each half an ounce. Mix. Dose, from 
five to ten drops before each meal, in alternation with fifceen- 
drop doses of tincture of sulphur, both administered highly di- 
luted in water. And on retiring to bed every night, the follow- 
ing is to be injected into the rectum : three drachms of the fluid 
ext. of hamamelis; two drachms of the fluid ext. of hydrastis cana- 
densis ; and two ounces of sweet oil. Mix, and if possible, re- 
tain over night. As a palliation, and often curative remedy for 
local and internal piles, hamamelis is very superior to all other 
remedies. The external parts should be bathed thrice daily with 
warm water and castile soap. 

After each morning stool, the rectum should be injected with 
warm water, or if great debility exists, beef tea, and permitted to 
remain half an hour or longer. When this is passed, a cocaine 
suppository should be inserted, or a half a drachm of either of 
the following should be introduced into the rectum : sub-nitrate 
of bismuth, two drachms ; muriate of hydrastin, thirty grains ; 
butter of coca, one ounce ; oil of eucalyptus, twenty drops. 
Liquefy the butter of coca by heat, then add the bismuth, 
hydrastin, and eucalyptus; run in moulds so as to give thirty 
grains to each. Or, the following may be tried : fluid ext. 
eucalyptus, one drachm ; oxide of zinc, two drachms ; butter of 
coca and vaseline half an ounce. Use as above. Petroleum 
oint, one ounce ; salicylate soda, solid extract elder bark, and 
burned alum, of each one drachm. Mix. All are excellent, and 
should be applied to the outside, and inside as far as possible. 
This treatment will get rid of the inflammation. 

Small piles, or cutaneous excrescences around the anus should 
be remov^ed, or absorbed. For this purpose some of the following 
should be tried : Monsul's solution of iron, one ounce and a half; 
fluid ext. belladonna, three drachms ; fluid ext. hamamelis, three 
ounces ; tinct. calendula, four ounces ; sulphate of morphia, 
thirty grains. Mix. Apply locally around the parts once or 



BACTERICIDES. 45 1 

twice daily with a camel's hair pencil brush ; or a mixture of 
hamamelis, glycerine, and boroglyceride is excellent. 

In our treatment of both external and internal piles, whether 
they be blind or bleeding, protruding or ulcerated, or whatever 
name may be given to them, a cure can be effected in all cases with- 
out the use of the knife, ecraseur, clamp, torsion, or burning with 
-caustic, by simply injecting them to coagulate their contents and 
excite absorption. 

If it is decided to operate for either external or internal hemor- 
rhoids by injection, the bowels should be freely opened, and then 
the rectum washed out. If they are external, the mode of pro- 
cedure is very simple, simply throwing the injection into the 
centre of the pile; but if they are internal, the speculum must be 
inserted, and the tumor brought well into view. Then introduce 
the needle of the syringe (which is charged with one of the 
formulae which are given below), into the most dependent part, 
taking great care not to push the needle into the connective tis- 
sue underneath the sac. This accident would cause great pain 
and inflammation, and in some cases produce much trouble. 
Should this occur, a warm sitz bath should be imriiediately re- 
sorted to, to be followed by a cocoaine suppository. This affords 
instant relief 

It is unnecessary to state that there is always less irritation 
from injecting one, than two or more. 

In all cases the irritation passes off in from four to eight days, 
unless an overdose be given. Scarcely any pain follows if the 
injection is deposited in the centre of the sac. 

It is a good rule to adopt, never to inject internal piles when 
they are protruding, they should invariably be returned into the 
rectum before being injected, and the inflammation, if possible, 
must be reduced before treatment is carried on, although we have 
treated piles when protruding from the anus, with our favorite 
prescription, with no unpleasant results. 

The following are a few of the formulae in very general use by 
rectal specialists for the purpose of coagulating the contents of 
piles, and causing their disappearance or perfect obHteration by 
absorption : 

Carbolic acid crystals, fifteen grains ; fluid extract thuja occi- 
dentalis, thirty drops ; oil of eucalyptus, sixteen drops ; glycerine, 
thirty drops; aqua dest, three drops. Mix. Inject from five to 
fifteen drops into each pile, the quantity injected being governed 
by the size of the pile to be injected. 

In using this, and either of the following formulae, no irritation 
or sloughing will occur, even if a drop or two penetrate into the 
connective tissue. 



452 



DISEASE GERMS. 



In preparing any of the formulae, a very small quantity should 
be prepared at a time, as it will be fresher, more active. None 
of them should be exposed to a strong light for any length of 
time. 

A variety of formulae for injecting piles : 

Carbolic acid, glycerine, of each one drachm ; fl. ext. ergot, 
one drachm ; water, one and a half drachm. Mix. Three to 
eight drops to be injected according to the size of the pile. 

Carbolic acid, thirty-five grains ; fl. ext. ergot, twenty drops ; 
glycerine, fifteen drops ; dist. water, fifty drops. Mix. Inject 
two to ten drops. 

Carbolic acid, four drachms ; olive oil, three drachms ; oil ori- 
ganum, one drachm ; salol, five drachms. Mix. Inject two to 
six drops. 

Olive oil, twelve drachms ; carbolic acid, ten drachms ; tinct. 
opii, one drachm. Mix. Heat to 290° F. ; evaporate to two 
and one-half ounces to drive off the water and alcohol, then in- 
ject from two to ten drops. 

FL ext. thuja, six drachms ; fl. ext. hamamelis, one drachm ; 
fl. ext. horse chestnut, three drachms ; water, four drachms. 
Mix. Inject from five to twelve drops. 

Carbolic acid, one drachm ; sperm oil, three drachms. Mix. 
Inject from three to fifteen drops. 

Carbolic acid, one ounce ; creosote, twenty drops ; olive oil, 
glycerine, of each one ounce; muriate of cocaine, three grains. 
Mix. Inject three to six drops. 

Salol, ten grains ; fl. ext. horse chestnut, one drachm ; fl. ext. 
ergot, one drachm. Mix. Inject ten to thirty drops. 

With those, and like formulae, a good rule to adopt is never to 
inject inore than one pile at once; if small, two can be injected, 
provided the amount injected did not exceed ten to twelve 
drops. Better to repeat the operation in eight or ten days, until 
all have been injected and cured. In some rare cases, very large 
piles may require two or three treatments. 

Select one of the following formulae, to apply on cotton or lint 
continuously for irritable piles : 

Hydrochlorate of cocaine, five grains ; two drachms each ot 
fluid extract of opium, aconite and stramonium ; glycerine, one 
drachm. Mix. 

Tannic acid, two drachms ; solid extract of belladonna, five 
grains ; pulverized opium, one drachm ; ozone ointment, one ounce. 
Mix. Apply inside and outside. 

Subnitrate of bismuth, two drachms ; hydrarg. chloride mit., 
forty grains ; sulphate of morphia, three grains ; glycerine, three 
drachms ; ozone ointment, one ounce. Mix. Apply in pile 
syringe. 



BACTERICIDES. 



453 




We cannot speak too highly of the utility of curing hemor- 
rhoids by injecting and dispensing with the old and barbarous 
methods. It is the most serviceable and requires very little 
skill, nothing but good common sense ; the number of drops in- 
jected should correspond to the size of the pile. It is best to use 
a curved needle, it throws and holds the medicament deeper into 
the base of the tumor than a straight one. The operation is sim- 
ple with hemorrhoids situated near the anus, a little more diffi- 
cult higher up. 

The injections are more painful the nearer they are to the 
external anal orifice, but this soon subsides. Even in very sensi- 
tive ladies pain is scarcely appreciable. 
In is undoubtedly the best plan, after 
they are injected, to lock up the bowels 
for a few days by administering a grain 
of opium thrice daily. Even when the 
bowels are moved there is no difficulty, 
no danger of any complications what- 
ever. 

The almost freedom from pain per- 
mits the patient to follow his avoca- 
tion undisturbed, there is no need of 
chloroform or ether with their dangers 
and disagreeable effect. There is every 
argument in favor of the method. 

Hemorrhoids and Prolapse of the Rectum often co-exist. In 
cases of this kind the eminent rectal specialist, Prof G. W. 
Powell, M. D., Moriah, New York, gives what he denominates a 
safe, simple, and effective mode of treating these troublesome 
affections. He injects into the tissues with a hypodermic syringe 
an eight-grain solution of muriate of cocaine with an equal vol- 
ume of phenol sodique. The quantity of this solution injected 
varies from twenty minims, in small hemorrhoidal tumors, to 
one ounce, in prolapsed rectum. 

One injection is sufficient to cure haemorrhoidal tumors in all 
his cases, while two to four trials are found necessary to cure 
prolapsed rectum. The syringe point is introduced at the 
most prominent point of the tumors — large or small — and thrust 
boldly to the most vascular part of their base, arid a liberal por- 
tion of the solution deposited, according to the size of the 
tumor. 

Then the balance of the tumor is well saturated with the solu- 
tion. After injecting hemorrhoids no topical treatment is ap- 
pliedj except a daily wash of dilute solution of boroglyceride as 
hot as can be borne. After injecting prolapsed rectum a mild 



]SuPTierous small piles protruding 
from the anu<, which were all 
injected at one time with car- 
bolic acid injection; excellent 
cure. 



454 



DISEASE GERMS. 



antiseptic healing salve is applied. The following formula 
was found very efficient : 

Iodoform, in fine powder, balsam Peru, oil of camphor, oil of 
sassafras, of each half a drachm ; pine tar, castor oil, powdered 
aloes, of each one drachm ; subnitrate of bismuth enough to 
make a stiff salve. Apply thoroughly twice a day, and cover 
with a soft cloth. 

Before applying the salve each time, let the parts be well washed 
with the syringe ; soapsuds from tar soap, as hot as can be 
borne, being employed for the purpose. 

In addition to whatever general internal treatment may be indi- 
cated in any given case, he is in the habit of directing, with ex- 
cellent results, something like the following: 

Fl. ext. witch hazel, half an ounce ; sat. tinct. horse-chestnut, 
one drachm ; muriate of ammonia, one drachm ; glycerine, four 
ounces. M. ft. sol. Dose. A teaspoonful three times a day, 
just after meals, on alternate days. 

Muriate of hydrastin, twenty-four gr. ; ergotin, twelve gr. ; 
ext. capsicum, ext. ipecac, aloin, of each six gr. Mix. Make 
twenty- four pills and silver-coat. Dose. One pill three times a 
day, just after meals, on alternate days. 

These last two prescriptions should be administered regularly, 
on alternate days, as long as the hemorrhoids or prolapse give 
trouble, and for several weeks after they have ceased to do so. 

After operation on hemorrhoids, patients are allowed to 
attend to their ordinary business at pleasure. 

The cases of prolapsed rectum are confined to bed until cured, 
which is in the mildest cases about two weeks, and in some 
severe or complex cases about four weeks. They are then 
allowed to move gently about the room, but if the patients are 
parturients, the horizontal posture and quietude are doubly 
indicated. No general anesthetic is found necessary in any of 
the cases, as the operations produce but little pain or subse- 
quent soreness. No inflammatory reaction follows the injec- 
tions. 

Pain indicates a partial death, so here we have, 

Headache, in the brain, an organ suffering a loss of its vitality 

from the wear and tear of civilized life ; this lies 

at the origin of all headaches ; then the presence of disease 

germs in the blood acts as an exciting cause, so we have the 

headache of syphilis, gout, rheumatism, malaria, etc. 

Poisons in the blood, like uric acid ; polluted atmospheres, with 
sewer-gas and other effluvia ; want of nutrition in the brain proper, 
as starved areas ; reflex causes and organic disease of the brain 
substance. 



BACTERICIDES. 



455 



A division or classification of the various headaches is of great 
value in the application of remedies for its relief 

Of all varieties the nervotis is the most common, it is due to 
debility, exhaustion, poor blood, to the use of a diet deficient in 
phosphates ; to hemorrhages, over-lactation. When neurasthenic 
men or women suffer from this headache, it is confined to one 
spot, resembles the driving of a nail into the part, and is known 
as the clavus hystericus. 

The congestive form is due to inherent weakness in brain sub- 
stance and a determination of blood. There are symptoms of 
plethora, vertigo, beating in ears, caused by over-stimulation, or 
it might arise from a sudden suppression of the catamenia. 

What is termed bilious headache is associated with derange- 
ment of the stomach and liver. There is usually a coated 
tongue, fetid breath, flatulence, nausea, constipation, stools clay- 
colored. 

In the organic form, there is some well-defined cerebral disease, 
with vertigo, muscse volitantes, tinnitus aurium, vomiting, con- 
vulsions. The character of pain will indicate its location, whether 
it be the membranes or substance of brain. 

In the treatment of all headaches general principles should 
guide us. Bowels should be regulated either with cascara sagrada 
or kolatina lozenge, skin stimulated, rest inculcated ; warm mus- 
tard foot baths and a light nutritious diet given, and above all 
things breathe pure air. 

We briefly enumerate a few of the more prominent remedies 
in the cure of headache : 

When purely 7tervous the salicylate soda in the effervescing 
citrate of caffeine, guarana, fluid extract tonga, simabicidia, one- 
per-cent. solution of nitro-glycerine. 

The caffeine in this form of headache is oi great efficacy. 
Nothing can excel it. Menthol also of utility. 

When bilious, compound extract of colocynth, nux vomica, 
gelsemium, chloride of ammonia. 

When due to congestion, bromide of potass, liquor ammonia 
acetatis, bryonia, exalgine. 

In ancEinic states of the brain, as in cerebral neurasthenia, nitro- 
glycerine stands unrivalled ; Indian hemp also good ; cimicifuga, 
caulophyllum, pulsatilla, are three excellent remedies at the 
climacteric period, with pain at vertex and hot and cold flushes. 

In headache, due to the inhalation of foul air, sewer-gas, 
densely populated localities, peroxide hydrogen, compound oxy- 
gen, chlorate potass. 

In that due to organic changes in the brain, large doses of solid 
extract hyoscyamus, alternated with sulphonal; croton chloral 
hydrate. 



456 



DISEASE GERMS. 



An acute affection in which one or more groups 

Herpes, of vesicles are seen seated on a red and inflamed 
base. The vesicles are generally small and their 
contents clear, but sometimes they become opaque ; several may 
coalesce. The vesicles begin as papules, but these quickly be- 
come vesicular, and the eruption is at its height in twenty-four 
hours. In a few days the vesicles dry up and scabs form, which 
drop off, leaving simply a patch of redness. Two varieties are 
described in the official nomenclature : H. facialis, {Syn. labialis) 
and H. prceputialis. Other varieties also receive special names 
according to the part affected, as H. aiiriciilaris, etc. 

H. labialis is a not uncommon accompaniment of catarrh, espe- 
cially when accompanied with much fever. It so constantly 
occurs at the onset of croupous pneumonia as to form a marked 
symptom ; it follows the rigors. 

H. prceputialis is a vesicular eruption occurring on the genitals, 
as implied by its name. It may cause alarm by being mistaken 
for a venereal affection. It is sometimes exceedingly obstinate, 
recurring again and again. 

H. circinatus and H. iris are rare forms which are occasionally 
seen. The former is the name applied to a ring of vesicles 
seated on an inflamed base. This gradually enlarges and fresh 
vesicles form at the periphery while the centre clears. H. iris 
is a very rare form of eruption, in which vesicles form in con- 
centric rings upon a reddened base which gradually increases in 
size. 

In the treatment of these different forms of herpes, we must 
always recognize the fact that the serum of the vesicles contains 
the germ, the factor of the disease ; that if this is permitted to ooze 
around and contaminate sound parts, it will have a perpetual exist- 
ence. So that whatever dressing is applied, must be powerfully 
germicidal, wet or dry, to kill the microbe ; if a lotion is desired, 
let it be made of either ichthyol or resorcin, or creolin or 
bichloride mercury; if a powder, the anti-microbe powder ; oint- 
ments are to be avoided if possible, but if used, must be made of 
resorcin, ichthyol, creolin, bichloride of mercury, etc. 

Internally, patient should be placed upon alteratives and tonics, 
as saxifraga and cinchona ; at the same time the blood must be 
kept sterilized by the constant administration of either ozonized 
sulphur water, peroxide hydrogen or compound oxygen. 

Herpes, zoster, shingles, formerly described as a variety of herpes, 
but now considered a distinct disease, and named zona in the 
official nomenclature. In appearance it somewhat resembles 
ordinary herpes, consisting, as it does, of small vesicles seated on 
an inflamed base. It has, however, marked differences. The 



BACTERICIDES. 



457 



distribution of the vesicles should alone suffice to diagnose it. 
They usually appear along the course of one of the principal 
nerves, very commonly one of the intercostal or superficial cervi- 
cal nerves, though it may also occur on the limbs. The eruption 
is almost invariably unilateral. It is generally preceded or accom- 
panied, sometimes followed, by neuralgic pain along the course 
of the affected nerve, which may be very severe. Zona is regarded 
as a neurosis. Changes have been found in the adjoining nerves, 
also in the inter-vertebral ganglia. Hyperaemia and hemorrhage 
have been found to occur within the ganglion and surrounding 
cell- infiltration. Peripheral nerves show neuritus or perineuritis. 
Both motor and stnsory nerves have been found affected. Dubler 
believes that zona is not a neurotrophic disturbance, but a direct 
extension of inflammation along the nerve to the skin. 

Eruption . may occur at any age, but more common in latter 
half of life. A second attack is rare. In many cases no dis- 
coverable cause is present. In others, some source of nerve irri- 
tation may be known to be present, as tumors causing pressure 
on nerves, caries of vertebrae, locomotor ataxy, etc. Eruption 
has also been observed after poisoning with carbon monoxide, 
and has been known to appear during the medicinal administra- 
tion of arsenic. 

The vesicles of zona may be few and isolated, but more often 
occur in groups, the individual vesicles being small, prominent and 
set rather closely together. Successive crops may come out for 
a week or more. The vesicles become opaque and then dry up, 
leaving yellowish scabs which soon drop off It is not followed 
by scarring unless ulcers have formed, or the inflammatory pro- 
cess has proceeded to gangrene. 

This form is best treated by the local application of powerful 
stimulating bactericides and the use of such remedies as gly- 
cerite of kephaline, tincture of oats, and such formulae as the fol- 
lowing : 

Glycerite of kephaline, four ounces ; sulphate of quinine, one 
drachm; tincture of nux vomica, two drachms. Mix. One tea- 
spoonful thrice daily. Phosphide of zinc and extract of nux 
vomica, of each, one-third of a grain, added to solid extract of 
hydrastis, thrice daily. 

Hiccough is a short, convulsive and noisy inspi- 
Hiccough. ration, followed immediately by expiration. It is 
due to the sudden and involuntary and momen- 
tary contraction of the diaphragm with the simultaneous narrow- 
ing of the glottis. 

The cause is either in the brain, at the origin of the pneumo- 



458 



DISEASE GERMS. 



gastric and vagus, or at their periphery in the stomach or recur- 
rent branches in the diaphragm. Occurring in brain irritation or 
disease, it is to be looked upon as one of great danger when de- 
pendent on irritation of digestive organs ; usually not to be 
dreaded, but the paroxysms occurring at short intervals, and for 
days in succession, give rise to pain about the heart and great 
exhaustion. Young and old are most liable to attacks. In all 
cases the treatment should be adapted to the cause ; but if no 
acute or dangerous malady is under way, in a mild case it can be 
checked by patient taking a deep inspiration, and then holding 
the breath as long as possible, so as to keep diaphragm con- 
tracted ; the wearing of a belt around epigastrium. In other 
cases it can be checked by snuffs, a good sneeze. 

In more severe forms try one of the following remedies by the 
smell, as inhalation of a few drops of chloroform, ether, nitrate 
of amyl ; by the mouthy ammonia, musk, camphor, menthol, 
Indian hemp, aconite, belladonna, nux vomica, chloroform, 
bromohydric acid, hydrocyanic acid; local, dry cups, aconite, 
belladonna and chloroform; liniment to nape of neck and over 
diaphragm. 

If due to dyspepsia, emetics, bitter tonics, cinchona and 
ammonia. 

If hysterical, sambul, valerianate of zinc. 

If intermittent, iodine and quinine. 

If infantile, a few drops of oil of aniseed, wintergreen, warm 
bath ; see to the milk. 

In the United States, with its heteroge- 
Home-Sickness, neous population of different races of men, 
all possessing more or less an affinity for 
that spot of earth on which they each respectively originate, we 
find this malady very common and in a most aggravated form. 
Among the Caucasian race the Anglo-Saxon is the most easy to 
climatize, whereas, the Celt, with all his vivacity and dash, is the 
most difficult. In the latter race there is often a perfect want of 
adaptability, especially if there exists a poverty of nerve force in 
the individual ; in the former the acclimatization faculty is per- 
fect, truly cosmopolitan. 

Neurasthenia lies at the root of this disorder, and all its varied 
symptoms are present. 

Nostalgia shows itself by a fondness for solitude, and an indul- 
gence in grief and despondency; together with a loss of appetite, 
constant pain in the stomach, difficulty of breathing upon the 
least bodily exertion, paleness of the face and palms of the hands, 
whiteness of the tongue, with an appearance like stains of ink 



BACTERICIDES. 



459 



upon it, whiteness of the lips, drowsiness, inactivity, unwilling- 
ness to attempt and inability to perform motion, and general 
debility. The tunica adnata is of a glassy whiteness, the skin of 
an olive complexion and cold to the touch ; the eyelids, face and 
extremities show evident signs of an extravasation of water in 
their cellular membrane; and the unhappy sufferer can only 
breathe in an erect posture, from water being likewise collected in 
the chest and cavity of the abdomen. The entire lymphatic sys- 
tem becomes vitiated and fails to raise the standard of the blood 
to that of red discs. 

As a sovereign remedy, none can excel the tonic and stimula- 
ting effects of the coca. It is used with the most gratifying suc- 
cess for the cure of this form of neurasthenia — it facilitates diges- 
tion, relieves the depression of spirits and all other attendant 
symptoms. 

Added to this the glycerite of kephaline acts well in aiding a 
restoration of vital force and building up nerve tissue. The avena. 
sativa also is very effective. 



May be defined to be* a contagious and in- 

Hooping-cough, fectious disease, due to the presence of a 

{Pertussis.) micrococcus in the blood — a disease of 

great frequency in childhood, and to which 

a large proportion of infant mortality is due. Indeed no disease 

germ, except the comma-bacillus of cholera infantum, kills more 

children under two years of age than 

this. It exists in all parts of the world, 

and has been recognized from the most 

remote times. 

The cause is the presence of a micro- 
coccus in the blood, its field of nutrition 
seems to be in and around the cervical 
portion of the spinal cord, in which ^*"?r«o<*>' 

locality it finds a proper pabulum for Micrococrof hooping-cough. 
growth and reproduction ; although the 

germ is constantly present in the blood, it is also found in the 
breath, expectoration, saliva, urine and faeces, and it can be 
detected within a radius of fifty feet on the furniture, walls, 
carpets, etc. 

The germ consists of elliptical cocci or their mycelia, and looks 
like the annexed cut, with figure 8 interspersed. 




460 DISEASE GERMS. 

Like all other living poisons in the blood, it has a period of 
incubation, sprouting, fecundation, growth, activity, and death, 
depending greatly on the vigor of vital force of the patient. 

The pathological effects produced by the micro-organism are 
embolism, and as it is a free excretor of ptomaines, toxaemia of 
the brain — convulsions. Its duration under the old treatment, 
from six to eight weeks. 

Symptoms. — The earliest is a common cold or catarrh, accom- 
panied by a cough ; there is also a slight amount of fever, rest- 
lessness, and sometimes running at the eyes and nose. The 
cough in a i^ssi days becomes more troublesome, and some glairy 
fluid may be brought up from the chest ; in a week or ten days, 
but oftener later, the child will begin to have the characteristic 
hoop ; the cough comes on in paroxysms, and is more frequent 
by night than by day ; each paroxysm begins with a deep and 
loud inspiration, followed by a succession of short and sharp ex- 
pirations, again followed by a deep inspiration, and the repeated 
expiration ; this may go on several times, and last one or two 
minutes, according to the severity of the case. Just before each 
attack comes on, the child clings to its nurse or mother ; it sits 
in an erect position ; during the paroxysm the face is flushed, 
the veins in the head and face prominent, the eyes suffused and 
watery, and generally there is some glairy fluid expelled from the 
mouth, or vomiting may come on. After the paroxysm the child 
will rest for a time and appear pretty well until the next attack 
comes on. In bad cases there may be twenty and thirty 
paroxysms a day, and several fits of coughing besides, without 
the hoop being heard. In ordinary cases there are from four 
to ten spasmodic attacks in the twenty-four hours. These symp- 
toms last for three or four weeks, and then the cough abates in 
severity and frequency, and finally ceases altogether; even when 
there is no hooping, the child may continue to have a trouble- 
some cough for some time. In most cases there is some bron- 
chitis attending this complaint, and this is shown by the hurried 
breathing, rise of temperature, and by hearing rattling noises 
over the chest. The more mischief there is in the lungs, the 
greater is the danger to the child. Convulsions are a sign of 
ptomaines being liberated, and this is generally the way in which 
such cases die. Hooping-cough cannot be made out until the 
characteristic hoop appears, with microbe in breath, and then 
there can be no difficulty in recognizing the disease. 

Complications, as measles, small-pox, bronchitis, pheumonia, 
disordered bowels, as cholera infantum, tubercular meningitis, 
always render it fatal ; cough, accompanied with hemorrhage 
from nose, mouth, ears, effusion into the conjunctiva are bad 



BACTERICIDES. 



46! 



complications. It may prove fatal from exhaustion, marasmus^ 
convulsions from embolism, or thrombosis in heart or large 
arteries. Renal complications are extremely common, if the 
physician fails to recognize its germicidal origin ; stasis of blood 
in the kidney, albuminuria, suppression of urine. When disease 
is permitted to run its course, emphysema, dilatation of ventricles 
of heart and glucosuria are common. 

In the treatment, child should be kept as quiet as possible; if 
the weather is fine, it can be taken out, but if stormy, it must be 
kept within its room, which should be of an even temperature 
and protected from draughts. Warm clothing should be worn, 
nourishing diet given, and well bathed morning and night in an 
antiseptic bath ; all complications, as diarrhea, carefully guarded. 
In all cases, the reflex impressibility of the medulla oblongata 
and spinal cord must be diminished by the administration of 
some one of the following remedies : comp. syr. lobelia, musk 
root; bromides of potass and ammonia; tinctures of calabar 
bean ; black cohosh ; belladonna, etc. Such a formula as the 
following : comp. syr. lobelia, six ounces ; fluid ext. sambul, one 
ounce ; tinctures of belladonna, calabar bean, each one drachm ; 
bromide of potass, half an ounce ; bromide of ammonia, two 
drachms. Mix. Dose, from a few drops to half a teaspoonful 
or more every three or four hours. The action of this can be 
aided by applying local stimulants to the back of the neck, as 
concentrated ozone and chloroform ; or thymol dissolved in chlo- 
roform ; or an ointment of eucalyptol and iodol. Children, as a 
rule, do not bear inhalations well, but if they can be used, in an 
atomizer or otherwise, the best are distillations of jequirity, pine, 
eucalyptus, creolin, naphthaline, glucozone. 

The little patient should be taken off some distance, a mile or 
two, twice a week, and while absent the apartment in which it is 
domiciled should for one hour be fumigated with burning sul- 
phur, doors, windows, and every crevice carefully closed ; this 
has a salutary effect in destroying every germ in the apartment, 
on the walls, floor, playthings, etc., so that when the patient 
returns it will breathe a sterilized atmosphere. This sulphur 
fumigation is most beneficial, exercises a marked effect on the 
future evolution of the germ. 

Having attended to those preliminaries, then the correct treat- 
ment of the case should begin. 

The patient, as far as possible, should be surrounded with an 
antiseptic atmosphere ; tincture of iodine, or distillation of the 
pine or solution of carbolic acid, etc., should be exposed in the 
apartment in saucers, so that they mix freely with air breathed, 
and thus paralyze the activity of the micrococcus. 



462 



DISEASE GERMS. 



Internally, the true curative treatment consists in administering 
persistently some efficient germicide that will either completely 
sterilize or annihilate the germ. For this purpose, one of the fol- 
lowing formulae may be selected : Syrup of tolu, iour ounces ; 
resorcin, half an ounce. Mix. One teaspoonful every three 
hours while child is awake. Liquor ammonia acetatis, six ounces ; 
salicylate soda, four drachms. Mix. Dose, as above. Hydro- 
gen peroxide (ten volumes strength), six drachms ; glycerine, 
four drachms ; distilled water, three ounces. Dose. One table- 
spoonful thrice daily. Syrup of benzoin, four ounces ; drosera 
rotundifolia tincture, two drachms ; tincture belladonna, thirty 
drops. Mix. Dose. One teaspoonful every three hours. Other 
germicides often used. Salicylic acid, pyridin, exalgine, chloral 
hydrate, benzoic acid, boroglyceride, bromohydric acid, etc. 

All complications should be carefully guarded and treated on 
general principles, holding on to germicides as the agents to 
destroy the factor of the disease. Warm clothing, moderate 
exercise ; some mild, efficient tonic should be given. 



are watery vesicles in whose fluid are found the 

Hydatids larval elements of the tape-worm. These hydatid 

sacs may occur in any part of the body of man 

and animals. They are generally enclosed in an external sac, 

which is attached to the tissue of the organ in which it is situated ; 

^",^.^9' -. .^^ ^^^y rapidly grow, young broods sprout- 

^^.*.. -t, V .^^ forth, with distinct envelopes peculiar 

to each. The fluid in the interior of the 

hydatid contains millions of larvae, and is 

almost colorless and limpid, but the fluid 

in the common cyst in which the hydatids 

float is often of a yellow color. 

Two species of echinococcus are usually 
noted, that which is peculiar to man, met 
Showing the growth and bud- with in thc brain, eye, liver, intestines, 
ding of hydatids. kidncys, and that which is common in 

animals, but it is by no means certain that they are distinct. 

Whenever any of the hydatids are swallowed by man or ani- 
mals they proceed under favorable circumstances to be developed 
to a higher stage of existence, the tapeworm. 

These echinococci do not become developed into tapeworms 
unless they reach the intestinal canal of some animal by being 
taken in as food or drink. 

In ordinary cases of hydatids, consisting of echinococci, the 
cysts and their contents undergo a species of degeneration, be- 




BACTERICIDES. 



463 




>coming changed or altered in some cases into fatty or calcareous 

matter, while in other cases the contents become granular. The 

peculiar hooklets which occur in them, and which remain unal- 
tered for a long time, reveal their true origin. 
The common globular 

hydatid or acephalocyst, 

which sometimes attains 

quite a large size, is merely 

a degenerated or abnormally 

developed echinococcus. 

Hydatids sometimes oc- 
casion so little inconvenience 

that persons in whom they 

are discovered after death 

have not even suspected any 

disease in the organ in which 

they were found. On other 

occasions they grow rapidly 

and cause so much irritation 

that suppuration occurs in 

and around the common 

sac. In such a condition it 

is very liable to either burst 

externally or into a mucous 

canal or serous cavity. When discharged 
into any of the natural outlets, all is well ; 
recovery may take place, but if it ruptures 
into a cavity, a shut sac, like the chest, 
abdomen or brain, fatal inflammation will 
follow. 

False hydatids are simple serous cysts, 
either occurring alone, or in clusters, com- 
mon in the choroid plexus of the brain ; 
constituting the fluid of ovarian dropsy. 
These false hydatids are comparatively 
common in the uterus, where they cause 
great enlargement of that organ, simulat- 
ing pregnancy. 

Most remarkable cases of epilepsy, chorea, 
be cited as due to the presence 
of those larva formations in brain and 
cord. 
Even the eye becomes affected by bathing it in water from a 

pond in which animals have drunk. 



Hydatids, i, Coenurus eerebralis, natural size; 2, one 
head magnified; a, oval circlet of hooks ; b, suckers; 
3, Cysticercus tenuicoUis, natural size; 4, head 
magnified; a, circlet of hooks; b, suckers. 




A bright elastic tumor of a 
translucent appearance on 
neck of the womb ; wheu 
punctured, its serum yields 
myriads of echinocerons. 



might 



464 



DISEASE GERMS. 



Hydatids of the Brain. — Parasite cysts of the brain are very 
commonly found in sections of the country in which the inhabi- 
tants live chiefly upon pork. 

Chiefly two parasites, the taenia echinococcus and the taenia 
solium, are found in the human brain in the cyst condition, and 
it is of some importance to distinguish between them more defi- 
nitely than has hitherto been done. Where dogs are admitted 
freely to human dwellings and have access to sources of drink- 
ing water, the echinococcus will be the more common, as, for 
instance, in Iceland. In our Western States, the cysticercus 
cellulosae is the more common parasite, and it has been shown 
that it has a special tendency to affect the brain in man. Out of 
eighty-seven patients in Cincinnati, Ohio, who were affected with 
this parasite, it was found that in no less than seventy-two the 
cyst was situated in the brain. Two cases have been reported 
where the cysticercus acanthotrias and the coenurus respectively 
were discovered in the brain, but these were isolated instances. 
It is not surprising, seeing that the male sex is more liable than 

the female to cerebral tumor, to find 
that a much larger proportion of men 
than of women are attacked by hydatids 
of the brain. The proportion is greater 
than that of their general tendency to 
hydatid disease. 

The echinococcus forms in the brain 
a much larger tumor than does the 
cysticercus cellulosae. A case has been 
recorded which weighed eighteen and 
one-half ounces, and contained eighteen 
ounces of clear fluid. In regard to the 
anatomy of these cysts, it is curious that in a large number of the 
cases collected, the tumors consisted of the parasite pure and 
simple. In other organs, as, for instance, the liver, the echino- 
coccus cyst has around it a fibrous capsule, derived from the 
tissues among which it lies. In most cases the brain cysts 
appear to be devoid of this coating. A consideration of the seat 
of the parasite brings forth some facts which may become of 
some practical importance. In more than half of all cases, the 
cyst was in one or other hemisphere of the brain, and more com- 
monly in the right than in the left side. Again, in only four 
out of the ninety-seven cases collected was the cyst situated in 
the cerebellum, or " the ratio of cerebral to cerebellar echino- 
cocci was about fourteen to one.'' 

One naturally turns to the symptomatology, hoping for further 
practical guides, but the signs have been so various in different 




Cysticercus as seen in the eye. 



BACTERICIDES. 



465 



cases as to give no very definite clue. Headache, blindness, and 
convulsions seem to be the symptoms which is most common to 
such cases. 

Hydatids ^ of the Liver. — The essential cause of the development 
of hydatids is the entrance into the stomach or intestines of the 
taenia echinococcus. If they remain in the intestines they be- 
come tape worms ; when they pass into the liver they develop 
hydatids. They are chiefly met with between thfe ages of thirty 
and fifty, rare in children and the aged. They are most com- 
monly met with among the poor, the filthy, and those that are 
surrounded by insanitary states. The percentage of people 
affected is quite large. Dogs, sheep, pigs, cats, rats, are victims 
to tape worms, and as the ova of those parasites are discharged 
in the excrements of those animals, they can only gain access to 
the human stomach through polluted drinking water, or un- 
c3oked food. 

The method of growth is as follows : an ovum of taenia echi- 
nococcus, either during mastication, or from the action of the 
digestive juices, has the envelope containing the echinococcus 
removed, and then by its hooklets it bores its way from the 
stomach or intestine into the liver. It there becomes encysted ; 
the cyst consists of an external laminated cuticular layer, and an 
internal parenchymatous lining. From the internal layer numer- 
ous little heads bud forth in the form of vesicles, and these in 
turn bud out into others, and so on, the mother-sac keeping en- 
larging to accommodate the young broods. Successive genera- 
tions or broods of embryonic taenia, immature scolices, form upon 
the internal surface of the mother-sac, while the young crop cling 
to the mother, pushing the older ones forward into the fluid of 
the sac, which keeps on enlarging. Proliferation is excited by 
pressure of the surrounding tissue, which developes into a cyst. 

During the process of enlargement, a hydatid tumor loses its 
spherical shape, and becomes indented, the fibrous capsule be- 
comes thickened, rough, cartilaginous, and in some cases ossifi- 
cation takes place. 

There are various contingencies that may arise that may de- 
stroy the echinococci, such as, bile may enter the cyst and 
destroy its living breeding contents ; inflammation from numer- 
ous causes may arise, that may cause the disappearance of the 
mass. They may suffer fatty degeneration, or they may die 
from over-growth and other forms of degeneration. 

They are liable to rupture in every direction, and cause grave 
organic changes, even death, consequently they are dangerous in 
proportion to their size and the direction of their growth. 

The symptoms of hydatid tumor in the liver are those which 



466 



DISEASE GERMS. 



belong to liver disease. There is the presence of a tumor in the 
region of the liver, weight, dragging, difficulty of breathing, 
cough, bronchial catarrh; pain in the right shoulder; brown- 
coated tongue ; constipation ; jaundice ; ascites ; hemorrhoids. 
Prophylactic measures consist in preventing the drinking of 
water contaminated by the evacuations of animals, and in not 
permitting dogs to feed upon the offal of sheep ; chloride of 
sodium, resorcin, naphthaline, iodide of potass; 
^'t*A ^fe aspiration if the tumor is superficial. 

- 'C^.^^:*^-feV' Hydatids are found in every organ of the 

.:,'^V&^3)°° ' body, and are to be seen in v^rious micro- 
k**'C'/*(?l^'^^ scopical conditions. 
gv4^,ov»*t%Vo Hydatids of the Kidney. — Every disease 

'^W^^>^4 germ, and nearly every parasite incidental to 
"^ ^ * the human body is to be found occasionally 

Hydatids of the lung;; {*, fUg kidnCVS 
the appearance cf the "^ ^^^^ KlUIlCyb. 

elements found in the As a rulc, whcn the kidncy becomes the 

sputum. -.,.,,, •' 1 !• 

seat oi nydatids it becomes enormously dis- 
tended or enlarged. A tumor is usually the first noticeable 
sign, and an examination of the urine may reveal echinococci 
hooklets. 

If the case can be made out c'early, aspiration should be 
practiced, and iodine injected into the cyst. 



Dropsy of the scrotum may be a result of 
Hydrocele, inflammation, or disease, as enlargement of testis 

injuries, or dependent on general dropsy. 
Symptoms. — The scrotum becomes gradually distended with 
serum, which forms a smooth, pear-shaped, elastic and translucent 
swelling. The spermatic cord can usually be detected free at its 
neck, and the testicles can be detected lower down. There is no 
impulse on coughing. To take patient into a dark room and 
hold the scrotum between you and a lighted candle is an absurd 
proceeding ; for the serum in the scrotum is often grumous, 
turbid, and it may not be transparent, although in a good number 
of cases it is of a pale straw-color. In quantity, it averages about 
twelve ounces, less or more. If it is allowed to become chronic it 
may lose its pear shape, become thick, and almost invariably 
opaque. In some cases, instead of the water being in one mass 
or volume in the scrotum, it is found in cysts, resembling a honey- 
comb ; it is then called encysted. Little boys may be born with 
this accumulation, and the communication between the peritoneal 
cavity and scrotum may not have been obliterated ; it is called 
cono;enital. 



i^ACTERICIDES. 



467 



Treatment. — In the early stages or in acute form, such as in 
scarlet fever or from testitis, try treatment for dropsy — diapho- 
retics, diuretics, hydragogue cathartics, preceded with digitalis, 
then iodide potass, and back on those remedies {^See Dropsy), 
using the lotion of muriate of ammonia over scrotum. If medi- 
cinal means fail, then tap the scrotum about three-fourths of an 
inch from the median line at the base, boring gently in with tro- 
car and canula until the serum appears between the fingers ; then 
withdraw the trocar, leaving the canula in, through which the 
fluid oozes out. After it has been entirely drained away, insert 
the trocar again, and push it through the walls of the scrotum 
high up. After perforating, withdraw the 
trocar, and insert up through the canula 
a strand of seven threads of saddler's silk, 
and holding the upper end, withdraw the 
canula, and then tie the ends of the strand 
together ; undo this knot every morning, 
and remove one thread every successive 
day till they are all withdrawn. By this 
method the secreting faculty of tunica 
vaginalis will be destroyed, and a perfect 
cure is the result. There is no deceiving 
the patient with this manner of dealing 
with the case, as the result is always most Tapping the scrotum for hydro- 
satisfactory. Some tap without using 

the seton ; others tap, withdraw the fluid and inject tincture o 
iodine ; while another class aspirate ; all such measures are un- 
certain and inappropriate. 

In the encysted form each sac must be punctured, one by one, 
and their contents drained off, and then the seton. In the con- 
genital form a truss must be worn, so as to irritate a little, and 
thus close up the vaginal process. Usually the muriate of am- 
monia lotion to scrotum is sufficient. 




Dropsy of the brain may be congenital, 

Hydrocephalus, and associated with cerebral malformation. 

When it does not originate in that way it is 

a result of tubercular meningitis. It is rarely met with after two 

years of age. 

In dropsy or effusion of serum from the membranes of the 
brain, the head often attains a large size ; the unossified sutures 
yield readily to the pressure of the fluid. It may be equal all round, 
or one side may be larger than the other ; bones thin and trans- 
parent ; meninges thickened. Serum, in quantity, varies from a 
few ounces to as many pints; if in large amounts, the lateral ven- 
tricles are expanded in one large cavity. 



468 



DISEASE GERMS. 



The predisposing cause is tubercle bacilli irritating the mem- 
branes of the brain, causing the effusion. The exciting causes 
are falls, blows, cradle rocking, or reflected irritation, as teething, 
worms, cholera infantum, etc. 

Symptoms. — General symptoms of tubercular meningitis to a 
greater or less degree, followed by extreme wasting of the body. 
Although the child may eat ravenously there is no nutrition. 
The appearance is remarkable ; skin very white, body emaciated, 
face small, with a large globular cranium and overhanging fore- 
head ; head drops helplessly on one side. Th^re may still exist 
a little inflammation; if so, there will be headache, irritability, rest- 
lessness sleeplessness, and a susceptibility to noise, light, motion. 
Intelligence very feeble; great prostration and muscular weakness; 
rolling movement of head, eyeba'Us, perhaps squinting and blind- 
ness ; great li ability to epileptic convulsions; nausea, constipa- 
tion, with dark-colored, offensive stools; grinding of teeth, screams 
on awaking. As the case progresses there is more pallor of 
the surface, a great deal of stupor, very slow pulse, dilatation or 
contraction of pupils, picking of nose and lips. In favorable 
cases the headache and irritability subside ; the skin assumes a 
better color, there is more energy, appetite becomes more natural 
and the body nourishes. If there is great prostration, rapid pulse, 
paralysis, coma or convulsions, it is very apt to end in death. 

Treatment. — Infants of a tubercular diathesis, with a tendency 
to any irritation of the brain, should be well cared for, and their 
constitution strengthened by every possible means. Nourishing 
food, abundance of good milk, beef juice, country air ; seaside in 
summer; daily bathing, followed by inunction of iodized oil; and 
when they become older, great precaution should be used, espe- 
cially against any mental strain or irritation. 

To get rid of the effusion, its cause must be removed, that is,, 
all irritation. Then the principles of treatment are the same as 
effusion of serum or dropsy. Small doses of infusion of digitalis,, 
with infusion of parsley or asparagus, with nitrate potassa. 

Bowels to be opened freely with leptandra and compound licor- 
ice powder, given as often as necessary to keep the bowels free. 

Other diuretics, if it is possible, should be crowded in, as. hair- 
cap moss, squills, etc. 

In the hospital for the treatment cf children's diseases, lactose 
or sugar of milk is recognized as a standard and reliable diu- 
retic, and so administered with great success in hydrocephalus. 

Whatever remedies are administered to get rid of the effusion, 
they should invariably be alternated with two grains of the iodide 
potass in simple syrup thrice daily. 

Warm alkaline baths invariably do good. 



BACTERICIDES. 



469 



A peculiar tubercular form of disease of 

Hydrocephaloid the brain in children, under two years of 
Disease. age who suffer from insanitary states, over- 

crowding in cities, with meagre or insuffi- 
cient or deleterious food. Often the result of reflex irritation, as 
teething, worms, summer diarrhea. 

It has a close resemblance to tuber- 
cular meningitis, although pathologi- 
cally different ; the surface of the fontan- 
elles are depressed, instead of being 
raised as in hydrocephalus. 

There is great prostration, heavi- 
ness of head, drowsiness, languor, 
chop-spinach stools; wakes from sleep 
in alarm, screams, dread of strangers, 
freaks of temper, irregular breathing, 
no fever, skin white and cool. 

The main point in treatment is to 
make an effort to destroy the tubercular 
bacilli by the administration of the 
glycerite of ozone, kephaline and 
avena internally ; locally, into the scalp an ointment of sozoiodol 
should be rubbed daily. 




Prolusion of a hydrocepha'oid brai 



An effusion of serum into the cavity of the 
Hydrothorax. chest may be either the effect of pleurisy or 
organic disease of the heart; in pleurisy, a 
result of the expectorant treatment ; in organic disease, obstruc- 
tion and exosmosis of the serum of the blood takes place. 

The presence of serum in the cavity of the chest is usually 
easily recognized, by the history of the case: the great difficulty 
of breathing when the patient lies down, in which position if the 
lungs are clear, there will be resonance from top to bottom, as 
they float on the top of the water ; then set the patient up, on 
percus'^ion, dulness will extend up as far as the water level. If 
the patient is of a spare habit, a splashing sound will be detected 
by shaking the patient in the sitting posture. 

This form of dropsy admits of removal without operation in 
the large percentage of cases when due to pleurisy. 



The microbe of rabies is communicated to 
man by the inoculation of the saliva of a 
rabid animal. Period of latency or dormancy 
of the germ varies with the grade of vital 
force. With strong vital force it may remain quiescent indefi- 



Hydrophobia. 

{Rabies.) 



470 



DISEASE GERMS. 



nitely, whereas, in a weak and impaired constitution the germ 
may take on vigorous growth and use up vital force in a few 
days. 

In the dog there can be Httle doubt that the degradation 
of Hving matter which gives us the germ rabies, may be due to 
filth, want of natural grasses and water, over-exhaustion, heat, 
and probably from other anim.als. The fact that a dog only per- 
spires by its mouth may have something to do with it, in render- 
ing it more obnoxious to its development. Licking the hand, 
bites, scratches are the ordinary forms of inoculation. As a 
latent germ or slightly active one in the human blood, it gives rise 
to a number of obscure nervous affections, as epilepsy, asthma, 
neuralgia, hysteria, special conditions of irritation of the brain, 
chiefly around the pons, spinal cord and great sympathetic. 

If the germ becomes active, or, in other words, if hydrophobia 
is about to appear, there is great nervousness and irritability, a 
mental condition of profound despair, haggard appearance of 
countenance. If from an old bite or inoculation, the cicatrix be- 
comes painful, sharp lancing pains radiate along the course of 
the nerves up the limb, and in a freshly bitten part the same sen- 
sations. Slight spasms come on, very light at first, and long 
intervals between, but they gradually become more violent, 
increase in length, and the interval between grows less and less 
with each occurrence. During these attacks the features become 
livid or purple, eyes protrude from their sockets ; thick, viscid, 
ropy saliva is secreted, which keeps him constantly hawking 
and spitting ; spasmodic action of the muscles of the throat and 
pharynx and diaphragm, and latterly, of the entire body. Dur- 
ing these paroxysms the patient is wild and delirious. In the 
interval between, nervous impressibility is intense; thus, dread of 
movement so great that even the moving of a curtain or door, 
the undulation of water in a glass, will excite a spasm. Still, 
there is a real dread of fluids. They are more difficult to swal- 
low than solids, as they bring all the rings of the oesophagus 
into active exercise. Great delirium, violent spasm, exhaustion, 
death. 

It is a disease that is easily recognized by the great mental 
irritability, by a total absence of fever, by the character of the 
spasm, very light at first with long intervals, by the fits gradu- 
ally becoming longer and more violent, with less time between ; 
the face, during paroxysm, livid or purple, eyes protruding, 
hawking and spitting thick, viscid saliva ; while paroxysm is off, 
conscious. 

The Microbe of Rabies, " canine,'^ consists of small globular 
cocci, single or united into characteristic colonies. They are not 



BACTERICIDES. 47 1 

met with in the blood, but are found literally swarming in the 
cerebral secretion, in and around the medulla oblongata and 
spinal cord. 

One hundred and twenty drops of brain juice from about the 
medulla yields three-fourths of a grain of a distinct crystallizable 
(ptomaine) alkaloid, one thirty- second of a grain of which injected 
into a mule, gives rise to all the symptoms of hydrophobia, and 
in a short time collapse, convulsions and death. 

The exceptional virulence of this microbe is due to its vital 
and reproductive energy, to the rapidity with which it multiplies, 
and the excessive amount of ptomaines excreted by the germ 
directly in the nerve centres. 

The microbe is pathogenic of the disease, bears culture well in 
a neutral menstruum. Inoculations of the cultures, or better 
still the ptomaines, give rise to the disease. 

From these cultivations new ones can be made, and carried on 
through successive generations, all cultures, behaving in the 
same manner, showing exactly the same changes as in the parent 
culture. 

The most minute droplet of any of those cultivations produces 
the disease in animals. 

Treatment. — After a bite ligate above the wound, then resort to 
free incision into it or apply wet cups over it ; encourage free 
bleeding with fomentations of hot water ; then either cauterize 
the wound freely with caustic potash or wood ashes, or if none of 
these are handy, chop a number of red onions very fine, and 
crush or beat into them pulverized muriate of ammonia, and 
apply for several hours ; if a large wound, fresh application every 
hour, then poultice with lobelia and slippery elm. At once the 
patient should be placed on small doses of lobelia, and if indica- 
tions of a spasm, larger doses, just enough to nauseate well, not 
to vomit. Keep on with it several days. Lobelia has a retro- 
grading action on the germ rabies ; it will not cure, but prevents 
its activity and development. The living germ will only die 
under a condition of quasi-suspension of the nervous system. 
This is to be obtained if commenced early, when the patient can 
swallow freely, by very large doses of fluid extract of sambul, a 
strong infusion of skull-cap and sesquicarbonate of ammonia. 
Administer often ; repeat one after the other in as large doses 
as the stomach will tolerate, and not let up until a condition 
resembling general paralysis is induced, with a sleep like coma. 

If this condition can be brought about the germ will die. The 
rate of growth of the germ rabies is determined solely by the 
debility of the affected person, and there is no way left, no time 
for anything but cutting off the pabulum by partially suspend- 



^'j2 DISEASE GERMS. 

ing nerve force. The power of growth is great, but if this quasi- 
suspension is induced, there seems to be no nutrient matter for 
the germ. It must be performed early. None of the remedies are 
in any way poisonous, so there is no danger from an over dose ; and 
there must be no stopping until the most profound anesthesia is 
produced. Never be satisfied with a sensation of pins and needles 
over the entire body, that feeling must be followed by profound 
narcotism. Anesthetics, chloral hydrate, opium, bromide of 
potass, are no good, neither are the general run of acro-narcotics, 
as aconite, belladonna. 

More recently practitioners of repute and trustworthiness in 
Asia have introduced hoang-nan (strychnos gautheriana) as a 
germicide which will destroy the microbe. 

The effects and physiological action of this drug are, general 
indisposition, with extreme fatigue, vertigo, tingling of the hands 
and feet, with involuntary movement of the jaws, and a partial sus- 
pension of nerve power. If these symptoms are not present 
while the drug is being administered, it is a certain sign of the 
presence of a microbe imbibing the remedy. In such cases, the 
treatment must be continued, the remedy increased every dose, 
until the microbe is destroyed, which is known when the above 
symptoms appear. 

If the remedy acts too violently, either because the microbe or 
its ptomaine is absent, or to the administration of too large a 
dose, it is easily counteracted by administering fluid extract licorice. 
Energetic, repeated doses, either in the stage of sprouting (incuba- 
tion) or upon segmentation (violent rabid stage) should be the rule. 

The passion of rage in any animal, even man, evolves a special 
living principle, a disease germ ; for the bite of an angry man 
free from the anesthetic influence of alcohol, is highly danger- 
ous and often fatal, causing bacterial poisoning, erysipelatous in 
flammation of cellular tissue, and death. 

The principle might be carried further. Are not there living 
principles in all our emotions, desires, affections, passions, which 
render them contagious? Have we not special epidemics which 
are catching, religions excitement, suicidal mania, seasons when 
special crimes seem to be propagated ? 

Enormous enlargement of the breast is often 
Hypertrophy met with in both single and married women ; 
of sometimes one gland, in other cases both 

The Breast, glands slowly increase in size. It is not at- 
tended by inflammatory symptoms ; no heat, 
pain, induration ; nothing but progressive enlargement, which 
becomes burdensome and unsightly. The affected glands may 



BACTERICIDES. ^^-> 

point right out, but more generally they hang, loose, flabby and 
pendulous, reaching, in some cases, well to the navel or knee. 

Causes. — Rather obscure; in some cases we can see its con- 
nection with goitre ; in another class with masturbation ; while 
in still another, uterine and ovarian irritation, chiefly from imper- 
fect sexual intercourse ; impaired health, etc. 

Treatment.- — -Alteratives and tonics ; every possible means to 
improve the general health and activity of the uterine organs 
should be resorted to. As a rule, however, all means are very 
unsatisfactory and unavailing. Amputation of breasts is most 
invariably f:)llowed by tetanus. 



Enlargement of the heart is much more 

Hypertrophy common than atrophy. The weight of an 
of adult male heart is about nine and a half, and 

The Heart. the female eight and a half ounces, but in en- 
largement it often weighs several pounds. 
Hypertrophy may take place in various ways. It may be gen- 
eral, that is, its walls increased in size or thickness without any 
change in its cavity, — this is called simple hypertrophy ; the 
walls may be thickened and the cavity enlarged, — called eccentric 
hypertrophy, or enlargement with dilatation ; or the increase of 
thickness of its walls may be accompanied with diminution of 
cavity, — concentric hypertrophy. In cases of valvular disease 
and other forms of obstruction, hypertrophy is of utility in over- 
coming the impediment to a free flow of blood. Hypertrophy 
of left ventricle is usually due to aortic valvular disease, or to 
Bright's disease, in which there is resistance to the passage of 
the blood through the arteries and capillaries. Hypertrophy 
with dilatation of right ventricle generally due to disease in the 
mitral valve, causing obstruction to the pulmonary circulation, 
or to some chronic disease of the lungs. 

Causes. — Enlargement of the heart may be predisposed to by 
the use of tobacco, tea, alcoholic stimulants, great mental strain, 
worry, disease of brain, blood, etc., although the common excit- 
ing causes are over-stimulation, excitement, violent muscular 
exercise, as running, jumping, rowing, hoisting, lifting; excess, 
use of malt liquors, sexual excitement. 

Symptoms. — There is usually vertigo, muscae volitantes, tin- 
nitus aurium, redness of face or plethora ; heat, respiration and 
pulse are up. The sounds of the heart are not only frequent but 
loud, audible at a distance ; there is a fulness or bulging, often a 
wearing away of the ribs ; instead of the area of dulness on per- 
cussion being four square inches, it is increased to more than 



474 



DISEASE GERMS. 



double; there is also numbness in left hand extending up the 
arm, caused by a distension or stretching of the recurrent 
branches of the subclavian nerve over the heart reflected to the 
brachial plexus, thence to the hand. There may be bleeding at 
the nose, cough, difficulty of breathing from enlarged heart 
pressing on lungs ; often palpitations ; difficulty in walking 
quickly ; uneasiness, and sense of fulness and pain about cardiac 
region. 

In the treatment of an enlarged heart, all mental and physical 
excitement must be rigidly avoided ; strictly forbid the use of 
tobacco, tea, coffee, whiskey, ale, sexual congress. Diet very 
nutritious but as little animal food as possible, unless there is 
debility, warm flannel clothing, and abundance of fresh air. 

The action of the heart must be carefully regulated with tinc- 
ture of digitalis, alternated with strophanthus. Possibly it may 
be necessary to keep the patient upon those two drugs for two 
or three years, slightly lessening the dose all the time. 

As the case improves, begin with a general massage of all the 
superficial muscles of the body, morning and night. 

Then other drugs, as dioxide of hydrogen, comp. oxygen 
fucus vesiculosis, etc., could be administered with advantage. 
A visit for a month or more to some mountainous region is of 
great benefit. 



There are a variety of forms of enlarged 

Hypertrophy liver ; it may be increased in size and weight 

of in chronic inflammation, with effusion of 

The Liver. lymph in fatty or starchy degeneration, and 

from the presence of tumors, but those are not 

conditions of true enlargement. 

Hypertrophy of the liver proper is characterized by an increase 
in size as well as the number of the secreting cells, causing gen- 
eral enlargement of the gland. It is usually the result of long- 
continued congestion, such as takes place in all tropical climates 
from the irritation of malaria, and whiskey. It may be looked 
for in the indurated spleen, or leucocythaemia, in or after dysen- 
tery, and very common in the glucose diathesis, or diabetes. It 
is often met with in a lobe or portion of the liver. It is then 
said to be partial. It is brought about by the healthy portion 
having to do the work of a portion diseased ; its cells become 
enlarged, new ones are developed, and in this way the developed 
part compensates for that which is diseased. It gives rise to 
gastric catarrh, etc. Treatment same as for chronic inflam- 
mation. 



BACTERICIDES. 



475 



Muscles may suffer enlargement by exces- 
Hypertrophy sive use. The muscles on the arm of a black- 
of smith or prize-fighter are enormously devel- 

Muscles. oped. In the former it is quite common for 
the right side to measure four or five inches 
more than the left. This can only go on to a certain extent — to 
a degree of growth in which there is an adequate nerve-supply ; 
when that limit is reached, and exercise still continued or per- 
sisted in, fatty tissue will begin to take the place of muscular 
fibre, and the muscle will lose its contractility and become use- 
less, because it has undergone fatty degeneration. 
The treatment is rest and alteratives. 



About two-thirds of the male population 

Hypertrophy of this country, about the middle period of 
of life, suffer from some unsuspected urinary 

The Prostate, trouble, as well as partial or complete im- 
potency, while the other third, from puberty 
up, are either victims of self-abuse, a perversion of the sexual act, 
or a neglected or imperfectly cured gonorrhea, etc. 

These are the most prolific sources of generative weakness, 
and in themselves are productive of irritation, inflammation, 
effusion of lymph, and enlargement of the prostate. 

It is doubtful, when once this gland is damaged by masturba- 
tion, by dalliance in the sexual act ; by withdrawal in the act of 
ejaculation ; by the wearing of condums ; or by a gonorrhea, if 
ever it regains its pristine condition of health ; and those and 
other causes plant the foundation of future trouble. 

Chronic inflammation, brought about by these and other like 
causes, invariably terminates in enlargement of the gland, with 
either tubercular or calcareous induration. 

The degree of trouble from an enlarged orhypertrophied prostate 
varies greatly. For example, the lateral lobes may be consider- 
ably enlarged without causing much inconvenience ; whereas, if 
the middle lobe, which forms the floor of the prostate urethra, is 
only slightly enlarged, there is difficulty in micturition. 

The symptoms of hypertrophy of the prostrate, even in the 
slightest degree, are in all cases well marked, and consist in some 
difficulty in emptying the bladder, dribbling after micturition ; 
inability to pass water, which frequently proceeds along to a> 
state in which he cannot hold his water at all ; the irritability 
becomes intense, the desire to urinate imperative, and still withal 
partial retention of an ounce or two of urine; which speedily 
undergoes decomposition, and there is evolved in its ammonia- 



4^6 DISEASE GERMS. 

cal products, the micrococcus urea, which gives rise to cystitis. 
The micrococcus migrates up the uterus to the kidneys, giving 
rise to grave anatomical changes in those glands. The sufferer 
from irritable, then enlarged prostate, is an incessant victim of 
pain, uneasiness, aching in the hips and thighs, a feeling of 
weight and heat in the perinaeum, and all around ; pains in the 
limbs,' and extreme irritability; besides he is liable to severe 
complications, even from the slightest indiscretion in diet, or 
from cold, or wet, and the residual urine in the bladder loaded 
with the micrococcus urea, excreting ptomaines gives rise to pain 
and fever. The spasmodic contractions of the bladder to void 
its germ-laden contents are irresistible. In the early stages, noc- 
turnal emissions, two or three in a night are not uncommon, 
with urine very cloudy, with a copious deposit of muco-purulent 
matter. A thin, transparent discharge at stool invariably pres- 
ent, or, if not present, a gluing of the lips. This moisture or 
discharge, if placed in the field of the microscope, will be found 
to be prostatic, often mistaken for semen. 

A rectal examination in all such cases, reveals the prostate, 
large, hot, indurated, tender to the touch. 

Enlarged prostate means complete physical and nervous bank- 
ruptcy, as is seen in the partial or complete impotency, in the 
wasted testes, in the blighted state of the organs, loose and 
patulous vesiculae seminalis ; in the gleety discharge, or weeping 
penis ; in the cold, clammy state of the parts. 

What does modern therapeutics offer for the alleviation of this 
affection, and anchoring its unhappy victim to the earth a little 
while longer ? 

One essential element in the treatment of such cases is, the 
bladder must be emptied; there must be no residual urine in it to 
give birth to the micrococcus urea and fungus ; it must be evacu- 
ated daily, and either injected with a germicidal fluid like boro- 
glyceride, or else a bougie of thallin or resorcin used to kill 
every microbe in the viscus. 

An effort must be made to control and wipe out all irritation 
and inflammation of the prostate, and establish a renewal of life 
in it For this purpose a selection of some of the following 
methods or modes of treatment should be tried, with some of the 
special remedies enumerated. 

It is unnecessary to state that the appetite should be stimu- 
lated, the diet should be the best and abundant; daily bathing 
inculcated ; the bowels regulated, so as to have one free motion 
after the morning meal, and an injection every evening, an hour or 
two before retiring to bed, this should consist either of witch hazel 
or infusion of uva ursi, or a like remedy, with occasional hip baths. 



BACTERICIDES. ^yj 

All cases of enlarged prostate are much benefited by a general 
alterative and tonic course of treatment. The best alteratives 
being saxifraga and phytolacca ; and preparations of cinchona our 
best tonics. Then the attending physician will select some 
special remedy to meet the peculiar outcroppings of each particu- 
lar case. 

If there is great irritability in a chronically inflamed and en- 
larged prostate, with either continence or incontinence of urine, 
there should be no delay, but large doses of green root tincture of 
gelsemium should be administered, with belladonna suppositories. 

The ozonized uric acid solvent is of inestimable value, it con- 
tains a large percentage of pichi, a most efficacious drug in 
breaking up fibrinous and calcareous deposits in this gland ; its 
power of disintegration on this gland is immense, in effacing all 
conditions of hypertrophy. 

Once the gland becomes soft, patulous, the action of ergot and 
damiana are of signal efficacy in inducing contraction. 

Unquestionably, the most efficient drug in hypertrophy is the 
salix nigra, being a tonic, vitalizer, sedative and anesthetic. It 
entirely supersedes the different preparations of bromine upon 
the prostate, possessing all the good properties, with none of the 
bad. The ulterior action of a long continued persistent adminis- 
tration of the black willow has a most marvellous action in de- 
creasing the size of an enlarged prostate. 

The introduction daily or every other day of the salix nigra 
bougie will effectually get rid of all leakages or emissions. This 
is an important point gained. Besides the black willow bougie 
those composed of ergotine, quinine, damiana, papoid, iodol, 
have an excellent effect, their use rouses up the vital energy of 
the gland ; they diminish its size ; contract the ejaculatory ducts ; 
change the whole sphere of morbid action. If the bougies fail, 
then suppositories of the same ingredients should be used. The 
cocaine suppository ; one prepared from ergotine and cocaine ; 
another composed of the glucosides of the black willow and stone 
crop. 

AH have an excellent action in contracting the motor cells 
in the vesiculae seminalis and cord. This method of treatment is 
good, direct, energetic, often effective, but in all cases it must be 
aided with a course of medical treatment to increase their efficacy. 

We attach the greatest importance in all cases to a careful 
rectal examination, as it determines the status of the case. 
When we feel the prostate soft, yielding to the touch, it indicates 
that muscle still prevails, that a complete restoration of function, 
is possible under good treatment, aided by the stimulating ab- 
sorbent action of electricity ; again, when we feel a hard, modu- 



478 



DISEASE GERMS. 



lated prostate, and there is evidence to the touch, that fibrous 
tissue preponderates largely over the muscular ; the power of 
the bladder seldom returns, unless electrolysis is resorted to. 

Electrolysis of late years has been brought to bear upon such 
cases with wonderful success. The medical electricians of the 
United States are scientific men of rare culture, arduous study 
and extensive experience. The plan they adopt in electrolysis of 
the prostate is, they place the positive electrode in the form of a 
plate over the region of the bladder, and the index finger guides 
into the disinfected rectum the negative pole in the form an insu- 
lated needle, with its point clear for half an inch. This, by a 
gently rotary motion, is inserted into the prostate. The two 
electrodes are switched on and the current gradually increased to 
ten or twelve cells, for five minutes. 

The needle is then withdrawn and reinserted the same way in 
another direction. This is repeated three times. Taking in all 
fifteen-minute sitting. The results in the hands of the following 
eminent savans have been pre-eminently satisfactory. No dan- 
ger, no unfavorable symptom, and no doubts can be entertained 
of its wonderful efficacy.* 

Every means failing, either to ameliorate or cure, and life being 
in imminent danger, suprapubic and perineal prostatectomy have 
been resorted to with great success. 

There is no gland in the entire body, more 
frequently the seat of irritation ; the tubercu- 
lar, the syphilitic, the gouty, the lymphatic, 
the sensualist, the sedentary, the bicycler as 
well as the rider on horseback are its victims. 
No matter what the irritation be, it invariably 
gives rise to fibrous excoriation, calcareous 
deposits, ulcerations, fistulous openings, ante- 
rior and posterior, vesical thickening, catarrh, 
and necessitates special illustration. 

This cut shows the external appearance 
of the middle lobe when the vesiculae semi- 
nales and the vasa deferentia under which it is 
situated have been removed. Although it is 
connected firmly on each side with the lateral 
lobes, it is distinct from them at the posterior part, and evidently 
a separate lobe of a rounded form. 




*We would enumerate the names of medical electricians who have met with brill- 
iant success in electrolysis of the prostate and subsequently effecting a radical cure ; 
C S. Hastings. M. D., Los Angeles, Cal. ; R. PI. Randolph, M. D,, Portland, Ore- 
gon; I. C. Hewes, M. D., Omaha, Nebraska; J. J. Jones, M. D., Philadelphia, Pa.; 
S. M. Piatt, M. D., Waterbury, Conn.; Frank L. Tuttle, M. D., Springfield, Mass.; 
E. T Skelton, M. D., Bloomfield, Iowa. 



BACTERICIDES. 



4/9 




The prostate gland varies more in its size in different men, than 
many other parts of the human body ; and this middle lobe is 
liable to do so in a still greater degree than the body of the gland, 
being frequently smaller than it is here re- 
presented, and sometimes of a larger size. 

This illustration represents the middle 
lobe of the prostate gland in an incipient 
state of its enlargement, putting on a nipple- 
like appearance, and pushing the internal 
membrane of the bladder before it, which 
everywhere adheres to the projecting parts, 
and forms a covering to it. In this view the 
fundus of the urinary bladder is removed, 
so as to expose the orifice of the bladder. This in a natural 
state resembles the narrow part of a funnel, but here the pro- 
jecting middle lobe is so situated that whcn^^ver th'e bladder 
contracts to expel its contents, the middle lobe is pressed for- 
wards directly upon the orifice; and 
although it could not completely shut it 
up, must form an obstruction to the pas- 
sage of the urine. 

This diagram is taken from the same 
parts, but the enlarged lobe is seen in 
relation both to the bladder and the ure- 
thra. The membrane covering it is put 
so much on the stretch, as to drag down 
the orifices of the ureters towards the 
tumor, so that the intermediate space 
forms a double projecting ridge, instead 
of a concave surface. In the opposite 
direction the loose membrane of the ure- 
thra, as far as the verumontanum, is so much elevated as to form 
a bridle of some breadth and considerable strength, by which 
the enlarged lobe and the verumontanum are drawn nearly close 
to each other, and the hollow between them is rendered much 
deeper than it is in its natural state ; this hollow is considerably 
increased by the lateral lobes having also become enlarged. 

In this state of the parts, there is some difficulty in passing 
a catheter into the bladder, unless it is a large metallic one. The 
best instrument is a silver No. 12, which should be well warmed 
and oiled, introduced with the greatest care and gentleness ; as 
it is being inserted it should press against the superior aspect of 
the urethra ; it will thus readily slide into the bladder. With 
such a sized instrument there is no danger in making a false 
passage or doing any damage to the parts. It should be inserted 
at least thrice daily and retained a short time. 




48o 



DISEASE GERMS. 




In this representation the bladder had been for many years 
disturbed by the passage of the urine being obstructed in conse- 
quence of strictures in the urethra; 
so that before the enlargement of 
the middle lobe took place, the 
muscular coats of the bladder had 
acquired great strength, and an un- 
common degree of thickness ; the 
internal membrane had been formed 
into sacculi, and was so much thick- 
ened, that its fibres were unusually 
distinct. The opening of the ureters 
had become so patulous, as to 
admit of regurgitation of the urine. 
Under these circumstances many of 
the pathological effects had taken 
place. 

The stretched state of the mem- 
brane of the bladder over the middle lobe is remarkably 
distinct. 

In this illustration the middle lobe of the prostate is more 
prominent than the last. 

The internal membrane of the bladder has a sacculated ap- 
pearance ; at the fundus there is a sac formed by the internal 
membrane, protruding between the fasciculi 
of muscular fibres. There is a cavity be- 
hind the ridge formed by the enlarged 
lobe, and the transverse fold of the mem 
brane ; and another on the opposite side 
between it and the verumontanum. 

It is evident, that, when the disease has 
arrived at this stage, the bladder can never 
empty itself completely, since, before any 
urine can pass out, the cavity behind the 
ridge must be full ; and the pressure of the 
liquid which it contains must force the 
tumor forwards, so as to shut the orifice of 
the urethra; but when a larger quantity of 
urine is collected in the bladder, the internal 
membrane being put upon the stretch, and the tumor pulled 
backwards from the orifice of the urethra, a certain portion is al- 
lowed to flow. The same ridge, which prevents the bladder 
from emptying itself, forms an obstacle to the point of the 
catheter when an attempt is made to pass it into the bladder to- 
draw off the urine. In the middle line where the lobe itself is 




BACTERICIDES. 



481 




situated, there must be great art in directing the end of the in- 
strument over it ; but laterally, v/here there is only a folded 
membrane which can be pressed before the instrument, and 
which does not rise so high, the catheter may be more easily di- 
rected into the bladder. The bridle extending from the veru- 
montanum to the lobe being only a narrow 
band, the end of the catheter cannot rest 
upon it, but descends into the space on one 
side of it, and is conducted into the bottom 
of the cavity before the lobe, where it is 
very probably entangled, so as with diffi- 
culty to be extricated, unless the catheter is 
curved at the point. 

The middle lobe is in this instance still 
larger than in the last ; the lateral fold of 
the membrane on each side is very distinct, 
and as the prostate gland itself is increased 
to a great size, the cavity before the middle 
lobe is very deep, and the left portion of 
the gland having swelled more than the 
right, it has put on a convex form towards 
the urethra while the opposite surface is concave, so that the 
canal of the urethra through that part, instead of being straight, 
forms a curved line ; wherever this is the case, there is great 
difficulty in conducting the point of the catheter into the bladder, 
for when it arrives at the prostate, the handle of the instrument 

is always turned round, and the point 
forced downwards and to one side, and 
goes on in that direction till it is en- 
tangled in the fold of the membrane 
close to the root of the projecting por- 
tion of the middle lobe. To counteract 
this it is difficult to insert a catheter. 

In this cut the middle lobe is not 
very prominent, but it extends laterally, 
and the transverse fold of the mem- 
brane of the bladder is unusually thick, 
so that they form together a very com- 
plete valve to the orifice of the urethra; 
the lateral portions of the gland are 
not much elongated but are consider- 
ably swelled, so that the hollow be- 
tween the middle lobe and the verumontanum is of unusual 
depth. The resistance to the passage of the urine was so great 
in this instance that not a drop could be passed, and the efforts 

31 




482 



DISEASE GERMS. 




of the muscular coats of the bladder to expel the contents were 
so great, that they occasioned the inner membrane to protrude 
just between the openings of the ureters, and a large cavity or 
reservoir was fo.rmed there capable of containing above half a 

pint of urine, while the cavity of the 
bladder became preternaturally con- 
tracted. In this case every attempt to 
pass an instrument into the bladder was 
ineffectual. 

In this representation, the middle lobe 
has acquired a larger size than the lateral 
lobes, so that it appeared at first to be a 
tumor of an irregular form belonging to 
the body of the gland taking this par- 
ticular direction ; but after having been 
examined more accurately, it was found 
to be an enlargement of the middle lobe 
only ; the transverse folds of the inner 
membrane of the bladder connected 
with it were dis- 
tinct when the parts were examined 
in a recent state. In this specimen, 
the increase in the size of the lateral 
lobes was more in the direction towards 
the bladder, which produced an effect 
the reverse of what has been met with 
in the former representations, since here 
the distance between the verumontanum 
and orifice of the bladder is increased, and 
the canal of the urethra is lengthened. 

The appearance of the middle lobe in 
this illustration is quite hypertrophied 
and extremely difficult to introduce an 
instrument. 

In such cases the use of papoid works in a marvellous manner 
as a digestive solvent. The difficulty has been to get it in con- 
tact with it. This has recently been overcome by mixing the 
papoid with butter of coca into a bougie. 

An instrument made in all respects like Lallemand's porte 
caustice, size No. 1 2 catheter into this ; after it is inserted right 
up against the prostate, this papoid bougie can be continuously 
pushed up as it melts ; it dissolves the hypertrophied tissue and 
makes its way into the bladder. 

Repeated several times it does most excellent work. 




BACTERICIDES. 



483 




In this instance the middle lobe itself has not acquired so great 

a size as in some of the others, but the left lateral lobe is very 

much enlarged, and, what is unusual, 

forms a prominent tumor in the bladder, 

by which the middle lobe is thrown to- 
wards the right side. From the mode 

in which the enlargement has taken place, 

the orifice of the bladder and urethra is 

enlarged to an uncommon degree, as is 

also a portion of the urethra itself, so 

that instead of being a canal, it has at 

this part the appearance of an oval cavity. 

This is a very unusual appearance, and 

is principally produced by the left lobe 

in its enlargement having extended itself 

to the same length in the direction of 

the membranous part of the urethra, as 

it has done towards the bladder in the 

opposite direction, and also in an equal degree laterally. 

This engraving exhibits great enlarge- 
ment of the prostate in the middle and 
lateral lobes ; the lateral lobe of the left 
side projecting into the urethra, and into 
the bladder, the middle lobe being 
pushed to the right side, and the left 
considerably more prominent. 

In this case the retention of urine was 
complete, and was only relieved by the 
introduction of a 
very large-sized 
catheter and sub- 
sequently cured 
by the persistent 
use of a papoid 
bougie. 

This represents 




the middle and left lobe of the prostate 
gland in a state of ulceration. This is 
of rare occurrence. In this instance the 
left lateral lobe forms so large a tumor, 
projecting into the bladder, that the mid- 
dle lobe is pushed on one side, and 
forms a less complete valve over the orifice 
of the urethra, than it would otherwise 
have done, which probably is the reason that the patient was less 




484 



DISEASE GERMS. 




liable to retention of urine in the earlier periods of the disorder 
.than in some other instances where the acual enlargement was 
less, and where there was less difficulty 
in the introduction of the catheter. The 
enlargement of the left lobe also extends 
further into the bladder. 

This cut represents the substance of 
the lateral lobes of the prostate gland, in 
which suppuration and ulceration had 
taken place with little or no increase of 
their size, and no apparent affection of the 
middle lobe. This state of the prostate 
is very common when the microbe of 
syphilis localizes itself in the prostate, 
giving it that germ-eaten appearance. 

In speaking of the operation for the 
removal of the hypertrophied prostate, 
we would say : 

/. That prostatic enlargements zvhich give rise to urinary symp- 
toms are intravesical and not rectal. 

It has been long recognized that the severity of the symptoms 
in a case of hypertrophy of the prostate bears little or no relation 
to its apparent size as felt through the rectum, and it is also well 
known that a considerable number of men, aged fifty-five and 
upwards, have prostates of an abnormally large size, though of 
these only a certain proportion, sayfiftypercent, suffer from urinary 
symptoms. This strange difference depends on the position at 
which the organ is enlarged. Prostates of immense size which 
project towards the rectum and perinaeum cause no urinary trouble, 
while severe symptoms may supervene when the prostate on 
rectal examination is apparently of normal dimensions. There 
are many varieties of the intravesical growth. We find (i) a pro- 
jecting middle lobe, pedunculated or sessile, (2) a middle lobe 
with lateral lobes forming three distinct projections, (3) the lateral 
lobes alone, (4) a pedunculated growth springing from a lateral 
lobe, and (5) ** a uniform circular projection surrounding the 
internal orifice of the urethra." This last variety, described by 
' Brodie, has in recent years escaped notice ; it is better seen i7i situ 
than in museum specimens, and is of not infrequent occurrence. 
It surrounds the urethra like a collar, and projects for a variable 
distance into the bladder, 

//. That retention is caused by a valve-like action of the intra- 
vesical prostate^ the urethral orifice being closed more or less com- 
pletely by the contraction of the bladder on its contents. 

When the bladder contracts on its contents the contained fluid 



BACTERICIDES. 



485 



is forced on to the projecting prostate, and the urethral orifice is 
closed. The mechanism is the same, with one exception, what- 
ever may be the variety of the enlargement. Whether there is 
a middle lobe or lateral lobes, or a collar, the same valve-action 
occurs ; and the more violent contraction the more complete is 
the action of the valve. A patient finding that he is unable to 
relieve himself soon ceases his violent efforts ; the pressure on 
the valve is then lessened, the urethral orifice is released,' and the 
urine flows away in a feeble stream. If he attempt to expel it 
more quickly the outflow again stops, and it is only after several 
attempts that he is able to obtain an incomplete relief A time 
comes when, though the bladder still contains urine, no more can 
be forced from it. This residual urine varies much in quantity in dif- 
ferent cases, sometimes amounting to a pint or more. Its pres- 
ence, and the consequent frequency of micturition, are accounted 
for by the fact that a more violent contraction of the wall is re- 
quired to completely than to partially empty the bladder, and that 
its muscular coat acts to a greater advantage, and consequently with 
greater force, in its partially contracted than in its distended con- 
dition. This greater force, pressing on the outside of the valve, 
more completely closes the urethra, and the urine that remains is 
unable to escape. An exception to the general rule is found in 
cases with a small sessile middle lobe, situated partly in the blad- 
der and partly occluding the prostatic urethra. When this is the 
case the passage is blocked by the projection, and no valve action 
occurs. The urine is expelled by a violent contraction, and the 
bladder wall is much hypertrophied, and its cavity conlracted. 
The cuts show instances of this condition. The explanation 
I have given of the mechanism of the residual urine is not that 
generally received, but want of time prevents me from discussing 
the various hypotheses that have been advanced. 

///. That in many cases self-catheterism is the only treatment 
required. 

This prosposition does not require discussion. We have all 
seen patients who with little discomfort have, by a passage of a 
catheter, kept themselves in good health, sometimes for years. 
We would none of us think under these circumstances of advis- 
ing a patient to submit to a radical operation. 

IV. That when the catheter treatment fails ^ or is unavailable, 
more radical measures are necessary. 

I am unable to prove the assertion, but my belief is that a large 
proportion of the cases treated by the catheter sooner or later 
break down ; in other words, that evenually the prostatic enlarge- 
ment is the cause of death. The breakdown may come soon, or 
it may come late, but in many cases it ultimately supervenes. 



486 



DISEASE GERMS. 



The urine becomes thick and ammoniacal, the desire to micturate 
is continuous, the passage of a catheter reHeves but for a (ew 
minutes, the suffering and discomfort are constant; day and night ; 
life becomes a burden, and death a happy release. The greatest 
care cannot prevent this result, and the greatest carelessness 
does not always induce it. 1 have seen a patient who daily for 
years passed a gum- elastic catheter, which he carried in his hat, 
which he never washed ; the urine was acid, and he was in robust 
health. I have also seen many in the last stage of prostatic 
cystitis who had previously taken every care. Not only does 
catheter treatment fail, but it is not infrequently, especially in 
hospital patients, unfavorable. The patient has suffered from 
frequency of micturition and general discomfort for some years ; 
he has probably consumed large quantities of herbs to cure a 
supposed attack of " the gravel," and has not sought surgical 
assistance till, from some cause or other, complete retention has 
occurred. The surgeon passes a catheter with difficulty, there is 
much hemorrhage, the bladder is full of blood, and the patient's 
life is in jeopardy. If he gets over the acute attack it is found 
that he cannot learn to catheterize himself. The constant attend- 
ance of a surgeon is impossible, and the catheter treatment can- 
not consequently be tried. Even in cases where there is ap- 
parently no difficulty it is sometimes impossible to teach a patient 
to pass a catheter for himself In these various cases, cases of 
frequent occurrence, it is plain that a radical operation is required. 
It is, indeed, absolutely necessary. 

V. That this treatment, to be effectual^ should (i) for a time 
thoroughly drain the bladder, and (2) permanently remove the cause 
of the obstructio7i. 

It is now some ten or twelve years since perineal drainage was 
introduced for the relief of cystitis in patients suffering from 
prostatic breakdown. The relief obtained in this way has been 
most marked, and the practice is well recognized and established. 
As soon as efficient drainage is effected the bladder ceases to be 
a receptacle, urine sweet from the kidneys flows through it, pu- 
trefactive changes are prevented, and acute symptoms cease. The 
relief is, however, only temporary. Either the patient must sub- 
mit to the discomfort of permanently wearing a urinal, or the 
artificial fistulse must be allowed to close, with the probable result 
of a recurrence of the symptoms. It is necessary, if we desire 
permanent relief, that our measures should be more radical. We 
have seen that the cause of the mischief in the intravesical pros- 
tatic outgrowth must consequently be removed. This can only 
be done by leaving a raw surface in the prostatic region of the 
bladder, and as mischief would undoubtedly result from stagnant 



BACTERICIDES. 



487 



urine accumulating in this position, another and not less import- 
ant reason for efficient drainage presents itself. 

VI. That these two indications are best fulfilled by a suprapubic 
rather than by a urethral or periiteal operation. 

There are three ways in which it is possible to perform a radi- 
cal operation for the removal of prostatic obstruction — the ure- 
thral, the perineal, and the suprapubic. Of these the urethral 
appear to be in every way unsatisfactory. It is founded on faulty 
anatomy ; it is supposed that the cause of the retention of urine 
is a bar at the neck of the bladder, and that the division of this 
bar will effect relief. 

We must next compare the perineal with the suprapubic 
operation. I prefer the latter, for the following reasons : — 

1. It is more generally applicable. 

2. It can be performed with greater precision, and completed 
with greater certainty. It is, I believe, impossible to diagnose 
the nature of the intravesical growth till the finger is in the blad- 
der ; we may suspect an enlarged middle lobe, but we cannot be 
snre that it exists alone. In no way can a bladder be explored 
with the same completeness as through a suprapubic wound. 
All projecting portions can be felt with ease, but often are re- 
moved with difficulty — a difficulty that has made me certain that 
attempts at removal through the perinaeum must often of neces- 
sity fail. 

3. It ensures complete and most efficient drainage. It may 
possibly be argued by some that the position of the suprapubic 
wound will prevent drainage, and that the urine will naturally 
escape more readily through a dependent perineal wound than 
through one above the pubes. Experience shows that this is 
not so. Drainage takes place more easily through the soft ab- 
dominal than through the hard perineal tissues. This was 
shown in a case already published. In a patient with fractured 
pelvis and ruptured urethra, I opened the bladder above 
the pubes, and also cut into the infiltrated tissues in the peri- 
naeum. A tube was passed through the bladder from above, 
and brought out below. On its removal all the urine escaped 
above, and continued to do so as long as the wound remained 
unhealed. 

4. It is equally safe. While making this assertion it is right 
to draw attention to the fact that it is merely an opinion, and 
does not rest on a statistical foundation, there being no statistics 
available for the purpose. In looking over a few cases we shall 
find that the mortality of the suprapubic operation has been 
lower than might reasonably be expected. Of ten patients, 



DISEASE GERMS. 

all old men, three were above sixty, while seven were upwards 
of seventy. 

It is unnecessary to describe fully the operation of suprapubic 
prostatectomy, but a few special points about its technique, 
founded on an experience of thirty-seven suprapubic cystotomies 
of various kinds, may not be out of place. 

1. The quantity of water injected into the rectal bag, espe- 
cially in cases where the prostate is abnormally hard, should be 
smaller than is usually recommended. Profuse rectal hemor- 
rhage may occur. 

2. The bladder should be irrigated till the antiseptic borogly- 
ceride solution used is perfectly clear. The quantity left in the 
bladder varies much from ten to twenty or more ounces. The 
hand placed on the hypogastrium will show when the distension 
is sufficient. 

3. In cases where the bladder is contracted with thick non- 
distensible walls it will usually be unadvisable to perform this 
operation. 

4. It is better to leave a catheter in the bladder till its cavity 
is opened, as it is a guide that expedites the operation. Care 
must be taken not to hook the peritoneal fold (superior false 
ligament) into the wound with the point of the instrument. 

5. The linea alba is best divided by incising it immediately 
above the symphysis, and then dividing upwards on a director. 

6. Care must be taken to secure the bladder before proceeding 
to remove the prostate. This is best done by inserting two 
sutures through each lip of the wound, and fastening it securely 
to the deeper part of the abdominal wall. When the operation 
is completed a third suture, passed through the lower angle of 
the wound, is an additional security against urinary extravasation 
into the retropubic space. 

7. The prostrate should be removed as far as possible by enu- 
cleation with the finger, and not by cutting. The mucous mem- 
brane over the projecting portion havjng been snipp<ed through, 
the rest of the operation is completed with finger and forceps. 
In this way excessive hemorrhage is prevented. A pedunculated 
middle lobe can, however, be removed by cutting through its 
base. Hemorrhage is best arrested by irrigation with water so 
hot as to make it unpleasant for the hand. 

8. A large tube should be inserted into the bladder, and the 
wound united above the tube, by a deep and superficial row of 
sutures. The tube is to be removed in forty-eight hours. 

9. The after treatment consists in keeping the parts clean, and 
washing the bladder and the wound — in exceptional cases — with 
a boracic solution. 



BACTERICIDES. 



489 



Enlargement of the testicle is comparatively 

Hypertrophy rare, not by any means so frequent as atrophy. 

of The same causes which cause the testes to 

The Testes, wither and die, in two cases out of fifty, will 

cause them to enlarge ; they are sexual excesses, 

-masturbation, germs of syphilis, hsematocele. 

Enlargement without effusion of lymph is rare, still it may take 
place, owing to obstruction of the seminal or ejaculatory ducts. 
The internal administration of iodide and bromide of potassa 
in some convenient vehicle will soon arrest this hypertrophy and 
diminish or reduce the size of the testes to a mere cypher. The 
bromide is invariably efficient in wilting the testes. 



Dropsy of the pericardium is invariably a 
Hydrops result of pericarditis. It is to be recognized 

Pericardium, by the history of the case; the cardiac ex- 
pression of the features ; difficulty of breath- 
ing, cough and general debility ; also, by the increased area of 
dulness on percussion ; by the sounds of the heart being 
muffled ; negatively, by the skin of the face being pale ; no 
Tmmbness in left hand ; by respiration, heart and pulse being 
low ; usually oedema of feet and legs. 

Treatw,ent, same as for Dropsy, with the addition of the steady 
application of the irritating plaster over region of the heart, 
and the persistent use of the hair-cap moss in the form of an 
infusion. 

The diet here should be very generous, consisting of articles 
that can be converted into good, rich bood. 



A morbid state of the blood, caused by the 
Ichorrhaemia. introduction of the bacillus pyocyanes and 
other germs of the pus family into the blood. 
It is called septicaemia, when it is fatal without any local for- 
mation of pus; and pyaemia, when secondary abscess follows. 

If rigid antiseptic precautions are not enforced in all surgical 
cases, and among puerperal women, ichorrhaemia may appear. 

It may manifest itself in a great variety of ways. In some 
cases where the bacillus pyocyanes enters the blood, it will ex- 
crete ptomaines so freely, in such great abundance, that he or she 
will die before any local phenomena are exhibited. In another 
class of cases, the ptomaine excretion is so prodigiously profuse, 
that both liver, kidneys, spleen, intestinal track, are saturated ; in 
another class of cases, there is a copious flow of black bile, in 



490 



DISEASE GERMS. 



others, an attack of diarrhea or dysentery. In another class of 
cases, the serous membrane of the pleura, heart, peritoneal coat, 
or even the cellular tissue bear the brunt of the poison, so that 
pleurisy, pericarditis, peritonitis, erysipelas and boils may be 
present. Another class of cases exhibit themselves in profuse 
suppuration of liver, lungs, joints, glands, eyes and ears. 

General symptoms are, rigors, sweating, rapid pulse, sallow 
look, sweet hay-like odor of the breath, diarrhea, dysentery, with 
inflammation of serous membranes, rapid wasting, feebleness, 
prostration. 

The absorption of pus containing the living germs of disease 
is the most productive of septicaemia, as the lochial products, 
the punctured wounds in dissection, the streptococcus of erysipe- 
las, bites of enraged men, rabid animals, venomous reptiles and 
insects, inoculations from scratches or abrasions from the secre- 
tions of those affected with contagious diseases. These living 
poisons multiply rapidly, when in the blood ptomaines are freely 
evolved. They are taken by the veins, the lymphatic system 
becomes involved, and the entire blood the field of a living 
deadly poison. 

In the treatment of such cases, the powers of life should be 
well sustained, free incisions made into suspected parts, then 
washed out with dioxide of hydrogen, followed with poultices of 
yeast, charcoal, wild indigo. 

These microbes must be destroyed in the blood ; hence the 
treatment, besides being essentially constructive, must consist of 
the most powerful bactericides, peroxide of hydrogen ; lactic 
acid ; salicylate soda and acetate of ammonia ; naphthaline ; 
creolin, etc. ; such a germicide as will destroy the living microbe 
in the blood. 

Often hereditary and congenital. 

Ichthyosis Xeroderma Frequently the abnormality es- 
(Fish-Skin Disease^ capes notice at birth, but its recog- 
nition is almost certain when the 
child is about a year old. 

The treatment is at first directed to the removal of the scales, 
accomplished by warm alkaline baths, with friction, followed 
with olive oil and resorcin. 

Then a selection must be made from some of the following 
bactericides : sulphur ointment ; creolin ointment ; napthaline 
ointment, etc. 

Whichever is selected must be rubbed into the affected part, 
morning and night, for some months. 

The internal remedies should consist of alteratives and tonics, 
as saxifraga, avena, cinchona. 



BACTERICIDES. 



491 



Jaundice is always to be regarded as a symp- 
Icterus. torn of hepatic disease, an evidence of either con- 

(^Jaundice) gestion, inflammation, irritation from poisons, 
microbes, degeneration, tumors, gall-stones, or 
acute or chronic atrophy, yellow fever and mental excitement. 
All forms of jaundice may therefore be classed under two heads : 
(i.) Those in which the functions of the liver are suppressed or 
will not work, and the coloring matter of bile and cholesterin ac- 
cumulates in the blood. (2.) When the liver works, perhaps 
well, bile is secreted in abundance, but cannot get away; there 
is an obstruction to its exit in the duodenum by gall-stones, or 
by pressure, or something, and the bile is re-absorbed into the 
blood. This condition cannot last very long without the liver 
ceasing to work, for the bile, being dammed back on the gland, 
becomes a poison to its own structure. If due to disease of 
liver, there will be oppression, pain, over liver ; if due to gall- 
stones, there will be the nausea and paroxysms of severe pains. 

Symptoms. — Jaundice, then, a symptom of liver disorder, dis- 
ease or depression, is characterized by yellowness of skin and 
conjunctiva, nausea, loathing of food, especially fatty substances, 
tongue coated brown, usually constipation ; stools, if any, pale 
or clay, or white colored ; urine very scanty, and of a saffron 
color, or dark mahogany color, according to the amount of bile 
pigment present. Drowsiness, giddiness and peevishness, dyspep- 
sia, bitter or copper taste in mouth, slow pulse, weakness or ex- 
haustion ; itching in the skin. In very severe cases the aqueous 
and vitreous humor of the eye is so heavily tinged with bile that 
the patient sees everything yellow ; very drowsy. 

If it is severe and allowed to last long, there may be stupor, 
delirium, and great cerebral disturbance ; extreme weakness from 
mal-nutrition ; there may be hemorrhage into the skin, profuse 
bleeding from nose, gums, stomach or bowels. 

The most successful treatment of jaundice, consists in the ad- 
ministration of an emetic of the wine of ipecac ; followed by 
opening the bowels with salines ; daily baths ; diet to consist of 
soups or broths ; raw eggs ; white fish, boiled ; oatmeat, with an 
abundance of ripe or cooked fruit. An external stimulant over 
the liver; this might consist in the application of concentrated 
ozone, followed either by hot packs or the irritating plaster. 

Then a selection of one or two of the following remedies 
should be made, and administered persistently to the patient : 
comp. tincture cinchona, four ounces ; nitro-muriatic acid, two 
drachms. Mix. Dose, one teaspoonful every three hours. 
With phosphate of soda a sufficient dose to move the bowels. 

The case might be tried either upon sulphur water, or tincture 



492 DISEASE GERMS. 

of lycopodium, with cascara sagrada lozenge, two after every 
meal, to move the bowels. Some of the vegetable cholagogues, 
such as leptandra, euonymine, chionanthus, might be tried. 

If there be any presumptive evidence of syphilis microbe being 
the cause of the trouble, place patient upon saxifraga. 



An eruptive skin disease, with hemispherical 
Impetigo, pustules surrounded by a red areola, contagious, 
and auto-inoculable, from the presence of a micro- 
scopical parasite. 

The treatment embraces the removal of the crusts by repeated 
poulticing, and as soon as removed, keep the part encased in ger- 
micides ; one selected from either of the following answers well : 
resorcin ointment, ointment of iodol, or creolin, or napthaline, 
or any other good germicide. 



In the treatment it is well to appreciate a 

Incontinence condition of nervous debility as its origin, 
of Urine. acidity of urine, worms, as exciting causes. 

Bathing, good food , sleeping between blan- 
kets, emptying the bladder before retiring, etc. 

The selection of remedies should be such as will soothe and 
tone the irritable sphincter muscle of the bladder, such as — 

Tincture of iron in alternation with belladonna. 

Rhus aromatica in alternation with fluid extract ergot. 

Strychnine is excellent where there is atony of the walls of the 
bladder and paralysis of the sphincter. 

Fluid extract of stone crop in alternation with tincture lyco- 
podium. 

As regards continence the same remedies are of utility, to- 
gether with gelsemium, in alternation with creosote. 

If the case does not yield after removal of causes, and the use 
of some of the above, then try cantharides. 

All remedies failing, better to retrace, and of all remedies give 
belladonna another trial. 

The peculiar and sedative action of belladonna upon the lum- 
bar plexus of nerves and sphincter muscle of the bladder renders 
it of infinite value in all cases of continence or incontinence of 
urme. The method of administration is of great importance. 
A sufficient dose should be given every afternoon about four 
o'clock, and another at bedtime, so as to insure dilatation of the 
pupil. If the pupils are well dilated with the first dose, the bed- 
time dose may be omitted. The essential point is that the pupils 



BACTERICIDES. 



493 



be well dilated during the sleeping hours, showing that the sys- 
tem is under its influence. 

All exciting causes, as ascarides, acid urine, cold sheets, etc., 
should be removed. While thus holding the pathological condi- 
tion, stone crop Virginia should be administered in appropriate 
doses and persevered with for a sufficient length of time, until a 
cure is effected. Ozonized Virginia stone crop fluid extract 
has a most remarkable vitalizing action upon both rectum and 
bladder, and is decidedly curative in all cases of incontinence of 
urine. 





signifies a closure of the rectum. It may 
Imperforate exist in various degrees. The anal opening may 
Anus, be closed by a thin skin, which soon becomes 

distended with meconium, forming a round 
swelling. In other cases again the 
bowel might terminate in a blind 
pouch, at any point from the sig- 
moid flexure downwards, and the 
anal aperture be altogether wanting ; 
in other cases again, the anus may 
be open for an inch or two, with an 
obstruction beyond ; or the rectum 
terminate in the bladder or urethra. 

The defect is congenital, often 
overlooked in the first cleansing of 
the child. 

Treatment. — If the end of the in- 
testine can be felt protruding when 
the child cries, -make a free crucial 
incision into it without delay ; if it 
cannot be felt, an incision of the 
same kind made, and the parts ex- 
plored, and an effort made to reach 
the bowel, which, if reached, is to be 
pulled down and opened. Nature is 
is very provident in those cases. Give her an opening, and she 
rapidly forms around the descending meconium a wall or tube, 
which becomes a rectum. The opening at the anus should be 
large enough to admit the finger — always made crucial. It is 
recommended, if no bowel can be tapped per anum, to make an 
artificial opening, or anus, in the left groin. 





Anus and rectum 
deficient. 



Anus absent ; rec- 
tum ending high 
up. 



Anus communicat- 
ing with vagina. 



Rectum opening 
by fistula, close 



494 



DISEASE GERMS. 



The hymen or guardian of virginity is differ- 
Imperforate ently located, in each particular race, affording 
Hymen. distinct anatomical relations, to exhibit the non- 
unity of races. In the Caucasian, it is over the 
vaginal entrance, in the negro, it is not over, but from two to 






Imperforate hymen. 



The hymen semilunaris, or 
normal hymen. 



The hymen cribriformis, 
sieve-like. 




The hymen fimbriatus. 




Upper and lower opening. 





Opening divided into two parts. 



Mon- 



three inches up in the canal; in the 
golian, from two to five inches up, etc. 

We have also the hymen fimbriatus, similar 
to the fringe-like appendages of the ostium 
abdominale of the tubse fallopianse. This 
form is the most important in a forensic point 
of view, as it maybe taken for the normal 
hymen which has been torn. 

In some instances there is a variety in which 
there exists an upper or anterior and lower 
or posterior opening, with simply a band lying 
transversely across the vagina. In rare cases 
we also find a second hymen existing above 
the first. There are numerous other forms, named according to 
their fancied resemblance to things in nature, as the horseshoe 
hymen, bilobate hymen, etc. 



Hymen circular is, with 
small central opening. 



BACTERICIDES. ^gr 

In rare instances the opening of the hymen is found divided 
into two parts by a perpendicular bridge from the concave 
border of the hymen to the meatus urinarius, where it be- 
comes fast. 

The hymen imperforatus, in which we have a thickened, rough- 
ened state entirely blocking up the canal. This usually requires 
surgical' procedure, on account of the retention of the menses, 
and its preventing copulation. 



Impotence is a morbid condition in either sex 

Impotency. that prevents the spermatozoa of the male from 
coming in contact with the female ovule ; in 
other words it is an inability to consummate the sexual act. 
Sterility is a condition in which neither spermatozoa nor ovules 
are either secreted or elaborated ; or, if evolved, their vitality is 
immediately destroyed or possesses no fertilizing power whatever 
— a perfect want of power to fecundate, or it may be defined an 
inability to copulate or perform the sexual act. 

I . Impote7ice iji Man. — Sexual impotence implies the existence 
of malformation, disease or derangement of the genital organs by 
which there is either an absence of sexual desire, or power of 
erection, or the capability of ejaculating the seminal fluid into the 
vagina, or experiencing pleasure during the act of copulation or 
emission of semen. 

Impotence relates to the act of intercourse, and differs from 
sterility, an inability to beget offspring. 

Impotency may be either due (i) to an absence of sexual de- 
sire ; or (2) to an inability, owing to certain physical conditions 
to permit of the entrance of the penis into the vagina ; or (3) to 
the absence of the ability to experience the sexual orgasm. 

Absence of sexual desire may exist in individuals of apparent 
good health, who may never nave experienced the least inclina- 
tion for sexual congress. There are a very long array of circum- 
stances or conditions which exert a governing influence in 
abolishing the natural sexual appetite, which is necessary for the 
perpetuation of the species and the happiness of the individual. 
The genital organs of both sexes in all highly civilized nations 
are very freely covered by branches of the great sympathetic, 
hence, depressing emotions, perverted desires, violent passions, 
and blighted affections, have a remarkable lowering effect on 
genital vigor, besides, add to these worry, care, struggle, sorrow, 
mental pre-occupation, a state in which the whole heart and 
soul are either engaged in scientific pursuits, or discoveries, or in 
study, or in engrossing business, or in exciting speculations. 



^gS DISEASE GERMS. 

Harassing toil, lack of rest, certain occupations, cause sexual 
indifference or cause, 

Individuals suffering from neurasthenia often are temporarily 
impotent either through fear, or anxiety, want of confidence or 
great love or disgust, and often find it impossible to get an erec- 
tion, the organ remaining flabby like an old rag. Some men in 
their eagerness to consummate the sexual act, not infrequently 
fail, ejaculate prematurely the first time ; whereas the repetition 
of the act corrects the trouble, they acquiring more confidence. 

Sexual desires may be extinguished^ the natural sexual appetite 
depraved, withered, perverted, and the very soul atrophied by the 
practice of masturbation, which induces genital debility, impo- 
tence, and throws the finely-knit mechanism of the nervous 
system into chaos, with loss of power so great that even the 
greatest fascinations or lewd imaginations fail to excite libidinous 
desires, or the slightest power of erection, which, sooner or later, 
gives way to continued masturbatory excesses. 

Onanism is degenerative; it destroys the exquisite sensibility 
of the organs and creates an insuperable aversion to women. 
Mental masturbation is usually caused by reading obscene books, 
scanning nude pictures of the opposite sex, witnessing sexually 
suggestive plays, etc., and, in the near future, gives rise to loss of 
virile power. 

Sexual desire is often extinguished by perversion of the sexual 
act, by abnormal methods of sexual congress, as by the practice 
of withdrawal in the act of ejaculation, the wearing of condums ; 
dalliance in the act, what is vulgarly known as tasting, in a short 
time destroys every vestige of erectile power. If any of those or 
other abnormal methods are indulged in, or persisted in, the 
power of erection will become weaker, more feeble, until, at last, 
it is forever gone, leaving, as its legacy, diurnal and nocturnal 
leakages, with imbecility. 

All abnormal methods cause natural desire to grow less, or be- 
come obliterated to such an extent as to render intercourse im- 
possible. 

Congress with women with large vaginas, loose, lax, or with 
those affected with leucorrhoea, where the sphincter muscle has 
become non-contractile, causes the erectile power pf the male to 
dwindle, grow feeble ; whereas, if the act is consummated in a 
normal manner with a fitting companion, not in excess, it is a 
tonic and sedative. 

Sexual excesses give rise to nervous debility and loss of the 
poiver of erection. Erections consist in the augmentation of the 
volume, stiffness, and rigidity of the penis ; due to an increased 
flow of blood in the organ, active dilatation of the arterioles of 



BACTERICIDES. 



497 



the cavernous and spongy bodies. It Is a law of the human or- 
ganism that over-stimulation produces exhaustion ; that any 
function overworked, or excited, before the organs producing it 
are fully matured, is certain to lead to derangement or even ex- 
tinction of the function. Any titillating of the genital organs in 
infancy, or before or after puberty, often leads to complete impo- 
tence, or at least, to a loss of power or desire. 

Young people are usually excessive in sexual matters, and, as 
a result of the great drain and loss of the nervo-vital fluid, become 
pale, weak, effeminate, exhausted, have roaring in the ears, 
specks and spots before the eyes, and are genitally weak. Young 
married people are given to excesses, and, if persisted in, become 
incapable of generative enjoyment. The earlier in life the ex- 
cesses are initiated the greater the impotence in after life, for the 
generative act absorbs all the physical and moral qualities. 

Impoteitce may be imaginary, or there may be at the origin of 
it a tissue-starved brain which gives rise to peculiarities and idio- 
syncrasies as to the capability of performing the sexual act. To 
one person who is really incapable of performing the sexual act, 
there are two who imagine themselves so. It is, nevertheless, 
too often a genuine disease, appearing as a slight deficiency of 
capacity, with increased desire ; profound deficiency of both 
desire and capacity, with penis cold, benumbed, anesthetic, 
weeping ; power of erection feeble, or erectile power may be 
increased with no discharge of seminal fluid, due to morbid idio- 
syncrasies, a tissue-starved brain, and the sexual appetite, the 
most powerful passion of the human mind, obliterated. Usually, 
in these cases, the great sympathetic is at fault. This nerve is 
intimately blended with sexual vigor. In such cases, an avoidance 
of mental care, worry, of sentimental ideas, of carnal thoughts 
and the like, which abolish the desire. Impotence may be due 
to imperfect erection, the erection so feeble that intromission is 
impossible, the power of erection is completely abolished. 

There is a certain class of impotent men, with whom the main 
trouble seems to be a blunting of sensibility, a lack of tone and 
sensitiveness of the nerves of generation. These nerves come 
from and go to the spinal cord, ending in small bulbous, and (in 
health) exquisitely sensitive, points under the mucous membrane 
of the glans (head of the penis). Here may be found in this 
small space, some six thousand of these " sensitive bulbs," or 
" points," as they are called, and hence the acute sensitiveness of 
this part of the organ. 

This peculiar arrangement of nerve points in the mucous 
membrane of the head of the organ has a distinct object. Both 
man and animal are almost wholly dependent upon this peculiar 
32 



498 



DISEASE GERMS. 



sensitiveness of the glands to friction for the sensation that oc- 
curs during connection, and hence it can be plainly seen that if 
from any cause (former abuse, excesses, debility, overwork, etc.) 
the sensitiveness of these nerve points is blunted, sensation either 
before, during or after the act, cannot be natural. 

Some men are impotent from this cause alone. In others, this 
is only a part of the difficulty, but requires as careful treatment 
as if it were the only cause, for it must be overcome before a 
perfect cure can be effected. 

Sexual Paralysis, which means loss or decay of the erectile 
power, sensibility and size of the organs, is really a very advanced 
stage of hnpotency, and is usually the result of blows or injuries 
to the spine, softening of the brain, neglect of ordinary impotency, 
etc. It is more often found in men well advanced in years, but 
sometimes in young men and men of middle age. Enlargement 
of the prostate gland at the neck of the bladder, by pressure on 
the sexual nerves, sometimes produces it. So, also, does vari- 
cocele by destroying the testicles. 

Spermatorrhoea is the most common of all causes. It is more 
usual in young and middle-aged men. It is usually, but not 
always, the result of self-abuse, neglected discharges, losses in 
the urine, and usually ends in coinplete impotency, shrinking or 
wasting of the organs, coldness of the parts, stringiness and flab- 
biness of the testicles, and sooner or later, nervous weakness, 
brain exhaustion, spinal irritability, and still later, if neglected, 
paralysis, St. Vitus's dance, insanity, brain softening,- etc. 

There are numerous other factors, besides the above, which 
are capable of producing a loss of virility, lessen or altogether 
abolish the power of erection and render the individual impotent, 
such as obesity, a defect of assimilation and elimination ; or to 
emaciation, a derangement of the nutritive system. Certain 
shocks, concussions, jars, incidental to railroad travel. Shocks 
to the brain and spinal cord, or to the lumbar plexus of nerves, 
are liable to be followed by atrophy of the testicles and impotency. 

Neuralgia of the testes, varicocele, circocele, scrotal hernia, 
hydrocele, lead to degenerative changes and irreparable impo- 
tency. Disease germs in the blood, localizing in the testes, give 
rise to wasting of the testes, imperfect development and atrophic 
changes with loss of virile power. 

Horseback exercise, bicycle riding, roller skating, give rise to 
prostatic urethral irritation and exhaustion of spinal nerves, 
atrophic changes in the cord, with a shrunken penis, a withering 
of the erectile tissue, a pronounced state of sexual weakness, 
nervous exhaustion, with paralysis of the erector muscles of the 
penis. 



BACTERICIDES. 



499 



Location influences the sexual appetite, highly oxygenized 
and rarefied conditions favor a loss of power. 

Fevers and nervous diseases are most productive of sexual de- 
bility. Habits, as the use of alcohol, chloral, opium, arsenic, 
render the individual incapable of copulation, by sapping and 
dwarfing the springs of life. 

Some drugs, as nitrate of potassa, tobacco, bromide, ergot, 
conium, digitalis, camphor, gelsemium, etc., when administered, 
cause loss of virile powers ; even the operatives in certain chemi- 
cals, as those by photographers, become impotent. 

Under one or other of these drugs, or a slave to any of those 
habits, the natural sexual appetite at the base of the brain be- 
comes impaired, desire and power both diminish, or entirely fade 
away, but in a large number of cases desire remains without the 
ability to accomplish the sexual act, or either erections fail and 
intromission becomes impossible, or there areimperfect erections 
and premature emission. 

A man may possess strong virile power, and still there may 
be an — 

Absefzce of the power of ejaculating seminal fluid into the vagina. 
This may be due to malforma- 
tion, disease, other abnormal 
states of the penis and testes ; 
also to a poverty of nervo- 
vital fluid. 

It is a well demonstrated 
fact of men who have com- 
mitted masturbation, or who 
have been the victim of sexual 
excesses, or abuse in early life, 
that prior to or about middle 
life (forty-five years of age), 
their semen becomes almost 
destitute of spermatozoa, pov- 
erty-stricken, and that instead 
we find in their so-called semi- 
nal discharge, dwarfed, dead or infertile germs, the discharge 
loaded with spermatic crystals ; that the presence of those 
crystals denote nervous bankruptcy, diminished spermatozoa, or 
their entire absence, degenerative changes, unproductive semen, 
decrepitude. 

The penis may be either absent or a mere stump, or it may be 
excessively large, or it may suffer a bifurcation, or a suture, or the 
urethra may hai^e an opening either above or below. There may 
be a stricture, real or spasmodic, or paralysis of the compressor 




Spermatic crystals. 



500 



DISEASE GERMS. 



urethra, anomalies of the glands and prepuce which render copu- 
lation impossible. 

The glans penis may be the seat of anaesthenia, chancres, 
warts. The testicles may be absent, or their development ar- 
rested by blows or falls on the back or head ; atrophy caused by 
injuries to spine and brain ; disease of the spinal cord ; bodily 
deformity operate disastrously. 

The essential parts of an act of sexual intercourse are the emis- 
sion of semen and the experiencing of a pleasurable sensation 
before, during and after the act. 

This sensation originates in the glans, being peripheral with an 
inhibitory action upon the central areas in the base of the brain 
and cord. 

Inability to experience sexual pleasure may be due to the cica- 
trices of chancres, warts, tight prepuce and utter insensibility of 
the glans from abnormal methods of excitation. 

The effects of impotency are most disastrous to the brain, in- 
ducing nervous bankruptcy, lunacy, idiocy, another class of cases 
are well physically, dead sexually. 

The last fifty years has brought to the notice of physicians a 
peculiar condition of the sexual organs, confined chiefly to men 
past the age of thirty, and most common at from forty to fifty. 
This consists in a peculiar form of impotency, producing partial 
or total loss of power and sensibility in the organs, but accom- 
panied by no very bad effects upon the general system. There 
seems to be a blight upon the sexual organs, while the general 
health remains good. There is oftentimes some little dyspepsia, 
and often great prostration during hot weather. 

Treatment of Impotency. — The most hopeless cases are those 
in which organic changes have taken place in the brain or spinal 
cord, or in some malformation that cannot be rectified, or congenital 
deficiency, or degenerative change. Nearly all other cases admit 
of a complete or perfect cure under the improved method of 
treatment and new remedies. Impotency resulting from an ina- 
bility to have an erection of the penis, without degenerative 
changes, is a curable affection,, and the means to restore this func- 
tion are numerous and reliable ; positive and efficient. The 
general management of the case embraces attention to the general 
health, taking every means to build it up. A most important 
measure is rest, an absolute cessation of all sexual excitement ; a 
freedom from all lascivious thoughts ; the duration of sleep 
should be extended to eight or nine hours in the twenty-four 
hours ; the bowels must be kept regular. Daily baths and 
douches must be resorted to, the ordinary tepid baths followed 
by the shower bath ; a hip bath of cold water thrice daily. The 



BACTERICIDES. 



501 



morning or evening bath, one or both to be followed by persistent 
massage for a suitable length of time, and this procedure followed 
by faradization of the whole body, but specially the brain, spinal 
cord and reproductive organs. 

Look carefully over all the causes that give rise to impotency 
and remove them if possible ; if it be due to imperfect develop- 
ment, retarded growth of the genital organs, that can be pro- 
moted by electricity ; by causing a vacuum, and a determination of 
blood to the part, by the use of stimulating liniments. If it be 
due to fear, or rather a weakness -of the great sympathetic, let in- 
difference be practiced, let the heart and sympathetic system 
be braced up by sparteine ; turn his back to his companion, wait, 
go to sleep, when probably by the early morning the difficulty 
will be overcome, confidence restored. 

Disgust, complete incompatibility, requires a good deal of tact 
and skill, but with good judgment the patient can be tided into 
recovery. 

The effects of masturbation, sexual excesses, perversion of the 
sexual appetite, are more tardy of recuperation. 

Digestion and assimilation, all nutritive derangements must be 
rectified ; all shocks, concussion avoided. There must be no 
study, no care, no worry, no scientific pursuits ; avoid intense 
solar rays, and in all cases forbid the use of tobacco, alcoholic 
drinks, all acro-narcotic drugs, as digitalis, conium, camphor, gel- 
semium, chloral, potassa, horseback exercise, or the bicycle. 

A most important indication in the management of all cases ot 
impotency is perfect digestion and assimilation of food. The ap- 
petite must be stimulated with columbo and nux, or with hydras- 
tis and stone root, and if necessary pepsin could be added to 
meals to hasten digestion. 

The diet should be generous to a fault, and should consist as 
much as possible of articles that will nourish the brain. Animal 
food, chiefly of those animals nearest to man in the scale of crea- 
tion, as broiled tenderloin steaks, roast beef, mutton, poultry, 
game, milk, cream, boiled white fish, oysters, eggs ; and among 
the cereals oatmeal, corn bread. 

Active bodily exercise should in all cases be inculcated, but 
never to fatigue. 

A mild but efficient alterative and tonic course ol remedies may 
be prescribed with advantage, having a tendency to improve the 
general health. 

. But it is by a special class of remedies that we obtain the most 
rapid and efficient results. 

Phosphorus naturally attracts considerable attention, but it 
should not be prescribed in impotency either in pill or in water, 



502 



DISEASE GERMS. 



or infusion, or tincture, or even in the dilute acid, as when admin- 
istered to such patients it predisposes the recipient to fatty degen- 
eration of involuntary muscular fibre, and to a laxity of erectile 
tissue. 

The best forms are either hypophosphorous acid dilute or in 
the form of phosphate of zinc. 

Best administered in all cases immediately after eating. 

Electricity, in the form of faradization, galvanism and franklinism 
is a genital stimulant and tonic of no mean order. Comparing 
the three forms, faradization is best adapted to the large propor- 
tion of cases, and when used in cases of impotency, the whole 
surface of the body from, the crown of the head to the soles of 
the feet should be brought under the influence of the faradic cur- 
rent. Used in this way, the current acts as a powerful constitu- 
tional tonic to the nervous system, promotes appetite, improves 
digestion, gives rise to refreshing sleep, equalizes the circulation, 
develops the musclar tissue and increases strength. Above all it 
has an invigorating effect on the genital organs. It influences 
the whole periphery of nerves, whereas galvanization brings the 
entire central nervous system, brain, spinal cord and great sympa- 
thetic under its sway. 

Local electrization by external and internal applications ot 
both galvanic and faradic currents, are always of utility. 

The glycerite of kephaline ozonized^ being the natural phos- 
phate of ox brain, barley, oats, wheat, is a true nervo-vital es- 
sence, and can be administered in all cases of impotency with the 
best success. 

Neurasthenia, poverty of nerve force, cerebral anaemia, or 
softening, or paralysis and other states of nervous shock, are too 
frequently the result of excesses, and thus by draining off the 
cerebral essence, leave that organ in a state termed starved. 

A brain in that state soon has its typical fissures of thought 
obliterated, and granular deposits appear on the arachnoid ; ad- 
hesion of its membranes to the surface of the convolutions ; 
crystalline granulations in the living membrane of the ventricles, 
with an unusual amount of fluid in the sac of the arachnoid. 
Besides, a tissue-starved brain gives rise to inflammation of the 
cortical portion, terminating in degeneration of the nerve cells ot 
the hemispheres, and these changes give rise to structural change 
in the organic cell. 

The brain of man, his brilliancy of thought, his energy, his 
force of character, are due to the quantity of phosphorus con- 
tained in the cerebrum. If this is economized, it might sustain 
him to a good old age in full genital vigor, but let overwork or 
excess drain it off, health fails, the vital forces can supply no 



BACTERICIDES. 



503 



more ; then, unless kephaline or oats can be administered, de- 
generative changes will take place in the gray matter of the brain 
and spinal cord, simply because the phosphorus in the brain is 
exhausted. 

Brain workers, mechanics, professional men, the libertine in his 
excesses, feel this in their languor, want of energy — victims of ex- 
cessive brain exhaustion. Nothing can invalidate the assertion 
that unless our present race obtain more phosphorus, impotency 
will prevail. 

Kephaline is an excellent brain food, a reconstructor of shat- 
tered nerve force, refreshing to the nerves, repairs lost sexual 
power. Kephaline gives intellectual capacity, a higher stratum 
of life. 

It is a stimulant to the molecular growth of the brain, with a 
special action on the lymphatics and pink marrow and other 
blood-forming and blood-raising glands, and above all an active 
energizer of the seat of sexual power of the brain. 

The phosphate d tincture of Scotch oats {Avena sativd) is a 
remedy of very rare value, great efficacy in all cases, and in every 
form of impotency, especially when it depends upon a tissue- 
starved brain. 

From among all the cereals, oats give us the best stratum of 
brain growth, one of the greatest vigor ; barley, wheat, rye, give 
us mental delicacy. Oats having a large per cent, of phosphorus 
in a most assimilable form, renders its use of national importance. 
The amount of brain matter it contains is immense, and renders 
it of the greatest value whenever there is a deficiency of life in 
nerve tissue, in mental depression, insomnia, loss of sexual power. 

It not only supplies the brain with its own constituents, but 
aids blood formation, rebuilds, recruits tissues and forces lost in 
the destructive march of sexual degeneration. 

This preparation of oats is the most valuable for all cases of 
nervous exhaustion, nerve tire, debility, excesses, reconstructs the 
most delicate, it aids the growth of the brain, the bones, the 
teeth, the skin, the nails of children, imparts to them a vigorous 
constitution, it gives to the old the vivacity of youth, and that 
part of the nervous organism — the sexual appetite in the brain — ■ 
it rejuvenates it. It is an excellent stimulant to the motor cells, 
a life-giving tonic. In order to get the full benefit of a phrenic 
pabulum of the phosphated tincture of oats, sleep should be 
prolonged to at least nine or ten hours in the twenty-four. 

This is the remedy when the entire system is sapped and ex- 
hausted, the blood acid, nerves prostrated, appetite and digestion 
gone. It is food to the nerves, brain ; also a muscle-strengthen- 
ing remedy. 



^04 DISEASE GERMS. 

The fluid extract of the sazv palmetto (Sabal serrulata) is of great 
utility indirectly in irnpotency. Its great property is the promotion 
of grandular growth in the testes, prostate, ovaries, mammae. 
It is a most appropriate and active remedy when impotency is 
associated with degenerative changes in the testes due to sexual 
excesses, perversion and masturbation. 

It is a nutritive remedy of much value and of a peculiar kind, 
especially when there is a deficiency of the nervo-vital fluid. 
The brain and the important net-work of glands connected with 
the genito-urinary organs wear out fast in these days of high 
civilization, and this remedy fills a vacuum long desired to pro- 
mote glandular growth, restore the testes and prostate, if they 
happen to be shrivelled or shrunken, to their pristine condition 
and even to an increased size. Atrophy of the testes is very 
frequently associated with impotency and varicocele. Atrophy 
of the prostate is also a prominent symptom of genital debility 
from the opium habit and sexual perversion, a state the reflex 
effect of which gives rise to a sense of goneness and suicidal 
despair. A much greater calamity than enlargement, for with 
the latter, he may go through the act of coition, but neither 
semen nor prostatic secretion can be ejaculated if the prostate is 
withered and atrophied. 

The exhibition of the fluid extract or wine of the erythroxylon 
coca is attended with excellent results. Its best form is the coca 
et celerina. It arrests the active metamorphosis of the brain, 
promotes cohesion of the cerebral faculty of thought and vital- 
izes the central areas of the sexual appetite. 

This is a remedy of intrinsic value in all cases of impotency 
on account of its peculiar action as a powerful nerve excitant, 
giving great vigor to mind as well as to body. 

The combination with the celerina acts energetically upon the 
cineritious substance, and has a most invigorating action upon 
the sexual sense. There is no doubt that it rejuvenates that 
sense and wipes out genital and phrenal incapacity. 

Cocaine Suppositories are of great efficacy in cases of impotency 
caused by masturbation or excess. Onanism, the modern vice, 
the bankruptcy of the soul, degrades primary nerve elements 
into a germ of auto-infection. Millions of vibrios, the signal of 
brain wreckage, are to be found in all parts of the body, and with 
it a germ-laden rectum, which gives rise to irritation and leak- 
age. These suppositories are of great utility, soothing the motor, 
sensual and urinary centre in the spinal cord, and vitalizing the 
atonic condition of the prostatic ducts. 

It is a well-known fact that disease in any part, or even a non- 
use, causes a decrease in the size and a diminution of its strength, 



BACTERICIDES, ^05 

This is a result of mal-nutrition, an insufficient supply of nerve 
force and blood to the organ. Tie up a Hmb, deprive its muscles 
of exercise, of a full supply of blood or nerve force ; it wastes, 
shrinks to an indefinite degree ; so with the genital organs when 
they suffer disease, excesses, congenital defect or abuse, they are 
deprived of a full amount of nerve force and blood — they shrink 
to a degree which renders them totally useless for the important 
function designed for them by nature, and the sequel is either 
partial or total impotency and incapacity. 

Various electrical apparatuses and other instruments, lotions, 
ointments have been suggested to remove these defects and re- 
store the sexual organs to their full size and vigor. All such 
contrivances are both dangerous and useless. 

What is wanted is something that will supply or impart more 
vital force and blood, increase nutrition of the marasmic, atro- 
phied, wasted or shrunken parts. 

The cocaine suppository acts specifically on the muscular 
tissue, nerves, arteries, veins and lymph canals of the organ, 
augmenting the supply or nerve force and rich arterial blood, 
increasing their nutrition, growth, and restoring to them their 
natural size, energy and power. They act gently, according to a 
natural method, and accomplish a natural result. Besides, if the 
impotency is in any way blended with prostatic trouble, it is a 
most excellent remedy to relieve vesical tenesmus, senile hyper- 
trophy. It enables him to sleep at night without disturbance. 

Damiana is a remedy introduced from Mexico, in which 
country it is used as a powerful aphrodisiac, of the. greatest 
utility in all cases of sexual atony or lethargy. It is a capital 
tonic to the nerve centres which preside over erection, it in- 
creases the flow of blood to the spinal cord and the genitalia. 
The greatest trouble to be apprehended is in getting the proper 
plant, the true or genuine damiana, as there are several spurious 
articles in the market. The true damiana is beyond a doubt a 
most reliable, useful, and permanent tonic to the genital organs 
of both sexes. Acting as it does, directly upon the nervous sys- 
tem, it restores, as it were, the debilitated functions of the gener- 
ative system ; besides, it is an unsurpassed nervine. Its merits 
are well established, if the proper article is used. A good tinc- 
ture or fluid extract is the most eligible form, and all nostrums, 
such as the so-called wafers or tablets, should be avoided. 

The fluid extract, in medium doses of fifteen to thirty drops, 
added to water, administered thrice daily, rouses up the vital 
functions, thoroughly invigorates the brain, and energizes the 
nerves of the lumbar plexus. It is well adapted to all cases of 
impotency, but especially those in which the sympathetic system 



506 DISEASE GERMS. 

is at fault ; consequently, under its use, there is intellectual 
brightness, courage strengthened, mental and physical vigor in- 
creased. 

Muira puama fl. ext. in very many cases excels the damiana 
it its action. 

Apiol is a remedy of considerable power in functional impo- 
tency, when the erections are feeble, seminal fluid watery, testes 
soft. It acts speedily. 

The leaves of the ruta graveolus increases the flow of blood to 
the genital organs. 

Gelatine caps, made of avenine, are most efficient in increasing 
the peripheral sensibility of the nerve fibrils in the corona glandis. 

Medicated caps act to increase the sensitiveness of the glans. 
Laid on the part for a short time the effect is marvellous, and by 
using one or two a day for a few weeks, many weak and impo- 
tent men have been restored to full power, vigor and sensibility. 
In cases where this is not the only cause of impotence the use of 
the ^nedicated tissues with the urethral treatment is certain to re- 
sult in success. It is by neglecting to restore this part of the 
organ to the healthy condition that so many cases of impotence 
and debility have failed to be cured. Middle-aged and old men, 
and men about to m,arry, whose organs are weak and debilitated, 
and whose sexual sensibility is blunted or lost, will find in these 
cleanly little films a speedy means of relief They are cut of 
proper size to fit the glans perfectly, and have simply to be laid 
on and left for from five minutes to five hours, according to the 
severity of the case. Wasted and dwindled, as well as misshapen 
organs, are wonderfully improved by the use of Xh^sQfihns. As 
the nerve sensibility and power improve, so does the strength of 
the muscles and the circulation, and in nine cases out of ten, 
weak, wasted and puny organs increase in both size and strength, 
and erections become firm and satisfactory. 

Erectile power and sensitiveness are results that quickly fol- 
low their use. 

They are perfectly clea^ily, produce no soreness, and are so 
made that they can be worn beneath the foreskin, and will not 
fall off or slip out. The gelatinous film that holds the remedies 
rapidly dissolves and brings them into direct contact with the 
membrane of the glans, where they act directly on the nerve 
ends. 

By their use, too slow or too rapid ejaculation is properly regu- 
lated, for these things are directly dependent upon the sensi- 
bility on non-sensibility of the glans. 

Of the use of the damiana ozonized soluble gelatine bougies 
there can be no doubt ; the remedy is good, the mode of appli- 



BACTERICIDES. 



507 



cation unexcelled in energizing the glands and stimulating the 
erectile fibres. The application is a modern idea to heal a defect 
of our present civilization and a gap in our nation's health. 

For the growth, vigor and future prosperity of a nation de- 
pends upon the strength and energy of its young men, and if the 
places of the robust and healthy are to be filled by effeminate, 
weakened, nervous and physically drained youths, such as the 
vice of masturbation and sexual excesses is yearly giving us, the 
result cannot be otherwise than nationally disastrous. 

Every man suffering from impotency or from disease or dis- 
order or a leakage should use those bougies once, twice or more 
frequently weekly. 

To some, these may be inconveniences or annoyances, but the 
result is invariably a brilliant success. 

The value of ozone as a therapeutic agent and of ozonized 
remedies in the modern treatment of impotency is thoroughly 
appreciated by every liberal-minded practitioner. It makes 
little difference whether it be ozone water, peroxide of hydrogen, 
or comp. oxygen, as the three are analogous as therapeutic 
agents. 

Either of these excites a perfect renovation of the sexual appe- 
tite, removes the lethargy or sexual inability. 

In administering these remedies it is important to understand 
that they are the most powerful of all microbe killers ; that the 
blood-discs take up the ozone and are depurated by it without 
undergoing any change themselves. 

In any deviation from health there is no fluid or solid in the 
body exempt from the presence of disease germs.^ But so long 
as a metamorphosis is active, and renewal normal, germs are 
passive or dormant ; but when vital action is depressed they 
become active. 

The use of ozonized remedies in disease is a step forward, as 
they are not only death to microscopic life, but to all animated 
existence, life, vitality. 

The source of supply of ozone is unquestionably electrical, 
unceasingly going on in nature, aided by geographical position, 
as rocks, waves, hill-tops, billows. Its presence or absence modi- 
fies the denizens of towns, gives rise to peculiar idioms of speech, 
vigor or weakness of the sexual appetite. 

Look at the highly vitalized American race, the prototype of 
the ancient Roman, who inhabit the Eastern States, with their 
brain clear, perception keen, full of practical utility and magna- 
nimity, the result of ozone. Compare them with the Jerseyman, 
the Marylander or Virginian on their sandy beach and malarial 
swamps, where no ozone can exist. Compare the gigantic 



5o8 



DISEASE GERMS. 



achievements of the one with the proverbial meanness of the 
other, and say what ozone does for race and location. Another 
urgent reason why ozone or ozonized remedies should be admin- 
istered in impotency is, there is a contagium vivum in all diseases ; 
for example, introduce three or four confirmed masturbators into 
a village where the act is unknown, in six months every young 
man will be a victim of the habit. So with the genital debility 
or impotency or effeminacy. 

//. Impotency in the female may be due to a want of develop- 
ment of ovaries and uterus, and absolute want of sexual desire ; 
inability by reason of malformation, or other physical conditions 
to obtain the entrance of the penis into the vagina, such as vagina 
occlusion, with an excessively developed and ligamentous hymen ; 
obliteration of the vagina ; double vagina, or a normal vagina 
and no uterus ; absence of the ability to experience the sexual 
orgasm. The entire absence of all sexual desire may be the re- 
sult of abuse or excesses, or arrest of development of the clitoris, 
or an impairment of the sexual sense by falls or blows on back 
or head. Inability to permit an entrance into the vagina by a 
neurosis, as vaginismus, or super-sensitiveness of the surrounding 
tissues of the vagina, involving its sphincter muscle, forming a 
complete barrier to coition ; tumors, involving the vagina, uterus 
or ovaries, may mechanically prevent copulation ; cancer may or 
may not be a cause of impotency; hydrocele of the labia, warts, 
hernial protrusions, hypertrophy of the clitoris, or vagina, catarrh 
of the uterus, masturbation, as well as sexual excesses, render 
a woman impotent. 

The same cases that exist in men ; disease of the brain, cord, 
and certain dis'ease germs in the blood ; the use of tobacco, alco- 
hol, opium, chloral, coca, arsenic, belladonna, conium, gelsemium, 
the bromides, render women callous and often impotent. The 
want of ardency or callousness or icicle coldness of some women 
is not always to be attributed to impotency, but rather to incom- 
patibility. 

The interruption of the procreative faculty of the female may 
be due to many other conditions. This is most apparent when 
we consider the anatomy of the genital organs of both sexes. 

They consist chiefly of erectile tissue, a loose, elastic substance, 
intimately interwoven with nerves, and divided into multitudinous 
cells, into which, under excitement, blood is forced, filling or 
congesting them to their utmost capacity. The penis and glans 
penis of the male, and the clitoris, nymphae, internal labia and a 
portion of the vagina of the female are largely made up of this 
tissue, and the nerves in those parts are numerous, and in a 
healthy state highly impressible. 



BACTERICIDES. 



509 



The fallopian tubes of the female, which convey the egg from 
the ovaries to the uterus, are also composed of erectile tissue, like 
the penis and clitoris. 

During coition, if the female -is not impotent, the fallopian 
tubes are erect at climax of the act, the fimbriae grasp the 
ovaries ; if the egg is mature, it is sucked up by them and 
carried forward to meet the spermatozoa of the male for im- 
pregnation. 

///. Sterility in either Sex. — In order to thoroughly grasp 
the subject of sterility, it is necessary to have a clear idea of the 
physiology of conception. Several factors are concerned in concep- 
tion, and these should act in harmony. The woman must pro- 
duce healthy ovules, and the man must secrete healthy sperma- 
tozoa. There must exist no condition in either sex to destroy 
the vitality of the ovule or spermatozoa before they come in con- 
tact, and this union or junction must take place under proper 
conditions, to produce impregnation. There must be no con- 
dition existing which prevents the fastening the impregnated ovule 
within the uterus. Conception depends upon the combined mat- 
ter of two individuals, male and female. 

Sterility is very prevalent among modern men, due to excesses,, 
perversion of the sexual appetite, to gonorrhea, epididymitis,, 
which causes destruction of the vas deferens. A very large per- 
centage of sterile women are married to men who have had gon- 
orrhea before or after marriage. Spermatozoa may be secreted, 
yet in copulation not ejaculated, on account of some congenital 
or acquired defect, or their vitality may be destroyed by an in- 
flammatory process with its acid secretions. When secreted or 
ejaculated, they may be prevented from entering the uterus by 
contraction of the external or internal os, flexion, or conoid 
cervix, or their vitality may be destroyed by unhealthy conditions 
of the mucous membrane lining the uterus, cervical canal or 
vagina, as intra-uterine catarrh, tumors, preventing fixation or 
conception of the impregnated ovule. 

Healthy ovules may not be produced on account of feeble 
health ; sudden or profound shock to the nervous system, caus- 
ing ovarian incapacity, or from any disease in or about the ovaries, 
as chronic ovaritis; cystic, sarcomatous, cancerous, or inflamma- 
tory degeneration, or from peritonitis, or cellulitis. Of course 
there are no ovules in absence of the ovaries. 

They may be secreted in a healthy condition, and their en- 
trance into the uterus may be prevented by displacements, de- 
tachment or absence of the fallopian tubes, or by any condition 
which obstructs or contracts, or obliterates their cavity. 

All forms of dysmenorrhea are causes of sterility. 



510 



DISEASE GERMS. 



Some women, while potentially fertile, are actually sterile or 
may have relative sterility. This is seen in women who marry 
two or more men, and have children by only one of them, or 
when a man marries two or .more childless widows and has 
children by each of them. This may be termed sterility from in- 
compatibility. Sedentery habits, monotony, confinement, absence 
of sunlight, certain climates, all acro-narcotic drugs, all habits of 
opium, alcohol, chloral, arsenic, obesity, syphilis, like tempera- 
ments, in-and-in breeding, are causes of absolute and relative 
sterility. 

Most fertile women experience pleasure in sexual congress, 
and may have strong passions or desire, but women may con- 
ceive who have neither desire nor pleasure ; while others who 
have both desire and pleasure remain sterile. 

No woman should be pronounced sterile unless she has some 
defect to prevent conception, until 'the semen of her husband is 
examined to ascertain if it contains living, healthy spermatozoa. 



One of the greatest wants of the age 
Infantile Diseases, is health — '' a sound mind in a sound 
body." Without it our national future 
— the future of families, of races, becomes more a matter of 
chance than a certainty. Physical degeneracy has blotted out 
many names from the face of the earth that ought to have been 
perpetuated to bless and take part in civilization and progress. 
Many parents bring into the world feeble children, because the 
laws of life and growth were not understood. Many more have 
consigned their loved ones to an early grave, or had them afflicted 
with disease, feebleness, deformity, through a want of a knowl- 
edge of the natural laws of life. It is a true maxim, that a large 
and healthy population is the life and strength of a nation, as 
well as the source of its success in sciences, arts, agriculture, 
commerce ; so that it is a point of momentous importance to 
secure to the child a perfect state of health. It is true that pure 
air, cleanliness, suitable clothing, plain, natural food, will do much 
in preventing disease and prolonging life. Marriage should be 
prohibited among persons of like temperaments, or diseased, as 
they produce a diseased offspring. Neither should there be any 
incompatibility of ages, of blood affinity, or disposition. In 
order to do her duty to herself, to her country, to her offspring, 
a pregnant mother should sustain her health in its highest per- 
fection. This she will accomplish by attention to diet, clothing, 
cleanliness, exercise, and moral discipline. 

Her diet should be simple, light, nutritious, with abundance of 



BACTERICIDES. 



511 



brain, bone, and flesh-forming elements, adapted to the require- 
ments of the individual and the condition of the digestive organs. 
The clothing should be warm, comfortable ; all tight lacing, 
corsets, etc., should be avoided. Keeping the skin in the best of 
order, by daily tepid sponging, is very conducive to good health 
during gestation. Gentle, moderate exercise is to be recom- 
mended, and all violent movements avoided. She should live 
in well-ventilated rooms, so as to breathe pure air at all times. 
There should be a perfect state of mental and bodily equilibrium 
on the part of the mother on all occasions ; a well-balanced state 
of all her emotions, desires, affections, passions ; her mind calm, 
cheerful ; there should be no strain either on the intellectual or 
physical, especially on the former. She should entertain a high 
sense of her social duties, of her eminent status in nature as the 
mother of our race, and have implicit trust in Him whose name 
is honored in His marvellous works. The mother is all in all ; 
her mental condition stamps the character, the calibre of the 
future man, the future mental condition, sex, and capacity of an 
immortal being; so that every precaution should be taken to 
look well to the mother. 

At the moment of impregnation, both parents, to a certain 
extent, transmit their qualities to the offspring ; and either parent 
may transmit, to a greater or less degree, their constitutional 
peculiarities, thus occasioning the greater or less resemblance to 
one or other parent. But from the moment of conception until 
birth, and even during lactation, the influences of the mother are 
constant. She is specially present ; to her we owe all, even the 
determination of the sex. The natural tendency of a healthy 
mother is to breed a great excess of male births. This she can 
only do under certain conditions, to wit : saving her mental 
forces for perfect production. One would naturally think that by 
education and improvement of mothers in the sciences and arts, 
that we would improve the stock, and further increase male 
births, which is true, if the mother does not exercise, or exhaust, 
or overwork her intellectual powers during the breeding period 
of life. If a woman, before and during the child-bearing period 
of married life becomes an astronomer, teacher, preacher, physi- 
cian, attorney, she exhausts her manhood, and cannot bear male 
children at all, or if she is capable of giving birth to boys, they 
will have small heads, weak brains, feeble or meagre intellectual 
capacity ; in other words, they are deteriorated and effeminate. 
So that if married women crowd the avenues of scientific life, 
before and during the child-bearing period, we run the risk of 
becoming a nation of girls. 

Anything that affects the mother injuriously or depressingly, 



512 



DISEASE GERMS. 



to the same extent damages the child. Let the mother partake 
of gross food, and there is a strong probability that the child 
will be tubercular ; if she is of sedentary habits, it will be weak 
and flabby ; if she has been dosed with drugs, they will impair 
the constitution of the child. And so with mental influences — 
if she has contemplated feticide, the future child will have sui- 
cidal mania ; if she reads trashy novels, they will react on the 
offspring in some vice ; if she is passionate, has an unhappy 
home, or bad husband, each one, or all, will give rise to some 
deterioration in the child. So that if we want healthy, buoyant 
children, free from all diseases or immoral taint, we must have 
happy, comfortable mothers. 

To have healthy children, parents should be free from disease, 
either inherited or acquired; should exercise no deleterious 
trade, nor should they use alcohol or tobacco — both productive 
of imbecility and nervous disease in the child — and should have 
healthy organizations, and conform to all the requirements of 
hygiene. 

A most important condition to our having healthy children, is 
to give them abundance of pure air to breathe. Respiration is 
the first act of independent life ; air is a vital necessity. Shut a 
child up in a clos.e room, or in a crowded city, every breath he 
takes changes the quality of the atmosphere ; it loses oxygen, 
becomes loaded with carbonic acid gas ; besides, there are the 
emanations from skin and lungs, which are poisonous. Pure air 
is essential to life, to the blood, and to all the tissues. 

Next to air comes exercise ; the activity of every organ and 
function. There is not an organ, muscle, faculty, gland, but 
what was made for use, for movement, exercise. Exercise is 
necessary to development; without it, anaemia and disease. 
Good health requires, nay, demands, the regular performance of 
all the organic and animal functions, secretions, excretions, and 
all muscular, nervous, intellectual, moral and passional activities. 
It demands for the entire body, bathing once or twice a day ; it 
demands a temperature neither too warm nor too cold, and easy 
clothing, so as not to impede motion, aeration and perspiration. 
As destruction is rapid, and renewal very active, everything 
about a child should be scrupulously clean. 

Rest and sleep are important factors in growth. Sleep, during 
which the brain picks up its pabulum from the blood; the brain 
must rest for fresh supplies. The child, the microcosm of Deity,, 
with its dawning intelligence, sleeps nearly all the time. Noth- 
ing so withers and blasts incipient vitality as want of sleep. In 
childhood, ten to twelve hours in the twenty-four should be 
devoted to sleep ; in maturity, eight hours is sufficient ; and in 
old age we do with less. 



BACTERICIDES. r j ^ 

Management of the Infant at BirtJi. — The most striking pic- 
ture of utter helplessness that can be imagined is that of an in- 
fant at birth ; for if assistance be not speedily afforded it will 
perish. The first thing to be attended to is the umbilical cord,, 
which should be tied with saddler's silk, about three-fourths or 
one inch from the abdomen ; then another ligature about an inch 
further on, and the cord divided between the two with clean- 
cutting scissors. Any mucus should be removed from the 
mouth, or ears, and it should be examined to see that it is a per- 
fect child. i\fter the function of respiration is established, the 
infant should be wrapped up in a blanket and kept very warm, 
protected from cold, and the nurse, or other attendant, should 
bathe it at the earliest opportunity, after the mother has been 
duly cared for. The first bathing of the infant is of much im- 
portance, and it should be performed with the greatest care and 
precision. All children, to a greater or less extent, are covered, 
either partially or wholly, with a thin or thick sebaceous secre- 
tion, which will not unite with soap, but readily unites with fat 
or oil. So, after the nurse has been provided with a low stool, a 
basin of tepid water, castile soap, and some olive oil, or lard de- 
prived of its salt, she sits down and first freely anoints the scalp 
of the little stranger, rubbing it in gently, efficiently, causing it 
to unite with the sebaceous secretion, and then takes the soap 
and washes o^\ then she* goes over the face, ears, and in the 
same manner, being most careful that not a particle of this mat- 
ter enters the eye, ear, vagina, axillae, as it causes inflammation ; 
and being very careful that not a particle of it remains about an 
ear-lobe, angle of nose, a fold or crevice of the skin. Then she 
manipulates each arm in the same manner, washing the arms, 
and watching the armpits and fingers, then the Hmbs, and look- 
ing after the corrugations about anus, folds of vagina, groin^ 
The utmost care should be exercised, and if it has been heavily 
covered, it might not hurt to bathe it in the same manner again 
in a few hours, lest the smallest particle or patch may have es- 
caped observation. The perfect removal of this sebaceous secre- 
tion is all-important, and should receive the most careful atten- 
tion and scrutiny, so as to prevent ophthalmia and other 
inflammations. 

Afler the child is thus not only bathed but thoroughly 
cleansed and well dried, a double piece of fine old linen, four 
inches square, with a hole in the centre to permit the passage of 
the cord, slightly scorched, should be applied over the navel, 
bringing the cord through the orifice, and the linen laid flat on 
the belly. Then another piece of linen the same size, with a 
hole in the centre, should be applied, into which the end of the 

33 



514 DISEASE GERMS. 

cord should be wrapped up and turned over to the right side ; 
and over and above all, a roller or bandage of finest flannel, 
reaching from the breasts to the groin, should be evenly and 
neatly pinned; and then the general clothing of the child, which 
should be easy and warm — flannel or silk. If the mother has 
been properly cared for, and the labor not too exhausting, she 
will have milk ; and it is the best plan to put the child to the 
breast pretty soon, as the mother's milk is the true nourishment 
for the infant, that which nature has provided, a perfect combina- 
tion for the due elaboration of every tissue in the body. Still, 
there are cases in which this cannot be done, and the child must 
be nourished with a little milk and water, or sugar and water. 
We are, however, most partial to mother's milk, as it cleanses 
out the bowels of the meconium, gives the nipple a better shape, 
facilitates a better flow of milk, induces contractions of the uterus 
by its reflex action, and diminishes all risk of secondary hemor- 
rhages. 

The child, for the first fifteen months, should be bathed morn- 
ing and night — a thorough ablution— followed by gentle friction, 
and clean, soft clothing, to maintain an active condition of the 
skin. Tepid bathing for infants is always to be preferred. Very 
great cleanliness should be observed, diapers changed the mo- 
ment they are damp ; soiled, and moistened parts sponged off. 

About the fourth month a child should have sufficient exer- 
cise in the open air, be occasionally placed in a sitting posture, 
and be allowed to roll round and kick at its pleasure. All these 
movements not only afford amusement, but act beneficially, by 
calling the different muscles of the body into action, and so in- 
crease their strength. A child should be exercised during the 
day, so that it may enjoy undisturbed repose at night. 

The child should be weaned between twelve and fifteen months, 
provided it has teeth, and the season of the year warrants. No 
child should be weaned at the approach of summer, not unless 
the mother be pregnant, then it should not be kept an hour at 
the breast, irrespective of season or age. In weaning, it should 
be gradual, less and less daily, gradually substituting milk-food 
and ordinary solid nourishment. In all cases avoid starchy food, 
as rice, arrowroot, corn-starch, farinas, as they contain neither 
brain nor bone ; not food for a Caucasian child ; besides, the 
child has no saliva to digest starch. In order to be brief, we 
shall next direct attention to various peculiarities of the infant, 
and then to special diseases. 

Peculiarities of the Infant. — Infancy may be said to extend 
from birth to the second year, or completion of dentition ; and 
childhood to the age of puberty. 



BACTERICIDES. 



515 



The general appearance of a new-born infant is as follows : It 
usually measures twenty inches, more or less, and weighs about 
six or seven pounds, more or less. The skin is very vascular, 
sensitive, and delicate ; of a deep red color. All the prominent 
parts of the body are well protected by fat and cellular tissue ; 
the tendons and ligaments are imperfect; the muscles soft and 
gelatinous ; the bones are small, chiefly cartilaginous, deficient 
in earthy matter ; the lower extremities are less developed than 
the upper ; the pelvis is small and looks contracted ; the thorax 
small, flattened at the sides, prominent in front ; the head and 
abdomen large. 

The digestive organs are perfectly adapted for producing 
rapid changes in the food introduced into 'them ; indeed, they 
afford room for a continual supply of the materials for nourish- 
ment and growth. The mouth is beautifully adapted for extract- 
ing the food prepared by the mother, and conveying it to the 
pharynx. The stomach is small and long, which shows that it 
is not suited for receiving much food at a time, or for retaining 
it long. The intestines are smaller and shorter than in the 
adult ; their peristaltic action is rapid, so that all excrementitious 
matters are quickly got rid of, the infant having an evacuation 
every four or five hours. The mucous membrane of the whole 
alimentary tract is thick, soft, villous, very vascular, and sensi- 
tive, and easily irritated by improper food ; the salivary glands, 
the pancreas, the lacteal vessels, the mesenteric glands, are 
largely developed ; the kidneys are large, the suprarenal capsules 
of considerable size ; the spleen is small, liver very large, oc- 
cupying one-third of the abdominal cavity, but becomes smaller 
by changes that take place in its circulation. The respiratory 
organs undergo a great change ; the lungs, on being permeated 
with air, increase in size, become light, vesicular in structure, 
and of a deep rose red ; the respirations are nearly double those 
of an adult. The action of the heart is quick, varying from 120 
to 130 beats in a minute. In looking at the nervous system, we 
find the brain large, soft, imperfect in structure, and weighing 
about ten ounces ; the convolutions are imperfectly marked ; 
intelligence is in direct proportion to their extent, while the gray 
portion scarcely differs from the white, in color. The meninges 
are more vascular than in the adult. The structure of the spinal 
cord and nerves is more perfect than that of the brain ; those 
parts being devoted to functions of sensation and voluntary mo- 
tion. The organs of the external senses are all present at birth, 
and the nerves distributed to them are large. 

Peculiarities of Disease in Children. — During childhood little 
boys are very delicate, susceptible to disease, whereas little girls 



5i6 



DISEASE GERMS. 



are tough and wiry, and resist morbid action. After puberty, the 
young man is vigorous, and the young lady delicate or tender, 
thus reversing the conditions. In childhood, in both sexes, there 
is a predisposition to disease on account of inherent weakness of 
organization, and the ease with which impressions are made, and 
disease at that period of life is very apt to be insidious, and run 
a very rapid course into some organic change. The activity of 
the vital force, the quick metamorphosis of tissue, predisposes to 
inflammatory disorders, and the great susceptibility of the nerv- 
ous system to impressions causes any affection to be keenly felt 
by the whole system. Hence, the slightest disease, or indisposi- 
tion in a child should never be regarded with indifference. It is 
also true that the same activity of the vascular and nervous sys- 
tem imparts an energetic, reparative power in the child, and es- 
sentially aids recovery from some severe affections which would 
be fatal in advanced life. 

The skin and the mucous membrane of the respiratory and 
digestive organs are the principal points upon which morbid im- 
pressions exhibit themselves, although they originate in the 
stomach, or from outside influences. The mucous membrane of 
the larynx, trachea, bronchial tubes, is liable to inflammation of 
various grades, mostly of an acute character. The gastro-intes- 
tinal mucous membrane is another source of disease in early life, 
and owing to irritation of these parts, so abundantly supplied 
with the sympathetic nerve, and the increased sensibility of the 
reflex centres in modern children, give rise to innumerable brain 
affections. Hence, the frequency of fits, convulsions and cere- 
bral disease. The early growth of the lymph canals, or lym- 
phatics, render them obnoxious to morbid action. Diseases of 
the urinary organs are not frequent or severe. 

The diseases of children present many interesting and re- 
marlcable features, the peculiarities decreasing as age advances. 
All affections of children, even the process of dentition, are at- 
tended with fever of a remittent type, having exacerbations 
towards evening or during the night. 

In all cases of disease in the infant the causes are the same as 
at other periods of life, though they react upon the child with 
greater severity than the adult. Errors in diet, impure air, inat- 
tention to the laws of health, intense cold, heat, damp, filth, 
meagre or improper food, insufficient clothing, disease-germs, 
poison ; reflex states, as dentition, worms, accidents, act ener- 
getically upon the feeble constitution. Again, many disorders 
that exist in early life may not exist at birth : Thus, some are 
unfortunately born with the germs of syphilis, tubercle, in their 
blood. The chief causes of death among our children are 



BACTERICIDES. 



517 



cholera infantum ; disease of the brain, superinduced by indiges- 
tion ; acidity, worms, teething, bad food and the Hke. 

Diagnosis of Infantile Diseases. — A little good sense is all that 
is necessary to form a correct diagnosis of the diseases of the 
child. The chief sources from which our information is derived 
are the countenance, the gestures, attitude, the sleep, the zxy, the 
mouth and breath, the respiration, circulation, etc. 

Countenance, — The human face divine is the most interesting 
and intelligible page in the book of nature. In its calm and 
smile, we read health, ease, happiness of mind and body; in pain 
and suffering we discover disease. 

In general uneasiness, excitement, and fever, the whole expres- 
sion of the countenance is altered, a flushed and wrinkled condi- 
tion alternately being remarkable. 

In affections of the brain and nervous system, the expression 
of the upper portion of the face, as the forehead, brows and eyes, 
is especially changed ; the skin white, the forehead contracted 
and heavy ; the brows are knit ; the eyes wild and vacant, or 
fixed and staring, partially open; rolling of head; squinting; 
dropping of eyelids. 

Morbid conditions of the organs of respiration and circulation 
affect the features of the middle of the face ; the nostrils, in 
pneumonia, are dilated ; tip of the cheeks red ; sharp, dark cir- 
cle round the mouth. In cardiac irritation, features are con- 
tracted. 

In diseases of the abdomen a peculiar expression is given to 
the face : cheeks sallow, sunken ; the mouth retracted or drawn ; 
the lips colorless. In irritation of the bowels from worms, the 
nose and upper lip are tumid, a dark ring below the eyes and 
round the mouth, and the white of the eye has a pearl-like look. 
In the exhaustion from diarrhea, the face is alternately flushed 
and pale, hot and cold ; in extreme cases, pallid, cold, glistening ; 
the eyelids half closed. In jaundice, the countenance is yellow. 
In measles, the running from eyes and nose, redness of the eye, 
swelling of eyelids, never can be mistaken. The features are 
emaciated, and present an appearance of decrepitude, in tabes 
mesenterica. The peculiar feverish look, sharp features, sunken 
eyes, pallor, of cerebro-spinal irritation never can be mistaken. 
Pain in the head causes the brows to contract ; in the belly, the 
upper lip is elevated ; in the chest, sharpness of nostrils. Before 
convulsions come on, the face becomes convulsive ; the upper 
lip is drawn, there is squinting. Suffusion of the face denotes 
fever ; flushes of heat and coldness denote exhaustion. 

Gestures and Attitude. — The beginning of disease in a child is 
made apparent by inattention to surrounding objects, by their 



5i8 



DISEASE GERMS. 



listlessness and dislike to movement They then become rest- 
less, languid. Inflammatory pain may make a child still. In ab- 
dominal inflammation the child lies quiet ; the knees bent, drawn 
up ; twisting about ; uttering loud cries on the sudden accession 
of pain. Acute spasmodic pain induces immediate contraction 
of all the muscles, and the infant starts in terror. In convulsions, 
the head is drawn back, and becomes rigid, or a leg is drawn up- 
wards, and the child cries violently from pain or fear; the breath- 
ing is spasmodically affected ; the thumbs and fingers are drawn 
into the palms of the hands ; the toes are firmly flexed down- 
wards. In irritation of the brain, the little hand is frequently 
raised to the head, attempts made to tear off' its cap, and perform 
other movements with the hands, while the head is rolled from 
side to side on its pillow. In disorders of the mouth, as difficult 
teething, the child presses its fingers into the mouth, or seizes 
and presses the nipple roughly and greedily, or rubs the gums 
with anything it can get hold of. In croup and other diseases 
producing difficulty of breathing, it pulls or grasps at the larynx, 
and tries to compress it laterally, and by its cries indicates the 
seat of suffering, which is relieved by the sitting posture. During 
dentition, throwing back the head, grinding of the jaws, or irri- 
tation of digestive tract, indicates convulsions. 

TJie Sleep. — The sleep of a healthy child is deep, tranquil, pro- 
longed ; the countenance is calm and happy ; the breathing slow 
and easy ; its limbs relaxed ; on awakening, it is lively, and seeks 
the breast. In disease, the rest is disturbed, broken ; the respira- 
tion is loud, labored ; the brow contracted, or the mouth drawn ; 
there is grinding of the teeth, or gums ; sudden startings ; the 
child is fretful, irritable, peevish. Any irritation anywhere, but 
especially in the brain or bowels, lessens the ability to rest. Rigid 
extension of the limbs, with a turning in of the great toes and 
thumbs, is indicative of convulsive movements. In jaundice, 
there may be deep sleep or coma. 

The Cry. — The first indication that a new-born infant gives of 
life is to cry, and the more loudly and lustily it does so, the 
better, as it thereby inflates the lungs more perfectly, and demon- 
strates the fact that the vital organs are well and vigorously 
formed, and the child in good health. But after being bathed, 
clothed, and warmed, and otherwise seen to, the well-cared for 
infant cries but little ; the act of crying being reserved to express 
pain, distress, hunger. Pain is productive of crying. In affec- 
tions of the lungs, the cry is more of a groan ; in croup, hoarse, 
muffled, crowing ; in cerebral disease, screams, with great irrita- 
bility at intervals ; in diseases of the abdomen, the cry is pro- 
longed, low, moaning. The sympathetic nerve and lachrymal 



BACTERICIDES. 



519 



gland being rudimentary until three or four months ; the Httle 
sufferer does not shed tears in crying until after that period. 
After four months, if a child shed tears in the act of crying, it 
is a most favorable sign ; but if the eyes are dry, sunk in the 
orbit, great danger to life exists. 

The Mouth and Breath. — In health, the mouth is moist and 
pale, the tongue smooth, and partially covered with a layer of 
whitish mucus ; the gums red. the breath sweet, free from smell 
or odor, only that of the mother's milk. This is altered by very 
slight causes ; the mouth may become hot, dry, red ; the tongue 
coated, and the mouth sour, acrid. This is the case in fevers, 
acute affections of the chest and abdomen, and in retarded, 
difficult dentition. In the eruptive fevers, tongue often swells, 
or its papillae project. In scarlet fever, with its strawberry 
papillae, it sometimes presents a swollen, hot condition. In sore 
mouth, or aphthae, due to bad milk, indigestion, teething, over- 
crowding, the breath is fetid, tongue excoriated, and there may 
be ulceration on various parts. (See Aplitlice.) 

The Skin and Temperature. — In a healthy skin of an infant 
we should find it firm, elastic, smooth, of a rosy fiesh-color, 
neither hot nor pale, but moist and cool. A hot skin is present 
in all febrile diseases ; a cold, moist skin in feebleness and pros- 
tration. Great redness indicates inflammation, or the eruptive 
fevers ; a pale, doughy skin warns us against tuberculae ; intense 
blueness, to cyanosis, a mixture of the arterial and venous blood, 
or some interference with the oxygenation of the blood ; a yellow 
skin, to some affection of the liver; a dirty, sallow hue, to diar- 
rhea. Rigors are not common in young children, even suffering 
from malarial fever, the usual symptoms being a paleness of the 
face, a discoloration of the lips, a bluish tint beneath the nails. 

Respiration. — An infant breathes instinctively, without method, 
but with regularity. All diseases of the air-passages are attended 
with noisy, rattling respiration and cough, which is hoarse and 
spasmodic in inflammation of the glott's ; ringing in laryngitis ; 
crowing in croup. In catarrh, bronchitis, pleurisy, and pneu- 
monia, the breathing is merely hurried, the cough hacking and 
dry, and the expectoration, as it comes up, is swallowed by the 
child. As the inflammation increases, the rapidity of the breath- 
ing becomes great, so that in lung congestion it is often panting : 
at the same time there is rapid dilatation and contraction of the 
nostrils. In pleurisy, the respiration is restrained ; in peritonitis, 
the inspirations are short, jerking, difficult. 

The Circidation. — The heart's action is more variable in infancy 
than at any other period, and impressions of every kind quicken 
the pulsations. Pulse, in health, ranging about 130. 



520 



DISEASE GERMS. 



Discharges by }\)}niti)ig and Stool. — The first stools after birth 
are of a black, or dark-green color, called the meconium. Subse- 
quently they become brown, or of a yellow hue, of a curdy con- 
sistence. The bowels move frequently in health — about every 
four hours. Heated milk, or anything that disturbs the digestive 
organs, may cause vomiting and diarrhea, and reflexly act on the 
brain. A great many diseases of childhood are ushered in by 
vomiting, or diarrhea, as cholera infantum, hooping-cough ; and 
the expectoration swallowed in diseases of the chest is often 
vomited, or causes diarrhea. Frothy, acid stools, with undi- 
gested milk, indicate disorder of the stomach and pancreas ; 
green, or chop-spinach stools, irritation of liver and brain ; slimy 
stools, common in difficult dentition, or when worms are present 
in bowels ; thin, fetid, dark-brown stools indicate chronic diar- 
rhea. Constipation is rare among children when they are fed on 
milk diet, until teeth are present for mastication. 

The Urine. — Scanty and high-colored in all fevers and inflam- 
mations ; of an intense uriniferous odor in difficult dentition 
and marasmus ; scanty, almost suppressed, in disease of the 
brain ; complete suppression -may follow a fall, shock, jar ; in dis- 
ordered liver, stains diaper a deep orange color. 

It will be impossible to notice the disease, accidents, deformi- 
ties, nutrition, dentition, of infants, in anything like order, so we 
shall isolate them and enumerate singly. 

Inflammation of the Umbilicus. — Many ignorant medical at- 
tendants, self-conceited nurses, and meddling old women, insist 
upon various applications to the navel, especially rancid and 
trichinous lard, which softens, irritates, and causes ulceration at 
this point. The scorched linen rag, which we have recommended, 
is the best application : it is absorbent and antiseptic, and always 
procurable. The period of time that elapses before the cord 
separates is about four days, and in cold weather, perhaps five 
or six. When it has not been tampered with, a slight oozing 
of serum takes place, and the part heals ; but owing to some 
condition of irritation, that instead of healing, it may become in- 
flamed and ulcerated, suppuration takes place, and very serious 
Hemorrhage may occur. When this takes place resort at once to 
germicide washes, for in the ulcer the streptococcus pyogenes fs 
ibundant, and must be immediately destroyed.. So bathe it with 
the boroglyceride or creolin lotion weakened down to suit age, 
and then dress with vaseline or ozone ointment. 

Swelling-, or Milk in the Bi^easts. — The breasts of the infant 
often .swell after birth, and become engorged with serum and 
milk. The best plan is to open the bowels freely with oil ; give 
a little sweet spirits of nitre, and apply over the breasts a lotion 



BACTERICIDES. 



52: 



of muriate of ammonia, and if it does not disappear quickly, 
belladonna in tincture form, or put on the iodide of potass, 
muriate of ammonia, and belladonna ointment. If still stubborn, 
iodide of potass, in grain doses, internally, thrice daily. 

Retention of the Meconium. — The black, or dark-green, viscid 
matter known by the name of meconium is sometimes retained 
in the bowels after birth, instead of being discharged freely the 
first day or so. Its evacuation is promoted by the first milk 
secreted by the mother, which is of a slightly aperient nature. 

As a rule, this is sufficient to bring away the meconium, but 
if it does not, then it should be aided by medicine ; a little castor- 
oil might be tried ; that not proving satisfactory, a few drops of 
fluid extract of leptandra in water, in which one or two grains of 
bicarbonate of potassa has been dissolved. 

The Yellozu Gum. — If the meconium is not discharged 
promptly, its presence seems to give rise to irritation and obstruc- 
tion of the biliary ducts, forcing the bile back into the liver; the 
meconium becomes impacted in the intestines, and a condition 
of jaundice supervenes ; or the jaundice may be due to the dis- 
turbance of the hepatic circulation, on the transfer of its chief 
blood-supply from the umbilical vein ; or, owing to some condi- 
tion of congestion, there may be difficulty in the bile finding its 
wav into the duodenum. 

This causes languor, indolence, yellow skin, bilious urine, a 
tendency to deep sleep, which keeps child from nursing, and 
may prove fatal. In some cases it assumes the condition of true 
jaundice. 

Treatment. — Cleanse out the bowels with oil ; follow with a 
solution of phosphate of soda, one grain every two hours. A 
few drops of the fluid extract of leptandra, in the neutralizing 
mixture, should be given morning and night. If liver does not 
act very promptly, better to put one grain of calomel on the 
tongue, follow with the breast, and in an hour with a teaspoon- 
ful of oil. This may be repeated and followed with bicarbonate 
of potassa in a little water, the idea being to rouse up the liver, 
and free the gall-duct from all viscid secretion. 

Asphyxia^ or Still-Born. — The apparent or real cessation of life 
in a new-born infant may be due to a variety of causes, such as 
inherent weakness of the vital powers ; peculiar conformations ; 
collections of glairy matter in the bronchi and air-vesicles of the 
lung ; the introduction of a quantity of amnii into the trachea, 
and congestion of the lungs, arising either from the neck of the 
child having been tightly encircled by the os uteri, or vulva, or 
navel string; or from its being long detained in the passage, 
from pressure of the cord in breech presentation, or where the 



522 



DISEASE GERMS. 



cord is prolapsed, or where the mother has been dosed with 
ergot. From the exhibition of this latter during labor, we have 
asphyxia, or still-born of a peculiar kind ; the blood is coagu- 
lated in brain, heart ; the child bloodless, and rarely manifests a 
sign of life ; its blood dried up, mummified ; and no method of 
reanimation can restore it to life. When unusual weakness of 
vital power seems to be the cause, and there are active pulsations 
in the cord, lay the child on right side, keep it warm, rub it 
gently ; but do not slap it on either back or side, and do not 
ligate the cord as long as pulsations are good ; artificial respira- 
tion should be tried ; but blowing in the nose, and trying to in- 
flate the lungs are very unsatisfactory, as the air is frequently 
blown down into the stomach as well as the lungs. If pulsations 
have ceased, ligate cord at once, and try the usual means for sus- 
pended animation. Then cleanse thoroughly ; wrap in flannel ; 
rub gently; use tincture of capsicum down the spine; sprinkle 
alternately hot and cold water on the chest, so as to get to sigh, 
and thereby inflate the lungs; blow on face. Try artificial re- 
spiration, warm bath ; and be careful while pursuing these or all 
those means, that the child does not lose its heat ; keep it in 
flannel, and rub with tincture of capsicum and whiskey. It 
there is an electro-galvanic machine about, set it at work, apply- 
ing the positive pole to spine, negative over stomach and dia- 
phragm. This is often effectual. If respiration can be estab- 
lished, give a kw drops of brandy in sweetened water, and 
repeat at intervals. 

When a portion of the liquor amnii gets into the trachea, and 
produces asphyxia, or the mouth of the infant is discovered to be 
filled with glairy matter, rendering the respiration difficult, sono- 
rous, rattling, we must wash out the mouth and throat; place 
child over on its belly on the nurse's lap, which will facilitate the 
discharge of the liquor. Having done that, we must endeavor 
to reanimate the child in the usual manner. 

If a congestion of the lungs be the cause, or if you suspect the 
nurse or physician has been dosing tht mother with forcing- 
powders (ergot), then it is a good plan to untie the cord, and let 
from a teaspoonful to a tablespoonful or more of blood escape ; 
then follow with warm mustard-bath, friction to surface. Slap- 
ping the infant is always reprehensible, as its lungs, liver, spleen, 
kidneys, and other organs, are so soft that they are liable to 
lacerattion. In all cases adhere to the rules laid down for suspended 
animation. 

Medical men are often called upon to give evidence in cases ot 
supposed infanticide; it seems proper to mention that much 
careful observation and experience is required to discriminate 



liACTERICIDES. 



523 



between a child that is still-born, and one that has lived only a 
short time after its birth. Various appearances, both internal 
and external, may be mistaken for marks of violence. Even the 
floating of the lungs in water, a test on which much reliance is 
placed, is found on many occasions to be fallacious ; for they 
will float if a putrefactive process has commenced, as well as 
when filled with air by respiration. It may also happen that an 
unmarried woman, on arriving at the full period, and having con- 
cealed her condition, may be taken ill alone and be delivered of 
a live child ; but that, either from syncope ensuing speedily, or 
from a convulsion, or from less of reason, or a distracted state of 
mind, or some other cause, she may be so far overcome as 
to be rendered incapable of assisting herself or child, and it may 
have been suffocated by the bed-clothes. In other instances it 
may happen that the child is born alive, still, from some injury 
in the birth, or inherent weakness, or some other obscure cause, 
it may cease to breathe without receiving any injury from the 
mother. No doubt cases of this nature are of daily occurrence, 
and they point out the impropriety of placing any reliance on the 
floating of the lungs in water as a test of infanticide. 

The dictates of humanity and reason require a radical change 
of this method of evidence, as it has been often injudiciously used. 

Excoriations, Chafing, Ulcerations. — From a want of care, 
neglect of proper cleanliness, children are very liable to chafe, 
or excoriate, in the folds of the neck, behind the ears, in the 
groin, and around the arms. To prevent this, there should be a 
removal of all damp or soiled linen promptly, the parts dried and 
exposed to the air. It is a good plan to bathe all excoriated 
parts in warm milk and water twice or thrice daily, or an infu- 
sion of sage tea and boroglyceride, and afterwards dust with 
pulverized starch, or anti-microbe powder, or rub over with 
vaseline. If the excoriations are of considerable extent and 
depth, use a solution of boroglyceride for a wash, and apply the 
ozone ointment for a dressing ; this will heal them rapidly. In 
obviating excoriations, it should be our aim to prevent the secre- 
tions of the body from mingling with them. 

In tubercular children, about the time of teething, when the 
child suffers from malnutrition, bacteria are very abundant in 
alimentary canal, blood, and they find their way about the skin 
of the ears and other parts, which gives rise to sores, the secre- 
tions from which are highly contagious. In these cases, an 
effort must be made to correct the malassimilation, by sulphate 
of cinchona and elixir cinchona. The sores should be bathed 
with a decoction of poppies, and either kept dry by dusting on 
anti-microbe powder, or applying ozone ointment. 



524 DISEASE GERMS. 

If the case is stubborn, push better food ; pure air; and alter- 
atives, as iodide of potass ; and use stronger antiseptic washes 
locally. 

Non-expansion of the Air-cells of the Lungs. — It often happens 
from a weakness, or from a long, tedious labor, or from severe 
compression of the head, or from the little one's blood being 
coagulated by ergot administered to the mother, that it is unable 
to inflate its lungs perfectly; that there is a non-expansion of 
the air-cells, and the infant looks as if about to die. It soon be- 
comes jaundiced; cry consists of a mere whimper; inability to 
nurse ; drowsiness, exhaustion, are great; surface cold and livid ; 
chest but partially dilated by imperfect respiratory movements : 
the lung condensed, but the consolidation will give way as 
strength is gained ; and good health may be attained, or death 
may occur from exhaustion and convulsions. To prevent this, 
bathe the child, wrap up in warm flannel in a room 80° F. ; hot 
bath twice every twenty-four hours ; massage gently with sweet 
olive oil, especially about the chest and abdomen; nourish every 
two hours with juice of raw beef, or milk and lime-water ; open 
bowels with magnesia. 

Cephalcematonia. — If the labor has been long, tedious, or the 
head large and pelvis small, or the-presentation a difficult one, it 
is very apt to so compress, or stagnate, or rupture vessels on the 
scalp as to cause the formation of a bloody tumor after birth 
between the bones of the skull and pericranium. Long-con- 
tinued pressure is the cause. 

Sjnnptoms. — Tumor varies in size from a hen's tgg to that of a 
large orange. It is generally formed on one of the parietal 
bones ; on right more frequently than left, and occasionally on 
both. Swelling is soft, fluctuating, and circumscribed ; its base 
often becomes encircled with a hard ring, caused by the coagu- 
lation of the plasma exudation. 

Treatment. — Never incise, nor apply compression ; administer 
a gentle purge, and apply a solution of muriate of ammonia, 
not very strong. If anxious regarding it, a solution of iodide of 
potass, five grains to the ounce of lime-water, and apply. 

Convulsions of Infaiicy. — There is a very rare form of convul- 
sions occasionally met with in infants, which is epileptic in 
its character, and leads to impairment of the intellectual 
faculties. 

It consists in a peculiar, involuntary, rapid bowing forward ot 
the head, and in some cases the whole body. The bowings are 
repeated in quick succession, one following the other, occurring 
every day, or less frequent ; usually worse in the morning, or 
when awaking from sleep, After child grows old, regular epi- 



BACTERICIDES. 



525 



leptic attacks take their place ; pure epilepsy, or convulsions, 
or paralysis, and wasting may follow. By attention to bowels, 
skin, and administration of alteratives, the symptoms will sub- 
side, and the health be completely restored. 

Treatment same as for Epilepsy aud Convulsions. 

Nine-day Fits. — There is a peculiar form of tetanus, or lock- 
jaw, that occurs in infants about two weeks after birth, and is 
very fatal. It is supposed by some to be due to cutting the 
navel-string or cord with blunt scissors, or to the application of 
irritating agents about the navel. 

Others imagine it to be due to cold, foul air, improper feeding, 
imperfect bathing, retention of meconium, ergot to mother. 
Precautions ought to be taken in the dividing of the cord that 
it be done by clean-cutting scissors ; that no irritants be applied 
to navel ; that the child be properly seen to by proper bathing, 
pure air, cleansing out its bowels with oil. 

Hide-Bound ; or, Sclerema. — A peculiar disease of new-born 
infants, consisting of an induration of the skin and subcutaneous 
tissue, with serous effusion, occurring at birth, or within ten 
days subsequently. It seems to depend on the latent elements 
of syphilis. 

Symptoms. — The skin, at first is dry, stiff, withered ; then as- 
sumes a waxy, yellowish appearance, and gradually becomes dis- 
tended and unyielding ; so the babe is said to be skin-bound. 
It grows cold, prostrated, unhealthy, and often jaundiced. Indi- 
cations of distress in restless, whining cries ; refuses the breast \ 
feeble pulse and laborious respiration. Gastric and intestinal 
disturbance sets in, and death is ushered in with prostration and 
asphyxia. 

Treatment. — Use warm bath ; inunction of oil ; flannel ; solu- 
tion of raw beef, and one-grain doses of iodide of potass ; milk 
and lirr.e-water ; keep bowels open with neutralizing mixture, 
and see that kidneys act well. Death is almost inevitable. 

Hiccoughs. — Some infants are greatly incommoded by hic- 
coughs. They usually arise from some acidity of the stomach, 
or from some nervous irritation. 

If due to acidity, try a few drops of lime-water in milk ; a grain 
of bicarbonate of potassa, in milk, or the neutralizing mixture. 

If due to nervous irritation, try one drop of chloroform, in 
water, sweetened, or tincture of aconite, or belladonna ; or a few 
drops of aromatic spirits of ammonia in water ; or some aro- 
matic tea, as catnip, anise-seed, caraway. In some cases a few 
drops of vinegar prove very effectual. If persistent, and not 
relieved, then some stimulant to spine and over stomach, as soap 
liniment and lobelia. 



526 



DISEASE GERMS. 



Our Infantile Mortality. — Our country, noted for every practi- 
cal improvement, every species of philanthropy, everything cap- 
able of ameliorating human toil and suffering, suffers the great- 
est infantile mortality in the world. Much of this is due to solar 
heat, city life, insanitary conditions, special diseases, but the 
greatest causes are bad feeding and improper drugging. The 
practice of not nursing, or weaning early, is now becoming more 
common, as the struggle for existence becomes greater, so as to 
enable the mother to work. As a result, the babe is fed on 
starch, farina, corn-flour, boiled bread, sour, or swill milk ; 
articles it cannot digest ; so that it starves — takes marasmus ; 
because it has lost the main factor of nutrition, mother's milk, it 
sickens, dwindles and dies. Parents cannot be too frequently in- 
formed of the unsuitabihty of farinaceous food for children. The 
practice of an American mother in this land of freedom and 
wealth being compelled to work during pregnancy and nursing 
drains away the life and vigor of both mother and child. It 
makes the mother prematurely old, and stunts the growth and 
destroys the vitality of the child. A mother's labor, a mother's 
worry and strain should be minimized by every possible means, 
and work avoided. 

As for drugging babes, it is a great wrong, and the immediate 
and remote cause of much mortality. Think of the millions of 
bottles of soothing syrups that are annually consumed, all loaded 
with opium, which whittles down and mummifies our new 
growth. Introduce a better system of feeding ; milk-food free 
from starch ; abolish drugging, and we will save this element of 
national greatness that is now lost. 

Infantile Syphilis. — Parents, either father or mother, affected 
with the syphilitic germ, are liable to transmit it to their off- 
spring. In the case of a father affected, and the mother free 
from the disease, the healthy uterus of the mother is likely to 
repel the diseased foetus at four or seven months, and cause an 
abortion ; but in some cases the mother may carry her preg- 
nancy through, and the child may be born, apparently free from 
disease. But in a period of time, usually inside of six weeks after 
birth, the original pock of the father will appear on the skin ot 
the child in the shape of blisters about ears, nose, face, body, 
arms and legs, forming a regular rash, copper-colored. Very 
soon there is a general shrinkage, or shrivelling of the skin, with 
general syphilitic ulceration of mouth and throat, and other parts. 
In other cases, the infant may be born with the withering effects of 
syphilis visible all over its entire body ; its hair may drop off, and 
general ulceration may occur. 

In still another class of cases there may be no visible appear- 



BACTERICIDES. 527 

ance on skin, but the disease may exhibit itself in the boneF, in a 
separation of the growing extremities of the ends of the long 
bones, which leads to the separation of their epiphysis. 

This affection of the growing bones seems to be painless, and 
even more amenable to treatment than the skin eruption. 

Same treatment "as for Adult Syphilis. 

Physicians meeting those cases in every-day practice, see the 
imperative need of legislative enactment to prevent the marriage 
of parties afflicted with this malady, entailing disease and death 
upon their offspring. Syphilis is a coutagiinn viviun just as much 
as small-pox, and some gigantic effort is necessary to prevent its 
wide-spread dissemination. 

TeetJiing. — Of all the occurrences to which children are liable 
not one is attended with such grievous and distressing symptoms 
as difficult dentition. With regard to the time of their cutting 
their teeth, no fixed or exact period can be laid down ; as in rare 
cases, some are born with teeth, others have them soon, others 
very late, and others extremely late. 

As a general rule, dentition commences, in the large majority 
of children, between the fourth and eighth month, and the pro- 
cess continues until the seventeenth month, and often later. The 
two front teeth of the lower jaw are those that usually appear 
first, and shortly after these are observed two more come out in 
the upper jaw, exactly opposite the two former. These are suc- 
ceeded by the four molars, then the canine, and, last of all those 
of an infant's first teeth, the eye-teeth, make their appearance, 
making sixteen in all. This is the ordinary number of a child's 
first teeth, as they are called, but some infants cut four double 
teeth in each jaw instead of only two, making the number 
twenty. 

In children who are healthy and strong, who have a good 
mother and abundance of milk — a mother who eats a wholesome 
diet, with daily meal of oatmeal porridge and cream, corn-bread, 
and boiled fish, the process of dentition goes on with perfect re- 
gularity, and the teeth are cut early, and wdthout a particle of 
trouble or pain ; but in the unhealthy and weak infant, who has 
a mother reckless of her diet, the process of dentition is slow, tardy, 
uncertain, painful and difficult. So that we meet with children 
cutting their teeth in a very irregular way ; perhaps the teeth 
appearing in the upper jaw at intervals apart, or overlapping, 
and the same in the under jaw, and various other condi- 
tions, which are attendant on tardy, difficult, or painful den- 
tition. The first two teeth give a pretty good index of what is 
to follow, the succeeding ones generally making their way in a 
corresponding manner. This first set is called the milk-teeth, 



528 



DISEASE GERMS. 



and are generally shed when the child becomes six or seven years 
old, according to their diet and health. 

At six or seven years of age, when the shedding begins, it is 
followed, in a gradual manner, by a fresh set; and about the age 
of twenty-one they get one more in the corner of each jaw, which, 
from their appearance at that period of life, have been named 
their wisdom-teeth. 

The following table exhibits a fair average of the eruption of 
the teeth : 

DECIDUOUS TEETH. 

( The lotver generally precede the upper by huo or three months.^ 

Central incisors 5 to 8 months. 

Lateral " 7 to 10 " 

1st molars 12 to 16 " 

Canines 15 to 20 " 

2d molars 20 to 36 " 

PERMANENT TEETH. 

1st molars 5 to 6 years. 

Central ipci>ors 6 to 8 

Lateral incisors 7 to 9 

1st bicuspids . 9 to 10 

2d " 10 to II 

Canines II to 12 

2d molars 12 to 14 

3d " 17 to 21 

Difficult Dentition. — Permature decay of the teeth is in a great 
measure due to the want of vegetable phosphates in the mother's 
blood ; to her neglect of the daily use of oatmeal, corn-bread 
and boiled fresh fish ; and the use of bakers' bread as diet. This 
also predisposes the mother to nervous diseases, which correlate 
to the deterioration of the teeth, each influencing, and, in a mea- 
sure, causing the other ; besides, the modern system of over- 
stimulating the nervous system by early precocity, causing a 
defective process of assimilation and tissue- formation, especially 
in teeth. 

Symptoms, — Difficult teething exhibits itself in a variety of 
ways, but the great bulk of the symptoms are reflex — irritation 
transmitted to a weakened bulb and cord. The child becomes 
fretful, its skin white ; nutrition is impaired ; the gums swell, 
spread, become hot, tender; the child is continually working with 
its mouth, desiring to bite something; irritable, restless, peevish ; 
some fever ; increased heat in the head, or pallor, with dilatation 
of pupils ; there is often a hectic flush on the cheeks, with erup- 
tion on the skin, especially on face and scalp ; a looseness of the 
bowels, with griping stools, of a green, pale or leaden hue, 



BACrERICIDES. 52Q 

sometimes mucus ; and the child becomes very peevish ; starts 
in its sleep ; eyes partially open ; rolls head, and throws its arms 
about, and seems convulsed in particular parts of the body. It 
exhibits great indications of brain-irritation ; in some cases 
screaming, throwing head back, thrusting its fingers into mouth; 
in other cases there is cough, difficulty of breathing, emaciation, 
marasmus, great fever, thirst, convulsions and a bad train of 
symptoms. 

When the child is properly cared for, its secretions and excre- 
tions kept natural, and elements supplied in its milk from which 
nature can make teeth, very few of the violent symptoms attend- 
ant on such a condition occur, and we need not apprehend any 
bad symptoms from teething. Infants cut their teeth more easily 
and readily in winter than in summer ; boys more difificult than 
girls. What is to be apprehended is the reflex condition, which 
affects all children to a greater or less degree. 

Treatment. — The irritation of teething causes the gums to swell 
and become tender to the touch ; there is fever, with irritation of 
nervous system, with occasional convulsions. In such cases, 
where the gums are conside-'ably swollen, and the child seems to 
suffer much from the irritation of the tooth in working its way 
out, and when the tooth is near the surface, it will be exposed by 
the retraction of the gum, then it may be advisable to relieve it 
with a lancet; when no such appearances present themselves, 
and the child is very restless and uneasy, we can do little more 
than attend to the different symptoms. In the mildest forms of 
dentition, sedation is very useful; bathing twice daily; put thirty 
drops of tincture of aconite in half a tumbler of water, and give 
a teaspoonful every one or two hours ; if there be strong nervous 
symptoms, with a tendency to convulsions, add a few drops of 
tincture green root gelsemium. If the breath is very acid, lime- 
water and milk, or the neutralizing mixture, or ozone-water ; if 
there seems to be griping, open the bowels with cascara, and fol- 
low with infusion of anise-seed. The above also will relieve the 
bowels if constipated. In some cases a grain of leptandra rubbed 
up in pulverized licorice is very efficient. If there is restlessness, 
violent startings, with screamings and twitchings — precursors of 
convulsions ; bromide of potass and ammonia in lavender or 
cinnamon-water. 

Opium, or laudanum, or paregoric, should not be administered 
to teething infants for the purpose of keeping them quiet. It is a 
most injurious practice; dries up their secretions, and whittles 
down their vital force. Mothers, and especially nurses, are prone 
to resort to that drug iii some soothing syrup, so as to have their 
own rest undisturbed. The only drugs of real merit are lime- 

34 



t^Q DISEASE GERMS. 

water in milk, compound hypophosphites of lime and soda in 
juice of raw meat, and ozone-water ; two of which could be given 
at alternate periods, say, every two hours ; otherwise the treat- 
ment must be upon general principles. If there is fever, aconite 
and asclepias should be given ; urine scanty and high-colored, 
parsley-root tea and sweet spirits of nitre. Watch convulsions ; 
let mother have tincture of lobelia on hand, and if she sees 
twitchings or throwing head back, alternate pallor and redness, 
administer a few drops as occasion demands. A free action of 
the bowels during dentition should not be stopped ; not unless 
the motions are very frequent, and then guardedly. Any other 
symptom that arises should be managed upon general principles. 
The practice adopted of giving infants toys made of hard rubber 
or ivory to suck and hold in the mouth, upon which they can 
press their gums during teething, is highly improper, as it has a 
tendency to harden the gums. 

Aphth(£, or Nursing Sore Mouth, is most common in ill-fed 
children, and the parasite present often makes destructive ulcera- 
tion of the gums. (See Aphthce.) Pure air, proper exercise, 
wholesome, nutritious milk ; flannel clothing, regular bathing, 
secretions, and everything that is calculated to promote good 
health, will greatly contribute to the safety of dentition. At the 
same time guard the reflex centres, by keeping them well stimu- 
lated by proper means. 

In all cases of tardy, difficult, or painful dentition, we must 
never ignore the main defect — a want of histo-genetic material 
in the blood ; provide in all cases material from which the sys- 
tem can elaborate teeth. 

Weaning Brash is a term applied by mothers and nurses to a 
disorder that takes place upon being suddenly deprived of the 
mother's milk by disease, pregnancy, or death, or where children 
are reared artificially with bad milk. The use of the milk-food 
has stamped this disorder out. It consisted in derangement of 
the stomach, vomiting and purging, with green stools ; and if it 
occurred during the hot weather, speedily merged into that fatal 
disease, cholera infantum, with its sequel, tabes mesenterica. A 
quick transition from one kind of food to another should never 
take place ; it should be progressive, and adapted to the age and 
condition of the child. 

Malformations and Deformities. — SomiC attribute them to im- 
pressions made upon the mother during pregnancy, and there is 
no doubt but this is a fruitful source ; others attribute them to 
defects, or deficiencies, or absence of certain histo-genetic mate- 
rial in the body; and others, to a variety of causes. But there 
can be little doubt that by far the most prolific causes of deformi- 



i 



BACTERICIDES. ^oj 

ties are incompatibility of temperament, close consanguinity, in- 
and-in breeding. Although this is the main source of the trouble, 
it would be well in our present state of civilization, where the 
nervous system is developed at the expense of the physical, 
where the brain is alive, vivid to external impressions, to guard 
pregnant mothers from theatre scenes, deformities, animial or fowl 
killing, choreaic movements, fits, appalling accidents, death, or 
anything of an unfavorable nature that would be likely to impress 
her keenly or acutely. Defects or mutilations may also be 
classed under the same causes. Imbecihty, an abrogation of the 
facial angle of forty-five, or idiocy, is likely to be due to the use 
of whiskey and tobacco by the father, the former causing true 
imbecility, the latter wiping out the typical convolutions of the 
brain. 

As a rule, all extra fingers, and toes, and other malformations, 
should be rectified at birth. 

To7igue-Tie. — The tongue may be unnaturally adherent to the 
sides, or to the under surface of the mouth, so that nursing may 
be prevented. The adhesions must be carefully and cautiously 
divided with a bistoury and the bleeding controlled by the 
perchloride of iron. Genuine tongue-tie is when the bridle of 
the tongue is so short as to reach nearly to its tip and interfere 
with its motions. This is to be remedied by dividing the edge 
of the bridle with the scissors. 

Hare-Lip, — The simplest degree of this deformity is single 
hare-lip, in which the lip is fissured on one side ; it may be com- 
plicated, with partial or complete fissure of the palate. The 
greatest malforma- 
tion of this kind is 
double hare-lip and 
fissure of the pal- 
ate. The arrest 

^ * . Diiferent forms of hair-lip. 

curs only m the 

upper lip ; the fissure never occurs in the median line, but always 
under one or both nostrils, and the deformity may vary from a 
notch to a complete fissure, extending into the nostrils. The 
only point of interest is the treatment. The operation for the 
relief of this difficulty should be performed immediately after 
birth. The child, after being properly nourished, should be 
wrapped up in a sheet ; the edges of the cleft should be liberally 
pared, and then hare-lip-pins inserted two-thirds the thickness of 
the lips, from its anterior face. A sufficient number of pins 
should be used, and over each the figure 8, formed of lead wire, 
which should have the preference to silk. 



»#^S^ 



^-,2 DISEASE GERMS. 

Cleft Palate is often associated with hare-lip, and frequently 
closes when the lips are healed. The operation for this has 
generally to be delayed till patient becomes ten or fourteen years 
of age, or even older. 

Wry-Neck. — A distortion in which the head is drawn to one 
side, and the face to the opposite ; due to contraction of one 
sterno-mastoid muscle. Paralysis of one muscle allows the other 
to overpower its fellow. 

Causes, — Blows on neck ; caries of cervical vertebrae ; enlarge- 
ment of cervical glands on one side ; to the cicatrix of a burn or 
ulcer ; rheumatism ; gout. 

Treatment varies much, generally embraces alteratives and 
tonics, with shampooing, friction, electricity of the paralyzed side. 
Try every means to improve general health ; all failing, the muscle 
on sound side to be divided. 

Knock-knees y due to a relaxation of the internal lateral liga- 
ments of the knee-joints, allowing femur and tibia to become 
separated, so that an angular obliquity of the bones results. It is 
common in tubercular children ; may be noticed before beginning 
to walk. The best plan is to treat for tuberculse, and resort to 
every means to build up the general health. Massage, locally, 
twice daily. 

Bow-legs belong essentially to rickets, and is generally due to 
starch-feeding of infants. It can be overcome by a better diet, 
one containing vegetable phosphates, as corn and oatmeal mush, 
boiled white-fish, animal food, etc.; keeping patient off his feet, 
and in addition, using locally, massage, salt-water baths, and 
general treatment for tuberculae. Perseverance is essential, as 
many months are indispensable for a cure. 

Club-Foot. — A gradual change in form and positions of tarsal 
bones, chiefly owing to undue action, or paralysis of certain mus- 
cles, or their atrophy, or want of development, or to contraction 
of tendons. Usually congenital, and dependent on same causes 
as other malformations; or it can be acquired' by conditions 
affecting either the circulation of nerves, or growth of muscles. 
There are quite a number of varieties, but for all practical pur- 
poses they may be embraced under four principal heads. 

(i.) Talipes Equinus : This is the most common form, and 
consists either in a rigid contraction of the tendo-achillis, of the 
muscles of the calf of the leg, so that the heel cannot be brought 
to the ground, and the patient walks on the metatarsal bones. 
When this is not congenital, it is h' able to occur during dentition, 
from worms, acidity and other reflex causes of irritation. The 
patient, either from incompatibility or other causes, is very tuber- 
cular; and the slightest irritati^m in the body is transmitted to 



BACTERICIDES. ^33 

the weakened nerves. A cure is easily effected by a division of 
the tendo-achillis under the skin. 

(2.) Talipes Varus : The heel is raised, the inner edge of the 
foot is drawn upwards, and the outer edge rests on the ground. 
In extreme cases, patient walks on dorsum of foot and outer 
ankle. There is contraction of the muscles of the calf and ad- 
ductors of the foot. Every tendon that aids in producing the 
deformity should be freely divided under the skin, and, last of 
all, the tendo-achillis. 

(3.) Talipes Valgus : This is the direct reverse of the talipes 
varus. The outer edge of foot drawn upwards, so that patient 
rests on inside of instep and inner ankle. All the tendons 
that are concerned in producing the deformity are to be cut under 
the skin. 

(4.) Talipes Calcaneus : Elevation of the toes and falling on 
the heel, so that the patient walks on the latter. This is usually 
brought about by loss of nerve-power, or degeneration of the 
muscles of the calf, which affords the opposing muscles a chance 
of drawing the foot into the abnormal position. 

Every tendon to be divided subcutaneously, so as to bring the 
foot into its proper position. 

The principle upon which the tendons of the various muscles 
are divided is very simple : A cut, or incision, is made under 
the skin, so as to prevent any suppuration ; the cut surfaces, or 
ends, although stretched apart quite a space, heal by connective 
tissue or lymph, which lengthens the tendon the amount desired. 
It is necessary to wear a boot if performed at birth, as it ought to 
be, or a week after. 

When not congenital, but coming on during childhood, many 
cases can be cured without operation by the removal of the 
source of the irritation, by good food, fresh air, sea-bathing, 
tonics and by shampooing, friction or massage, with oil, and a 
proper use of bandages, splints, boots, adhesive plasters and the 
like. Rheumatism and gout should be carefully guarded against. 
We cannot too strongly insist upon a most constructive treat- 
ment as the best means of overcoming the true cause of the 
difficulty. 

Flat Foot. — A sinking of the sole of the foot from relaxation 
of the supporting ligaments. Walking is rendered awkward, 
slow, painful, and in bad cases, lameness and deformity. It is 
usually the result of debility, and can be remedied by the 
mother when the child is quite young, by bathing, friction and 
good nutrition. 

Webbed Fingers and Toes. — In rectifying this malformation, 
the best plan is to make a small incision at the junction of fingers 



534 



DISEASE GERMS. 



or toes, through which introduce a piece of lead ribbon which 
should be permitted to remain about ten days, so as to give ample 
time for healing. Then remove and slit up the web its entire 
length, and dress with the lead ribbon, or otherwise. If the above 
method is not observed the webbing often returns. 

The Nutrition of the Infant. — Milk is the natural food of the 
infant up to the period when it is supplied with teeth for masti- 
cation. Its stomach is adapted solely for its digestion, and it is 
the only proper element for building up the body. Milk, if 
healthy, supplies everything for the whole organism, from which 
bone, muscle, brain, gland, etc., can be constructed, repaired and 
renovated. Milk is pre-eminently suited for the rapid oxidation, 
increased temperature, accelerated respiration and circulation, the 
only diet for building up infant organization. The milk taken by 
the child represents so much potential energy ; but before that 
energy can assume a vital form, the food must be converted into 
tissue, and in that conversion a large amount of energy must be 
expended. All the constructing and repairing powers in the in- 
fant are more active than in the adult. The infant requires, over 
and above the wants of the man, not only food for flesh laid on, 
but also for the energy used in making up that living, sculptured 
flesh out of materials that serve for food. In the growing organ- 
ism- there is a greater instability in the nutritive process, and this 
instability, must be guarded against by having good milk, else we 
will have defects in blood formation. American mothers have 
been accused of being bad nurses. Now, this is both true and false ; 
true, she is highly civilized, quick, excitable, and often, in the act 
of nursing, allows care, worry, to distract her attention ; will 
hastily lay her little one down before it has even partially emptied 
the breast, which act of all others causes the milk to dry up ; 
trne, she is absorbed in lectures, theatres, balls and other frivoli- 
ties, which engender late hours and irregularity, which has a de- 
pressing effect upon her; and her literature is not good ; true, her 
diet is not the proper kind or quality for a nursing mother, her 
ices, ice-cream, iced drinks, candies, pastry, etc., are pernicious 
and highly detrimental to the secretion of milk ; but let her re 
move these and other defects, she is as good a nurse as any other 
mothers of her race. Take the American mother, free from toil, 
care, struggle for existence ; free from the vices and depressing 
influences of city life, with a good diet of beef, mutton, poultry, 
game, eggs, milk, oatmeal porridge, corn-bread, carrots, parsnips, 
fruit and other vegetables, she is a good nurse. Excess of feed- 
ing, alcoholic or malt liquors, wines and sloppy food, never should 
be recommended ; neither is tea nor coffee of any utility. 

The nutrition of the child is of the greatest importance, be- 



BACTERICIDES. 



535 



cause in all our large cities we lose two-thirds of our entire 
infantile population during the first two years of existence, chiefly 
By bad milk, careless or improper nursing, insufficient food, and 
insanitary conditions. The mother's milk is too often deteriorated 
by fashion, theatres, improper food, worry, work, and other 
causes, and the want never can be supplied by artificial means, 
for there is no substitute for the life-giving mother's milk. If 
we could only teach mothers how much suffering they could 
save, how many valuable lives they could prolong, by seing that 
their children have proper food, it would be a holy task. Many 
modern mothers can only nurse their children partially,* or not at 
all. Their milk is often deficient through improper diet, and not 
emptying the breast properly; besides, the secretion decreases 
by care, worry, struggle, work, or her health may be feeble or 
delicate ; or her vital energies taxed by some latent condition, 
that she may have no milk. 

In this condition the infant must have nourishment ; if rich, a 
wet-nurse could be provided ; if poor, the cow's milk, or milk-food. 

As regards wet-nurses, there is always great danger to be ap- 
prehended from them in a moral and physical point of view. 
They are generally unfortunate women, women with hidden vices, 
uneducated, full of prejudices and disease, and the irregularity 
of their past life has a bad influence on the rnilk and moral well- 
being of the child ; and it is doubtful, rather than run risks of 
moral and physical degradation, whether artificial nutrition, 
administered by its own mother, or some other intelligent person, 
properly adapted to its age and development, is not the best. 
Artificial nourishment is often better than run the risk of wet- 
nursing. The great trouble of late years, in this particular, has 
been that parties, by advertisements and certificates of ignorant 
physicians, have foisted upon the people an immense array of 
infant food, all chiefly composed of starch. Indeed, starch-food 
is forced upon the mother wherever she goes, as a diet for her 
child. Now, our infants cannot digest starch, their stomachs are 
not made for it, neither have they the means of converting it into 
sugar, like an adult ; so children fed upon starch, as rice-flour, 
farina, Liebig's food, arrowroot, starve ; they have no teeth ; 
their bones and brain are destitute of phosphates. God never 
made a Caucasian infant to eat starch ; there is not a trace of it • 
in the white mother's milk. A Mongolian or Negro, without 
cerebral convolutions, may thrive on it, but never the white race. 
So, if there must be artificial feeding, let us have cow's milk or 
milk-food ; and with greater care, more fresh air, rigid cleanli- 
ness, abundance of sleep, an avoidance of insanitary states and 
contagious diseases, we may be able to raise the child. 



536 



DISEASE GERMS. 



The proper food, then, of all infants, is milk. That gives 
everything wanted — development and growth ; on it they are 
healthy and thrive. The first two months of life, cow's milk* 
two-thirds, water, one-third, with very little sugar, comes very 
near, that of mother's milk. There is still a difficulty here: if a 
cow is fed on pasture alone the milk is very poor ; but if they 
are fed with corn-meal and bran, in addition to abundance of 
good pasture, the milk is excellent; and besides, it must be seen 
that the cow is free from foot-disease, or tuberculosis, and the 
milker not affected by syphilis. In all our large cities there is 
much impure milk — milk loaded with diseased germs ; besides, 
nearly all the high-bred cows are affected with tubercle ; so if 
matters are not of the purest kind, condensed milk should be 
used : for in the process of manufacturing, the diseased germs 
are destroyed. 

About the third month nourishment should be more substan- 
tial ; for that is the period for true, rational nourishment to be 
given for the future welfare of the child. The Racine Malted 
Milk Co., Wis., has placed bef -re the American parents a nour- 
ishment for children at this period that is unsurpassed, and satis- 
fies all the phy.'=iological and chemical demands. It consists of 
the best milk, the wheaten phosphates, no starch, best cane-sugar, 
and a normal quantity of saline matter. The combination is 
perfect, and the most appropriate for infant-food, and of immense 
value as an article of general nutrition. It is highly nourish- 
ing, its composition is pure, fresh, superior to anything ever 
introduced ; it is very easily digested ; keeps well, never fer- 
ments or sours ; and is better than city milk, because it is free: 
from all diseased germs. Besides, it nourishes brain and bone 
well, consequently teething is easy; excellent for debility ; chil- 
dren and invalids never tire of it, but rapidly increase in flesh 
and strength upon it. It is so excellent in teething that they 
come easy, regular, without suffering; no diarrhea, or vomit- 
ing, or skin eruptions. It supplies a long- felt want, to wit : a per- 
fect form of artificial nutrition — the best that has ever been 
offered in the world. The milk-food is intended to be used when 
the infant is about from two to three months old. Its superiority 
consists in its containing no starch, which has been so detri- 
■ mental to the digestion of children ; and to the fact that bone 
and brain elements in it are abundant. 

As soon as the child has completed its dentition, the mouth, 
salivary glands, stomach, and pancreas become gradually adapted 
to digest solid food, and a change or transition from milk food 
should be very progressively made. Modern children are per- 
mitted by both parents to take the ordinary course of the house, 



BACTERICIDES. -37 

Avhich is a great wrong on the part of the parents. For exam- 
ple, the use of tea and coffee by children is very injurious, as it 
overstimulates and exhausts their nervous systems ; gives rise to 
catarrh of the stomach in their period of infancy, and pre- 
disposes them to dyspepsia and cancer of stomach in more 
mature years. The use of sweets, ice-cream, pastry, dumplings, 
is also improper food, because the gastric juices are not strong 
enough for their dissolution; so also with pork, veal, cabbage, 
nuts, salt fish, and corned beef, totally unfit for the diet of a child. 
Children should be early taught the injurious effects of drinking 
at meals. Whatever fluids are necessary should consist of milk 
or water. A new system of dietetics should be inculcated, or 
rather, an old method revived, among the children. All, irre- 
spective of sex, or condition in life, should, from weaning, up till 
twenty-one years of age, have a special diet — one of brain and 
bone-elements ; one hearty meal daily of oatmeal porridge and 
milk or cream. This should be a daily meal from September ist 
to May 1st; during the very hot months of the summer, better 
to discontinue its use, as it is somewhat heating. Corn-bread, 
made without baking-powder, should be a daily and staple article 
of diet ; boiled white-fish and home-made bread. Bakers' bread, 
with its noxious compounds of soda, tartaric acid, alum, sul- 
phuric acid, etc., is unfit for child-food, as the phosphates are 
destroyed in the process of whitening. The oatmeal, corn, and 
fish diet should be insisted on, as calculated to promote the nutri- 
tion of brain and bone. No baking-powders should be tolerated 
in the culinary department of any family, as their use is destruc- 
tive to the phosphates in all our cereals. To the toothless babe 
starch diet is starvation, but after dentition is completed they can 
digest starch ; but in our climate, with its highly oxygenized 
atmosphere, our children do not require much starch-food, such 
as potatoes, arrowroot, tapioca, rice ; there are no brain elements 
in them — not of thought ; they are converted into sugar, and 
thus into calorification — a process not very essential to the pre- 
cocious American ; so, as a rule, they should be sparingly fed. 
Carrots, parsnips, onions, vegetables, and ripe fruit generally are 
conducive to health and longevity in the child. 

The Child — its care and cidture, warding off and curing its dis- 
eases, must be carried out on physiological principles. In look- 
ing at the dawning intellect, we must remember that mind is 
brain-function, just as locomotion is one form of muscle-function. 
The brain, as it matures, acts, thinks, reasons, judges, and forms 
purposes. As the size, weight, form, and development of the 
bony skeleton, with its muscular apparatus, determine the limits 
and nature of physical power and activity, so do the size, weight, 



538 



DISEASE GERMS. 



form and development of the brain, with its apparatus of sense- 
organs, determine the Hmit and nature of intellectual power and 
activity. Its personal characteristics are passed down from the 
parents ; so that there are mental and moral qualities offering 
themselves for care and culture. The aggregate qualities of the 
parents, embodied in the child, are subject to surrounding influ- 
ences. It is essential to recognize this initial fact, so as to 
develop the good, and repress the evil elements of its nature. 
Every child is charged with potential energies that need to be 
stimulated for good, trained and taught in a manner and upon a 
principle peculiar to her or himself; the influences brought to 
bear upon it ; the tasks imposed ; the exercise of its body and 
mind — its regime, selected and graduated to its undetermined 
nature, and its special needs. 



A partial death of a portion of the body, 

Inflammation, and involves a condition of vital depression, 
and degradation of the bioplasm of the part. 

The causes are very numerous, and embrace everything that 
diminishes, damages, or tends to destroy any part of the body, 
such as heat, cold, wet, poisons, depressing passions, mechanical 
violence, etc. 

The permanent symptoms of inflammation are pain, heat, i^ed- 
ness, swelling. 

Pain is a symptom of partial death, of deficient vitality, or vital 
depression. It differs in structures and tissues according to their 
physiological function, chemical composition and anatomical 
structure. 

The nerve-tissue being intrinsically the most valuable, most 
highly organized, and vital, is the most resisting, the most diffi- 
cult to depress, and when once devitalized the most tardy of all 
structures to regain its vitality. The pain also, when it suffers a 
partial death, is out of proportion to all other pain, especially so 
if the brain has suffered the shock ; here it is frontal, and aggra- 
vated by noise, light, heat and motion. 

If the skin suffers a partial death or inflammation, the pain is 
burning, tingBig ; if the cellular tissue, throbbing ; if the serous 
membranes, like pleura, sharp, lancinating ; if the mucous mem- 
branes, sore, raw ; if in bone, dull, deep seated ; if in cartilage, 
more intense. Pain may not be experienced in the inflamed part, 
but reflected by recurrent nerves to a part at a distance, as for in- 
stance, in inflammation of the liver the pain is in the shoulder ; 
of the kidney, at the orifice of the urethra ; of the ovary, in the 



BACTERICIDES. cog 

front of the thigh; of the uterus, in the sacrum; of the hip-joint, 
at the knee. 

The heat of inflammation is caused by the semi-vital chemi- 
cal change, the passage of organic into inorganic matter, the per- 
version of nutrition, rapid oxidation, molecular excitement and 
general metamorphosis of structure. 

The congestion and redness are due to the lost contractility of 
the walls of the blood-vessels, whereby their walls become loose 
and lax ; the blood rushes in and the minute capillaries being 
also relaxed, i^ed blood circulates where white only passed 
through, and the walls being so relaxed the more watery portion 
passes through their walls. The blood-vessels owe their con- 
tractility to the nerves that supply them, so the vitality of the 
part or its nerves being so weakened permits of the changes ; 
indeed, its chemical character is altered ; in health neutral or 
alkaline, it is in inflammation intensely acid. 

Besides a change in secretion, there are important changes in 
the structure of the part, as degradation of living matter into 
disease-germs which cause it to spread. 

Inflammation has but one genuine termination ; resolution or 
recovery; the subsidence of the inflammation and the restoration 
of the part to its original condition ; but besides this legitimate 
termination, there may take place from various causes the follow- 
ing effects, viz.: Effiisioii of serum, effiision of blood or hemor- 
rhage ; effusion of lymph ; the breaking of lymph and formation 
of pus ; ulceration ; gangrene, or mortification. 

Inflammation miay be either acute or active, sub-acute or pas 
sive, and chronic. It is called acute when it sets in and runs its 
course rapidly, when the symptoms are all well defined and are 
accompanied with rigors and fever; sub-acute, same as the acute, 
with the exception that there is no fever. Chronic may be either 
a sequel of an acute or sub-acute attack, or it may come on per 
se. ■ It is liable to occur in patients of low vitality. It usually 
progresses slowly, insidiously ; symptoms not well defined ; no 
fever, and has a tendency to terminate in eff'usion of serum or 
thickening. 

Each form of inflammation is characterized by a special microbe 
of its own, which renders all inflammations to a degree conta- 
gious and infectious. 

The permanency of the pain, heat, redness and swelling is the 
best point by which to recognize inflammation. 

The correct treatment of all inflammation is powerful local and 
internal stimulation. A stimulation so powerful and so effective 
that will run the case in resolution. The local stimulants should 
be of such a character that they will stimulate to the point de- 



540 



DISEASE GERMS. 



sired and still not impair or destroy in any way the future in- 
tegrity of the tissues ; induce contractility of the blood vessels and 
overcome partial death. The class of internal stimulants of most 
utility are exalgine, aconite, veratrum ; these tend to lower tem- 
perature by checking the chemical metamorphosis, vivifying and 
toning the vessels. No case of inflammation can be treated with 
success without the use of bactericides; even ordinary bacteria of 
malnutrition require to be killed. 

If the largest dose of an arterial sedative, warranted by the 
nature of the case and good judgment of the physician, does not 
ameliorate the pain, then the impressibility of the sensorum must 
be blunted by anodynes to secure an entire freedom from pain. 

General attention should be directed to hygiene, rest, diet, 
sponging and secretions. 

If it is impossible to secure resolution by these means, then 
the case will terminate in either one or other of its six lermina- 
tioiis or effects. 

Effusion of seruui may occur during inflammation of any tissue, 
but by preference from serous membranes, as the periosteum, 
membranes of the brain, the pleura and peritoneum ; the cellular 
tissue is also obnoxious to serous effusions. When effusion of 
serum takes place, whether it be from membranes of the brain, 
pleura, peritoneum, or cellular tissue or other structures, it con- 
stitutes what we term dropsy, not a disease, a mere mechanical 
effect. Serouseffusion, however, often gives rise to much trouble, 
especially if within the cranium, chest, or abdomen ; in the 
extremities it constitutes what we term oedema or dropsy, 
pitting upon pressure. Although not a disease, its presence 
is liable to bring about grave complications, and it must be 
got rid of at the very earliest moment the inflammation can be 
overcome. 

The serum effused in the process of inflammation is a fluid of 
pathogenic microbes, of which neither the origin, kind, nor 
quantity can be accurately ascertained. These microbes exercise 
a morbid effect on the adjacent tissues, and constitute a febrile 
element in the body. 

To get rid of serous effusion, the appetite should be stimulated 
with tonics, as teaspoonful doses of compound tincture of cin- 
chona, before meals, and the very best of blood-elaborating diet 
given. Before making any decided attempt at the removal of 
the dropsy, place the patient upon an infusion of digitalis for a 
{^^ days. To half a pint of water, boiling briskly, add one or 
two grains of fresh pulverized digitalis, boil for five minutes, 
then cool and administer one wineglassful every two or three 
hours ; continue from day to day till the patient becomes quite 



BACTERICIDES. 54 1 

melancholy or despondent, then administer less frequently and 
in smaller doses. Now is the opportune moment to commence 
with diaphoretics, diuretics, and hydragogue cathartics, just as 
the digitalis has unlocked the flood-gates of the body. Then 
take of 

Pulverized mandrake, thirty grains ; pulverized nitrate of pot- 
ash, one drachm ; cream of tartar, one ounce. Mix. 

Make ten powders, and let the patient take two or more daily, 
so as to cause at least three watery evacuations from the bowels 
in the twenty-four hours. In addition, a teaspoonful of the fol- 
lowing mixture should be taken thrice daily, in a glass of 
water : 

Camphor water, four ounces ; nitrate of potash, half an ounce ; 
muriated tincture of iron, one ounce. Mix. 

At the same time an alcoholic vapor bath should be given 
every other day. As a drink, to encourage free sweating, an in- 
fusion of jaborandi or pleurisy-root. Patient kept moderately 
warm and clothed in flannel. 

If the above means fail, discontinue the mandrake mixture 
and substitute a pill, one-twelfth of a grain of elaterium. If the 
patient is unable to bear such active remedies, five-grain doses 
of iodide of potassium should be given in a tablespoonful of fluid 
extract of saxifraga. Other remedies, as infusion of hair- cap 
moss, buchu. 

Treat effusion or dropsy in the extremities in the same man- 
ner, with the addition of rest, elevation, compression by rollers, 
friction, shampooing, steaming with medicated vapors, elec- 
tricity. (See Dropsy}) 

Effusion of Blood. — Hemorrhage, as a result of inflammation, 
may take place prior to or during its activity; or the inflamma- 
tion may so terminate. 

Organs that are freely supplied with blood-vessels, when they 
suffer a partial death are more liable to have hemorrhage occur 
in them than others, as the lungs, stomach, bowels, kidneys, 
bladder, urethra, uterus. 

In the treatment of hemorrhage as a result of inflammation, 
the main point is more thorough arterial sedation, more active 
local stimulation. 

If from the lungs, large doses of veratrum viride ; if from the 
stomach, rectum, kidneys, or uterus, the green root tincture of 
gelsemium, and digitahs. 

If the hemorrhage is violent, styptics may be resorted to, but 
the true principles of treatment of inflammation should never be 
lost sight of. Salt, iron, gallic acid, digitalis, matico are useful if 
from the lungs ; capsicum, salt, gelsemium, if from the stomach ; 



r^2 DISEASE GERMS. 

erigeron, gallic acid, ergot, corn smut, if from the kidneys or 
uterus. 

In surgical operations, the vessels should be ligated ; still 
there are often minute capillaries that bleed. Then carbolic acid 
spray, exposure of the bleeding surface to the air, pressure by 
bandages, cold, perchloride of iron, matico, spider web. 

Effusion of Lymph. — This is a very common termination of 
chronic inflammation, still there can be little doubt but that it is 
present in all forms. When it takes place, it causes induration, 
thickening, adhesions, mechanical obstructions. 

In surgical practice, the greatest ingenuity has been exercised 
to procure effusion of lymph for the purpose of cementing or 
joining parts. For this purpose all foreign bodies are re- 
moved. Catgut ligatures are used. An antiseptic spray flows 
upon the wound to destroy degraded matter or bacteria. Me- 
tallic sutures and antiseptic dressing are extensively employed. 
Effusion of lymph for the purpose of repair can only take place 
when there is total absence of pain, and when the vital forces are 
normal. 

Lymph is often effused in general inflammations ; in pleurisy, 
where it forms adhesions ; in inflammation of stomach, thicken- 
ing ; in canals, forming strictures ; in glands and tissues, form- 
ing swellings. 

It is highly desirable to get rid of effused lymph, because if 
permitted to remain it is liable to break down at any time the 
vital forces of the individual become impaired, and form an 
abscess. 

To cause an absorption of effused lymph our best internal 
remedies are iodide of potassium, iodol, bromide of potassium, 
saxifraga, phytolacca, blue flag, mandrake. 

Our local remedies are green plantain leaves, phytolacca, stra- 
monium, belladonna, ozonized clay, iodide of potassium, iodo- 
form, potassa, ammonia. Shampooing, friction, and electricity 
are very doubtful in their utility. When adhesions have taken 
place, the continuous application of the irritating plaster is a 
powerful resolvent, and aids in the breaking down or absorption 
of the adhesions. 

The effused lymph, like the serum, contains the spores of the 
pathogenic microbe of pus. The presence of these spores in the 
effused lymph may for many years be innocuous, but when 
softening comes they are capable of provoking septicaemia, which 
may prove fatal. 

The Formation of Pus. — Lymph or plasma from the blood is 
effused to a greater or less extent in all forms of inflammation, 
but especially in the chronic, and is liable, at any moment there 



BACTERICIDES. r ^^ 

is the slightest nervous depression, to break down and become 
pus — become the bacillus pyocyaneus. This event is invariably 
ushered in with rigors, but when it occurs during acute inflam- 
mation, simultaneously with the rigors the pain changes to a 
tftrobbing or beating, the heat diminishes, congestion and red- 
ness disappear. When it occurs during chronic inflammation or 
after inflammation has ceased, it is also invariably preceded by a 
rigor. The broken-down lymph constitutes pus, an active living 
deadly microbe, and a collection of pus anywhere forms an ab- 
scess. The precursor or rigor is followed by the lymph break- 
ing down in the centre and gradually enlarging, perhaps point- 
ing, and a sense of fluctuation is experienced to the touch. 
There are numerous varieties of pus, as, healthy or laudable, when 
it is thick and creamy ; serous, when it contains water ; sanious, 
when it contains blood ; curd-like or cheesy, when it contains 
tubercle ; muco-purulent, when it contains mucus mixed with " 
purulent matter ; lardaceous, if like lard ; specific, when it con- 
tains a special living germ or poison ; and putrid, when dark or 
offensive. 

The division of abscess into acute and chronic, superficial and 
deep-seated, explains itself. 

The moment pus has formed, there should be an assiduous 
effort made to aid the vital forces of the part in its further pro- 
gress by the application of heat and moisture in the form of a 
well-made poultice, which should be continued until the lymph 
has entirely broken, when a free opening should be made into 
the part and the poultices continued for a day or two, then dressed 
with an ointment of vaseline. 

Simultaneously with the evacuation of the pus and breaking 
down of the entire amount of lymph eflused, nature begins to 
throw out lymph anew at the bottom of the abscess or cavity ; 
this is at once permeated by blood-vessels and nerves ; then 
another layer which becomes similarly organized, and so on un- 
til she reaches the surface, when around its edges can be seen a 
white milky scum, which gradually covers the entire surface. 
The process of effusion of lymph, its organization or permeation 
with blood-vessels and nerves, is called the process of cicatriza- 
tion ; when it is covered over with a new skin or cutis it is called 
a cicatrix. In order that the effused lymph may exhibit vital 
elements, the process may be devoid of pain, the pus laudable, 
and the granulations neither pale nor red. During such a pro- 
cess of repair the vital stamina of the patient should be well sus- 
tained with good food. 

Gangrene^ or Incipient Mortification. — When the vital forces of 
a part are so shattered that the salutary effort of nature fails in 



CAA DISEASE GERMS. 

obtaining resolution, then the process of dving is liable to set in. 
If it is an internal vital organ, the sudden cessation of pain fol- 
lowing a high intensity of symptoms, with a typhoid condition 
supervening, features becoming small and contracted, breath and 
extremities cold, intermitting wiry pulse, indicate the approach 
of mortification or complete death. 

If the inflammation occurs in an extremity and it is about 
to terminate in gangrene, pain suddenly ceases, the redness be- 
comes of a livid color, the congestion soft and flaccid. It crepi- 
tates when pressed upon, from the fact that it contains gase'=;, 
the productions of putrefaction and a train of typhoid symp- 
toms. 

In gangrene, when the parts yet retain a certain degree of 
vitality, the object should be to arrest the occurrence of morti- 
fication. Internal stimulants and antiseptics, as brandy and 
quinine, yeast; and locally poultices of charcoal, yeast, capsicum, 
wild indigo weed with carbolic acid, changed frequently. If this 
poultice does nothing in arresting the condition it will at least 
stimulate a line of demarcation between the living and dying 
part. Such a line usually makes its appearance in the form of a 
red blush, which soon rises into a blister; this soon ruptures, 
forming a line of ulceration with a furrow. 

In the treatment of all forms of inflammation, the most decidep 
and energetic measures should be resorted to ; internal and local 
stimulation should be the rule, in order to prevent the process 
of dying (gangrene) or complete death (mortification) from tak- 
ing place. 

Partial death of bone may arise from injuries; 

Infiammation poisons, as phosphorus; from the microbes 
of Bone. of rheumatism, syphilis and the tubercular 

bacilli, etc. 

The usual termination is effusion of lymph, in which we find 
the spores or seed of the saprogenes blended with other germs. 
Spores may be absorbed or break down, giving us caries and 
necrosis — ulceration of bone. 

Symptoms. — There is a deep-seated, severe, dull pain, with 
swelling of the soft parts, rigors and fever; if acute, the parts 
slowly enlarge, tenderness increases, with weight and pain. If it 
proceed to ulceration (caries or necrosis), there are rigors, and 
pain changes to a throbbing. 

The treatment embraces rest; control fever with exalgine, keep 
bowels open, and skin active ; local stimulants in the form of hot 
packs during the day, and the chloroform liniment at night. As 
soon as fever is controlled, iodide of potass in compound syrup 



BACTERICIDES. 



545 



stillingia ; keep patient under it for some months. If rigors and 
a throbbing have taken place, poultice, and as soon as indica- 
tions of pus formation are clear, free openings. If an opening, 
or several openings, have taken place, run them into one, so as to 
give nature as little work to do as possible. Inject with various 
solutions of peroxide of hydrogen. Abscess is rare, the condi- 
tion being a breaking down of lymph in the substances of the 
bone, giving us caries or necrosis. Either of these conditions 
can be easily detected by a gritty or sandy feel of the pus. In 
all cases general alteratives and tonics ; best of diet, with an ex- 
cess of phosphates, as oatmeal porridge, cream and boiled white- 
fish. 

The periosteum being fibrous tissue 

Inflammation of the is liable to suffer a partial death from 

Covering of Bone. various microbes, as bacillus of syphi- 

{Periostitis.) lis, tubercle, rheumatism, and from 

injuries. Whether it be of microbial 

origin or not, there is invariably a disease germ present. 

It is easily recognized by the history of the case, and the sharp, 
lancinating pain present. 

By killing the microbe, resolution may be effected before the 
streptococcus pyogenes appears. Any powerful germicide, 
which will not destroy the tissues, should be applied, as the oil 
or fluid extract of lobelia ; resorcin in ozone ointment ; iodol. 



No class of diseases are so interesting as 
Inflammation the various affections of the brain. The fact 
of the Brain, that the brain wears out sooner than it used 
Acute. to do, under what is termed civilization, and 

that its health and vigor, and even the pro- 
duction of disease in it, depends on the development and healthy 
condition of the great sympathetic, are highly suggestive. In 
women, children and all races outside of the Caucasian, the ab- 
sence to a great extent of cerebral disease can only be accounted 
for by the rudimentary condition of the sympathetic. The effects of 
isolation and sameness, or monotony, in causing contraction of its 
convolutions, thus causing epilepsy and insanity, and the action of 
blood poisons, are also of great moment in reducing the angle of 
longevity of our race. The study of brain diseases is not suffi- 
ciently advanced to enable us to elucidate all the points clearly ; 
neither are we yet able to distinguish correctly between inflam- 
mation of the substance of the brain and that of its membranes. 
35 



546 



DISEASE GERM^. 



Indeed, they cannot be really separated, although it has been 
attempted. 

A partial death of the substance of the brain may depend upon 
two general conditions. It may be due to causes within the 
body, such as depressing emotions, desires, affections, passions, 
the struggle for existence, or excessive mental strain, religious 
excitement, blood poisons, or it may be due to blows, falls, shocks, 
concussion of the brain or fracture of the skull. In the former 
case it is said to be idiopathic ; in the latter, traumatic. As brain 
substance is intrinsically the most valuable tissue in the body, it 
is the most difficult to depress and the hardest to establish a re- 
newal of life in ; so that in the idiopathic form, the stage of 





Section of brain : horizontal section 
through the brain to show the mode 
in which the two hemispheres, a, a, 
are joined together by the transverse 
band of white matter called the Cor- 
pus Callosum. In front and behind 
this the longitudinal fissure b sepa- 
rates the two hemispheres; b, b, is 
the sect. on of the cortical substance; 
a, a, of the medullary ; the section 
also shows the depth of the suki be- 
tween the convolutions. 



The brain : upper surface of the brain of 
man, showing its subdivision by the 
longitudinal fis'-ure into two lateral 
hemispheres, right and left, also the 
chief sulci and convolutions. The fis- 
sures of Rolando are the oblique fis- 
sures which commence near the mid- 
dle line and proceed outwards and 
forwards, marking off the frontal lobes, 
a, a, from the parietal lobes, which 
lie behind those fissures The occipi- 
tal lobes forming the posterior extrem- 
ity of the hemispheres completely con- 
ceal the cerebellum. 

shock or incubation is often for a number of years, and in the 
traumatic form, quite a good while ; even in ba;i fracture, with 
compression, a week or more often elapses before active symp- 
toms of inflammation set in. 

After the brain has received the shock, there is then an inter- 
vening period before the rigor and active inflammation, and dur- 
ing that time the patient is irritable, restless, peevish, sleepless, 
complains of heats and colds, burning in the skin, secretions are 
arrested, great lassitude, peculiar idiosyncrasies, great disturbance 
of the mental faculties, and there is a characteristic pain in the 
head, usually frontal, aggravated by noise, light, heat and motion. 
There is also intolerance of light, slow pulse, want of appetite, 
tongue dry, with white and brown coat, skin white. 



BACTERICIDES. ^.-t 

These premonitory symptoms , become more intense daily, 
when, if the inflammation is about to take place, the patient is 
seized with the most violent rigors and a high fever ; pulse hard 
and frequent, strong pulsations of the carotid and temporal 
arteries, headache intolerable and throbbing, eyes suffused, face 
congested, tongue dry and brown, bowels obstinately constipated; 
stomach rejects everything, secretion and excretion arrested; 
besides, there is apt to be violent delirium, coma, convulsions, 
paralysis, pupils contracted to a pin's point, articulation difficult 
or indistinct. If not relieved at this point, then pupils become 
dilated, the eyelids drop (ptosis or squinting), or paralysis of 
muscles of eyelids, frequent twitching of muscles, ghastly coun- 
tenance, sordes on gums and teeth, cold sweats, relaxation of 
sphincters, convulsive paroxysms, paralysis, profound coma, 
which usually soon ends in death. 

In some cases, the first symptom of an attack is convulsions, 
preceded by very slight premonitory symptoms that are often 
unnoticed. Convulsions, strong and severe, may be followed by 
coma, which is soon fatal ; or it may recur frequently at short 
intervals, and pass into coma at the end of twenty-four hours. 
When nausea and vomiting are the earliest symptoms, inflamma- 
tion has its origination in the cerebral pulp. When attacks 
begin with convulsions, the affection has started from the arach- 
noid or pia mater ; or, to be more explicit, if the inflammation 
involves the cortical substance and membranes, early derange- 
ment of the intellectual faculties, irritability, constant agitation ; 
if the medullary substance, chills, headaches, convulsions, great 
lassitude. 

The medullary substance of the brain is merely the passive 
servant of the cineritious substance, the conductor of its de- 
mands to the muscles. The gray presides over intellect ; the 
white, over movements. 

Rigors taking place during the active inflammatory stage, 
with squinting or dropping of the eyelids, palsy ; contraction of 
one pupil and dilatation of the other, indicate extravasation of 
blood into the brain and an unfavorable termination. Acute 
inflammation of the brain may terminate in any of the ordinary 
results of inflammation, but its common termination is effusion 
of blood or extravasation of blood on or in its substance, or 
recovery by the slow process of chronic inflammation. The 
hemorrhage is termed red ramollissement. 

In the recognition of acute inflammation of the brain, its his- 
tory, all the symptoms prior to and after rigor, the fever, intel- 
lectual condition, eyes, face, arrested secretions, and especially 
the headache, must be noted. True, there may exist compli- 



548 



DISEASE GERMS. 



cated phenomena during life, according to what extent the vari- 
ous structures are involved, but the leading symptoms are a good 
land-mark. 

Treatment. — At the earliest possible moment energetic treat- 
ment should be resorted to, to aid a renewal of life in the brain. 
For this purpose the patient should 6e placed in the recumbent 
posture in bed, head and shoulders well elevated, and in an apart- 
ment away from noise, heat, and pretty well darkened ; head to 
be shaved and towels kept constantly wet with hot water to be 
wrapped around it. The back and sides of the neck, down the 
back and over the shoulders should be dry cupped ; a roller, 
eight yards long and three inches wide, saturated with mustard 
of the consistency of cream, should be applied from the great 
toes to the knees, wet occasionally with fresh mustard and re- 
applied. Two to three drops of tincture veratrum viride should 
be given every fifteen or thirty minutes until pulse is seventy, 
and then continued at longer intervals of one, two or three 
hours, as indicated. Free purgation must be resorted to. For 
this purpose, twenty grains of compound powder of jalap and 
senna, with one drop of croton oil rubbed into it, should be 
given, and the same dose repeated every one or two hours, or 
often enough to keep the bowels open twice or three times a 
day — the croton oil to be left out after the third dose. Another 
important indication is sleep. It is very likely the patient has 
not slept for a long time. Then take twenty grains of the solid 
English extract of hyoscyamus with three grains of pulverized 
opium, ancf rub both up in a mortar until a fine powder is pro- 
cured, then add a drachm of sugar of milk ; mix well and divide 
into twenty powders, and give one every hour until the patient 
sleeps. If, after three or four are administered, there is no sleep, 
double the dose for three times, and if that fails, increase still, 
but very carefully, never to exceed five to one dose. If this fails, 
try sulphonal in twenty-grain doses and increase. If sleep and 
a pulse of seventy can be reached, by further good management, 
the patient is safe. On no account resort to chloral hydrate, 
opium, hypodermic injections, as they are totally contra-indicated. 
If arterial sedation and sleep can be procured, still persevere for 
some time with the above. Give little or no diet for several 
weeks ; barley or cracker water ; oatmeal gruel and the like will 
suffice. 

As the patient improves, other remedies to aid the salutary 
effort of nature may be tried, as bromide of potass, aconite, 
belladonna, lobelia. 

The bromide does good work given in the following manner : 

Camphor water, four ounces ; bromide of potass, one ounce ; 



BACTERICIDES. 



549 



bromide of ammonium, two drachms; bicarbonate potass, three 
drachms. Mix. Dose, one teaspoonful thrice daily. 

Just as the fever subsides is the best time to commence with 
the aconite and belladonna. A teaspoonful of the tincture of 
each in half a tumblerful of water; a teaspoonful ev^ery one or 
two hours. 

Belladonna, like bromide of potass, has ah anesthetic action 
upon the cortical substance, the quadrigemina tubercula and the 
membranes which aid in the removal of congestion. It will also 
be found advantageous in many cases to alternate them with 
lobelia in full form, as often as every two or three hours. Pills 
of pulverized green lobelia are slower in absorption, and less 
likely to induce nausea. Lobelia is a depressant and sedative, 
has a decided influence in all cerebral engorgements ; it dimin- 
ishes respiration, heat, pulse, and abates inflammation. With 
these and other means that the peculiarities of the case will sug- 
gest, we try to aid nature in controlling inflammation of this 
vital organ. The general principles of treatment of fever must 
be carried out, as to bathing, recumbent posture, heat to feet, 
great quietness, etc., and run the case into one of chronic inflam- 
mation in which our remedies are more numerous, and embrace 
alteratives and tonics, rest, change of air and a very cautious use 
of food. 

Is a condition in which we have a low 
Inflammation grade of irritation. It is apt to follow an 
of The Brain, acute attack, but more frequently it is an in- 
Chronic, dependent primary disorder. 

Its causes are very various : shocks, jars, 
concussions, blows, falls, railroad traveling, action of the sun, 
mental strain, worry, struggle for existence, study, depressing 
passions, as grief, sexual excesses, whiskey, tea, coffee, tobacco, 
quinine, opium, chloral and other drugs ; besides, the blood 
poisons, as rheumatism, gout,' syphilis, tuberculae, may, with 
numerous other conditions, be enumerated as causes. The vices 
or defects of civilization operate disastrously upon the brain, as 
well as insanitary states and diet. 

Its symptoms are much diversified : pain in the head, aggra- 
vated by noise, light, heat, motion, with irritability, restlessness, 
sleeplessness, with heats and colds, with mental depression, dis- 
turbance or idiosyncrasy, pallor or whiteness of the skin, anxious 
expression of countenance, arrest of secretions. There is often 
vertigo, specks or spots before the eyes, ringing or noises in the 
ears, unsteadiness of gait, hesitation in speech, stammering, 
stiffness of muscles, loss of appetite, irregularity of pulse, delu- 



550 DISEASE GERMS. 

sions ; subsequently symptoms become more marked ; memory 
fails, senses become impaired, paralysis, general breaking down 
of health. Its duration is very indefinite and it has a marked 
resemblance to insanity, once fairly established. 

In the treatment we must insist upon rest, freedom from care 
and worry, and an avoidance of all the causes, such, as jars, 
mental work, sexual indulgence, the use of tea, coffee, tobacco, 
alcohol, opium. The secretions should be stimulated, bowels 
moved twice daily with mild but efficient remedies, as cascara, 
neutralizing mixture, daily tepid bathing, followed with the 
shower-bath ; hair short, head cool, feet warm. Bitter tonics to 
promote an appetite and ameliorate the more prominent symp- 
toms. Sleep should be procured, and, if possible, prolonged to 
ten or twelve hours in the twenty-four, by the repeated and per- 
sistent use of hyoscyamus, thus : 

Solid extract hyoscyamus, English, thirty grains ; powdered 
opium, five grains ; powdered licorice, sixty grains. Mix. 
Make twenty powders. At least three or more daily, beginning 
in the afternoon and continuing on one or two hours apart until 
profound sleep is induced. Three times per week two small 
fly blisters, size of an ordinary visiting card, should be applied 
below nape of neck, top of each shoulder blade, for six hours at 
a time; or the irritating plaster or tartarized antimony in 
basilicon ointment. The idea being, as our people are affected 
with tuberculae to the extent of seventy-five per cent., and 
syphilis to the degree of fifty per cent, of our entire population, 
to attract or draw those two germs from feeding on the brain. 
There can be little doubt but that tuberculse and syphilis are at 
the source of at least seventy-five per cent, of all cases of chronic 
inflammation of the brain and insanity. An invaluable remedy 
here is the bromine, as already laid down. But the best plan is, 
to keep the patient upon a general alterative course with bitter 
tonics until all vestige of inflammation ceases, such as compound 
syrup Phytolacca ozonized, or saxifraga, glycerite of ozone, and 
when pain has ceased and natural repose is obtained, then 
such remedies as ozone-water, preparations of cinchona, com- 
pound hypophosphites of lime ; soda should be given in small 
doses. 

The diet should consist, as much as possible, of the chemical 
elements of the brain, as oatmeal, boiled fish, rare beef-steak, etc. 
Change of air of utility. Other remedies sometimes used with 
advantage. 

After the pain in the head is relieved, and the patient sleeping 
for ten or twelve hours every night, appetite returning, then the 
glycerite of ozone or kephaline should be administered persis- 



BACTERICIDES. 



551 



tently. Those two preparations promptly relieve the prominent 
symptoms, as the dizziness, mental depression, loss of memory 
and impaired intellectual faculties. They invigorate rapidly and 
remove that feeling of nerve-tire or exhaustion which is so dis- 
tressing. 

Induration of the Brain. — Effusion of lymph — one of the 
effects of chronic inflammation. The indurated portion of 
small extent presents the appearance of wax, or white of ^^^ 
boiled hard. 

The symptoms are often obscure, but it causes loss of memory, 
confusion of thought, derangement of mental powers, loss of 
appetite, desires, affections, passions, and paralysis. 

Abscess of the Brain. — May be the result of the induration or" 
some injury or disease of the ear and temporal bone. It may be 
acute, and severe cerebritis may be present, pain in the head, 
vomiting, fever, delirium and coma; or chronic , ^\\}i\ insidious 
headache, dulness of intellect, sometimes hemiplegia, which 
comes on gradually; it may end in convulsions and death, 
abscess bursting into ventricles of brain. 

The treatment is general alteratives and iodide of potassa. 

Softening of the Brain, Red and White Raniollissevient — the 
word ramollir meaning to make soft. During acute inflamma- 
tion an extravasion of blood taking place in or on the brain is 
ca led red ramollissement, and if it amounts to three or four 
ounces is usually fatal. From obstruction, calcareous disease of 
vessels, embolism and other causes, it may take place, and be 
absorbed, or the portion of brain in which it took place may be 
reduced to the consistency of cream. 

The most common form is the anaemic or white, that caused 
by imperfect nutrition or blood suppy, due either to wearing out 
of the brain by overwork or excess, or arterial or other forms of 
degeneration. There may or may not be pain in the head ; 
likely to be sudden and occasional attacks of vertigo ; diminu- 
tion of intellectual power, slow and hesitating speech, embarass- 
ment in answering questions, depression of spirits, tendency to 
shed tears on any excitement. Pricking and twitching in limbs, 
perhaps pain or numbness ; tendency to sleep, especially after 
meals ; more or less impairment of senses, mental faculties im- 
paired, appetite often good, even greedy ; limbs become the seat 
of painful cramps, stiffness or contractions ; paralysis with spasm 
not uncommon, general sensibility more acute. In a large per- 
centage of cases paralysis of one-haif the body coming on sud- 
denly without the loss of consciousness. Patient easily confused, 
has great difficulty in answering questions or in making himself 
understood. Great feebleness, weak and intermitting pulse. 



552 



DISEASE GERMS. 



vomiting and constipation, difficulty in emptying the bladder, 
often retention of urine with uriniferous odor, involuntary escape 
of stools ; respiration labored, at last becomes stertorous, coma, 
ending in death. 

The portions of the brain affected are often of the consistence 
of cream. In all cases white softening is the opposite of that 
due to congestion. It is due to a want of nourishment or an 
insufficient amount of blood in the brain. 

Softening of tJie Cerebellum is attended with fixed pain at the 
back of the head, impairment of sight, hemiplegia or paraplegia, 
tottering gait, vertigo, convulsive agitation, dulness of hearing, 
aphonia, eccentricities of conduct. 

Tumors, Tubercular Deposits, syphilitic growths, hydatids, tape 
worm ; cysticera are often found in the brain, and their existence 
is very obscure ; headache, sickness, giddiness, mental depres- 
sion, confusion, partial paralysis, epileptic convulsions. 

As to the location of softening, it is thought that the corpus 
callosum, septum lucidum, formix and cerebral substance around 
the ventricles are more frequently affected with red softening ; 
whereas, white softening attacks the gray matter of the convolu- 
tions at base, optic thalami, corpora striata. 

Treatment. — It is useless to disguise the fact that we have little 
to hope for in any kind of treatment; still, some cases are 
greatly ameliorated or their progress is arrested by judicious 
use of means. 

The treatment is very similar to chronic inflammation of the 
brain : daily bathing, flannel clothing, abundance of sleep, feet 
and extremities kept warm, blisters or plasters to nape of neck, 
bowels and kidneys cared for, diet pre-eminently of phosphates, 
oatmeal, boiled fish, wheaten grits, otherwise generous. Altera- 
tives and tonics. There are two remedies of undoubted utility — 
iodide of potassa and ozone water. We must never shut our 
eyes to the fact that by far the greater number of cases are due 
to affections of the blood; hence the very remarkable success ot 
those two preparations. Indeed, so convinced am I of the fact 
of their great efficacy in softening, that I could fill this volume 
with cases that have made wonderful improvement; memory, 
good judgment and the senses being washed, as it were, free 
from germs of tuberculae, syphilis, etc. The alterative saxifraga 
is the best as the case progresses ; glycerite of ozone and kepha- 
line alternately will effect a good cure. 

We have in sulphonal an invaluable remedy ; by its use in all 
damaged states of the brain we can regulate sleep — an impor- 
tant factor in the treatment ; besides, it is a germicide of some 
power. 



\ 



BACTERICIDES. ^r^ 

Inflammation of the membranes 

Inflammation of the brain may arise in children 

of the Membranes from a very trifling cause, as a 

of the Brain. blow or fall on the head, or exten- 

{Aczcte Simple Meningitis}^ sion of disease from the ear or 

nose, or by exposure to the sun. 
The fact that children have only one table in the bones of the 
skull, no middle or diploetic structure to resist shocks, renders 
them, up to puberty, very susceptible to irritation of the mem- 
branes from falls or concussions. Independent of violence, it 
may be caused by rheumatism, gout, syphilis, tuberculae. 

Sympioins. — The ordinary symptoms of languor, mental irri- 
tability, sleeplessness, headache aggravated by noise, light, heat, 
motion; intolerance of light; rigors and a fever; pain in the head 
becomes aggravated, irritability increases, delirium, frequent 
flushings of the face, followed by pallor, rapid pulse, muscular 
twitchings, prostration, coma. 

In distinguishing its locality in children observe carefully the 
following: 

Membranes covering the convexity of the brain. — In the child, 
first a rigor, then a convulsion, fever, skin hot, dry; pulse hard 
and rapid, vomiting, bowels constipated, intense headache, aggra- 
vated by movement, light, etc., face alternately flushed and pallid, 
eyes injected and staring, noisy and violent delirium sets in early, 
great restlessness, muscular twitching, squinting ; after three or 
four days a remission ; the pulse fags, tongue becomes heavily 
coated and dry, pupils sluggish, dilated ; the delirium passes into 
coma, and in a few days more intense prostration. If treatment 
be successful, improvement is very gradual but progressive. 

Membranes confined to base of brain. — Convulsions at com- 
mencement, fever, contracted pupils, frequent pulse, clenching of 
teeth and retraction of head, coma. In other cases, pain in tem- 
ples, vomiting, constipation, wry neck, loss of appetite, a desire 
for repose ; after a few days, vacant look, dejection, intelligence 
clear, pulse and skin natural. Headache unrelieved by remedies, 
coma, death. 

Inflammation of dura mater. — Often the result of violence, of 
disease of the cranial bones, chronic affections of the ears and 
nose in children, regarded as trifling, may end fatally by an ex- 
tension of morbid action to dura mater. 

Treatment. — In the treatment of this affection in children, it 
must ever be borne in mind that the law of reflex impressibility 
is strong in those born of highly civilized parents, so that the 
active measures used in adult cases must be laid aside when we 
have a delicate, impressible child to deal with. We want a quiet 



554 DISEASE GERMS. 

room, tree from noise, and heat and light excluded ; no cradle ; 
the hair on the head should be cut close, and cloths wet with 
either of the following applied : 

Liquor acetate ammonia, one ounce ; alcohol, two ounces ; 
camphor water, eight ounces. Mix. Or, camphor water, ten 
ounces; muriate of ammonia, one ounce; nitrate of potassa, 
half an ounce ; chloride of sodium, half an ounce. Mix. 
Strength varied to age. 

To the feet, dry mustard in socks. Bowels opened gently with 
compound hcorice powder or one or two grains of leptandra 
rubbed up in pulverized licorice or cascara. To control the 
circulation, tinctures of aconite and belladonna should be given 
in a tea of asclepias, and sleep procured with suitable doses of 
the bromide of potass, as under inflammation in adults ; and if 
not powerful enough, give the hyoscyamus, but in smaller doses. 
No cupping, blisters, or other cuuter-irritants on account of the 
reflex impressibility. In case of wandering pains, bryonia is 
often of great value. As soon as the fever is controlled, iodide 
of potass is of great utility, otherwise it must be treated accord- 
ing to the cause, taking the greatest care to procure a large 
amount of sleep, if possible ten or twelve hours out of the 
twenty-four. The diet here must be more generous, milk and 
lime-water, and beef tea. Convalescence established upon cin- 
chona and aromatic sulphuric acid, ozone-water, more nutritious 
food and change of air. 



An acute form of inflam ma- 
Inflammation of the Brain tion of the brain and its mem- 
and its Membranes branes, with effusion of tuber- 

in Children. cle from the blood in and on 

(Tubercular Meiiingitis}^ the membranes and superficial 

surface of the brain proper. 
Common among tubercular children under two years of age, 
and seldom met with over that period of life ; is, next to cholera 
infantum, one of the most fatal maladies among city children 
during the summer months. 

The mortality from this source is very great, and were moth- 
ers and health care-takers more efficient in their duties, infant 
mortality might be. reduced to a minimum. 

The predisposing cause is tuberculse. This may be an heredi- 
tary condition in the child, or the child may be entirely 
free from tuberculae at birth but acquire that cachexia by 
bad food, insanitary conditions, drugging with soothing 
cordials, retarded dentition, hence irritation of the gums. 



BACTERICIDES. 



555 



stomach, bowels, acidity, cholera infantum, etc., which irritation 
is transmitted to the seat of reflex action ; the centres of life are 
depressed, and in consequence normal living matter is changed 
into the living germ tuberculse. 

Cradle-rocking, blows, slaps, falls, jars, shocks are simply ex- 
citing causes. City life and solar heat act as powerful depres- 
sants, and in some cases the irritation of dentition, cholera in- 
fantum, burns, etc., are sufficient in themselves to cause tubercu- 
lae and give rise to the inflammation. 

It usually comes on slawly and insidiously, marked by debility 
and whiteness of skin, mal-nutrition, loss of flesh and other signs 
of a tubercular diathesis ; short, dry cough, great peevishness, 
restlessness, irritability, attacks of headache aggravated by move- 
ment, light, noise ; giddiness, skin often hot or cold, pale or 
flushed, appetite capricious, tongue furred and breath offensive ; 
sickness and constipation, child drowsy, yet restless ; rubs head 
with hand, rolls head in sleep with eyes partially open ; wakes in 
alarm and screams, and other warnings of cerebral congestion. 
These symptoms may last for weeks ; if they occur in early sum- 
mer, before the hot weather sets in, they may last the entire sea- 
son ; if late in the fall, they will disappear on the approach of cool 
weather, or if the patient have proper treatment applied, it may 
disappear at any time. 

But suppose the case progresses onwards, all the above symp- 
toms become aggravated and the child lies very quiet, its coun- 
tenance expressive of anxiety and alternately flushed and pale, 
the eyes listless, eyebrows knit, pupils contracted, and is greatly 
annoyed with light and noise; retching, bowels variable. If old 
enough, will complain of head; often delirium. Fever high, 
pulse, 1 80; temperature, 107°. After a few days the pulse be- 
comes irregular and diminishes, although the slightest exertion 
will cause its increase. Stupor and heaviness may come on, 
squinting, patient lies on back, head and heels thrown back, 
insensible, probably picking his nose and lips with tremu- 
lous fingers, convulsions, paralysis, urine and faeces passed in- 
voluntary. 

If there is no effort at recovery, the drowsiness passes into 
profound coma, from which it is impossible to rouse the child. 
Pupils are dilated and insensible, pulse becomes very feeble and 
frequent, extremities become cold, a clammy sweat breaks out 
over the entire body. Paralysis and convulsions follow, which 
soon end the scene. If the case is complicated with cholera in- 
fantum, these symptoms become modified to a greater or less 
degree by that condition. 

As to its duration little can be said. ' Some children will sue- 



556 



DISEASE GERMS. 



cumb in two or three weeks ; others, again, will struggle on the 
entire summer and finally terminate in hydrocephalus, from which 
they will recover in a few months. 

The growth of tubercle on membranes or brain, carefully 
scraped off after death, seldom amounts to from three to five 
ounces. There is always a great quantity of fluid in ventricles 
and frequently softening of brain substance. 

In the treatment, the highest possible medical skill, nice dis- 
crimination, and good management are required. 

The little patient is literally crowded out with the tubercular 
bacilli, and no depleting plan of treatment is at all admissible. 
The child should be placed in a large airy room, away from 
noise, heat, light, motion. It should be bathed thrice daily, be- 
ginning with tepid water, and gradually permitting it to be 
colder and colder. Dry mustard in socks should be constantly 
worn. One grain of euonymine and one of salol, well triturated 
in sugar of milk should be administered at bedtime. The hair 
cut close, and lotions of ammonia, and potassa in camphor-water 
kept applied. Nourishment, either mother's milk or juice of raw 
beef, or sterilized malted milk. 

Aconite is the best drug for fever to lower temperature and 
soothe the patient. 

The nature of the prevailing symptoms will indicate the best 
bactericide to administer to kill or sterilize the tubercular bacilli. 
For example, if there be diarrhea, creosote or naphthaline in 
mucilage acacia, does splendid work. Resorcin in syrup of 
tolu ; glycerite of ozone and iodol ; if there be convulsions, 
bromide of potassa with pyridin. 

Sulphonal must be administered in sufficient doses to insure 
sleep. 

We can lay down no definite rules to follow, the great point is 
to nurse it along, keep up nutrition, and push germicides. 



Partial death or inflammation of the 
Inflammation small intestines may be caused by both 
of The Bowels, local and internal irritation, and varies 
{Enteritis^ much in its severity, in some cases being 

very slight, in others very active. 
Symptoms begin with pain around the umbilicus, aggravated 
by pressure; nausea, vomiting, rigors, and a fever; great head- 
ache, features pinched, tongue buff-leather coated, heat high, 
pulse wiry ; great restlessness, prostration, anxiety of counte- 
nance. If the mucous coat alone is involved, there will be a 
muco-enteritis, or acute intestinal catarrh, and diarrhea, with 



BACTERICIDES. 



557 



mucous, bilious, or serous stools. When the peritoneal and 
muscular coat is involved, there is obstinate constipation.' The 
patient assumes the position on back, with knees drawn up so as 
to relax the abdominal muscles ; often delirium ; vomiting be- 
comes more persistent, and vomited matter highly offensive, 
sometimes stercoraceous. 

In the treatment, perfect rest in bed, stimulants applied over 
entire abdomen, as either turpentine or con. ozone, followed by 
compresses of hot bran. Aqua, four ounces ; tincture of aconite, 
thirty drops; tincture white bryonia, one drachm. Mix. One 
teaspoonful every hour until relieved. If these fail, substitute 
tincture of the green root gelsemium, in alternation with opium.. 
It is a good plan to empty the rectum with copious warm water 
enemata, medicated with tincture of opium. Drinks, infusions of 




Enteritis : colon laid open. 



Acute enteritis : small intestine, 
very heavily loaded with 
microbes. 



Deep-perforating ulcers of the 
ileum, following chronic 
enteritis. 



coUinsonia, or stone crop. Later on, aromatic sulphuric acid 
and quinine; simple Hquid animal food, malted sterilized milk, 
raw eggs. 

A chronic jorm of Enteritis corresponds exactly to intestinal 
catarrh, has the same sarcinae in the mucus of the stools. When 
chronic it has very limited areas of distribution in most cases. 

It can usually be localized by the soreness, and \{ near the 
duodenum, by some jaundice ; if near the rectum, by the tenes- 
mus or bearing down, while the pain or soreness enables us to 
locate it in some particular spot. The significance of the stool 
is of great value — mucus. Pure mucus indicates a disease of the 
sigmoid flexure; scybala or hardened lumps of faeces in mucus, 
an affection of the colon. The stools may be large and covered 
with mucus, and no pain ; or the stools may be soft, and incor- 
porated with mucus of a pulpy, thick consistence, or full of 
mucus. If there be unaltered food in the stools, fat or starch, 
the pancreas is at fault. 



558 DISEASE GERMS. 

In the treatment of the chronic form, a flannel roller should 
be worn around the abdomen. The best of all remedies is the 
Virginia stone crop, which should be administered persistently 
for several weeks, in alternation with aromatic sulphuric acid 
and comp. tincture cinchona. 

Collinsonia is also of great utility. 



A partial death of the bladder may 
Inflammation of the arise from the use of such drugs as 

o 

Bladder. cantharides, turpentine; from mechan- 

[Acute Cystitis.) ical irritation, as calculi ; introduction 

of instruments ; or by ignorant use of 
forceps during parturition; external injuries, or blows, falls, con- 
cussions ; from diseases of the rectum, vagina, uterus, prostate, 
especially inflammation of those organs ; to gonorrhea and other 
microbes ; to the use of injections. 

. Symptoms. — Commences with rigors and a fever ; heat, pulse 
and respiration greatly increased ; wiry pulse ; pain over region 
of bladder ; intense heat of urethra and base of the bladder, 
where inflammation is most intense ; constant desire to make 
water, which comes away in little dribs ; great mental depres- 
sion, and constitutional disturbance becomes greater; nausea; 
vomiting. Bladder can be felt as a small, rounded, tender tumor. 
Severe pain, extending to perinaeum and down the thighs ; in- 
creased by pressure, rectal or vaginal examination. Tenesmus, 
unless patient is relieved pain becomes unbearable. The calls to 
micturate become constant ; urine is expelled drop by drop, or 
there is retention ; urine becomes fetid and alkaline, containing 
shreds of lymph, fibrine, entangling pus, and blood-corpuscles; 
great prostration ; cold, clammy sweats ; cadaverous appearance; 
low muttering delirium ; fatal exhaustion. 

Its duration is from one to two weeks. Gangrene of bladder 
liable to occur. When well managed the symptoms subside, 
and the inflammation terminates in resolution or recovery. 

Treatment. — Patient is usually found on back with knees 
drawn up — a most convenient position for the application of 
stimulants ; apply over region of bladder, first mustard, and then 
hot linseed meal poultices, made with glycerine. If possible, 
empty bowels with oil ; if not, with enemata of infusion of marsh- 
mallow and opium. If vomiting is persistent, apply mustard 
over stomach, and begin at once with pretty large doses of tinc- 
ture of green root of gelsemium and pulverized opium ; admin- 
ister in small doses until there is a perfect alleviation of pain, 
and if necessary push to narcotism. If that takes place, patient 



BACTERICIDES. 3-g 

must be turned over on right side. Incorporate tincture of 
opium in poultice, and introduce suppositories of opium and 
belladonna per rectum. Drinks to consist of infusion of linseed 
or marsh-mallow, with nitrate of potassa and cream of tartar, 
enough to keep urine alkaline. If indications are bad, dissolve 
one or two grains of sulphate of morphia in one ounce of tepid 
water, and inject into bladder. If exhaustion is predominant, 
cream, raw eggs, essence of beef, etc. 

As soon as symptoms of inflammation have subsided, put 
patient upon compound tincture cinchona and nitric acid, or 
aromatic sulphuric acid and quinine, with an infusion of one or 
other of the astringent diuretics, as buchu, uva ursi, queen of the 
meadow, pareira brava, cleavers, pipsissewa, as a drink ; the idea 
being to restore the tone and vigor of the bladder. If convales- 
cence is slow, alteratives. The greatest possible attention should 
be paid to diet; let it be most nutritious, avoiding fat, sugar, 
starch, malt or spirituous liquors, or anything likely to cause 
acidity. T,he skin should be well stimulated by alkaline spong- 
ing daily, and the constant use of flannel. 



Chronic inflammation ot the bladder is 

Inflammation of the most common form met with. Some 
the Bladder. term it catarrh of the bladder. It may be 

{Chronic Cystitis), the sequel of an acute attack ; but most 
generally it is due to the crystals of gout ; 
the amylobacta of rheumatism, the microbe of syphilis, and other 
germs; venereal excesses, disease of the prostate, damp, cold, ex- 
posure ; foreign bodies, as calculi in the bladder ; ammoniacal 
urine ; uric acid crystals ; excessive beer drinking ; certain drugs, 
as the indiscriminate use of balsam copaiba, cantharides, turpen- 
tine ; to the metastasis of inflammation from other parts, as rec- 
tum, prostate, uterus ; to the natural decay of old age. 

The symptoms which are most prominent are a general feeling 
of languor, lassitude, debility, with an urgent, irresistible desire 
to void urine frequently, with pain in the urethra. Great tension, 
and increased sensibility of the walls of the bladder, after disten- 
sion from an accumulation of urine ; mucus in urine greatly 
augmented, and of an unnatural color ; first it is gray, then yel- 
lowish, or greenish (owing to the predominance of each species 
of microbe present), thick, viscid, ropy, often streaked with blood. 

When decided ulceration sets in, urine becomes loaded with 
pus, the quantity of this being immense, owing to the fact that 
the bacillus pyogenes has such room and nutrition for growth, 
often averaging several pints daily. 



560 



DISEASE GERMS. 



If there is no treatment resorted to, or but an inefficient one^ 
the case may progress onwards to a fatal termination; whereas^ 
under a thorough bactericide treatment, a good recovery will 
take place in the large proportion of cases. 

Indispensable to a successful medical treatment, the patient 
should partake of the best of food, of the most nourishing kind; 
daily bathing ; flannel clothing ; external warmth ; bowels to be 
regulated to one motion per day. 

An alterative and tonic course all through the treatment, such 
as compound saxifraga, phytolacca compound, in alternation 
with compound tincture of cinchona and nitro-muriatic acid; or 
aromatic sulphuric acid and quinine. 

While pursuing this course special remedies should be used to 
sterilize and annihilate the microbial family in the bladder, to wit : 
the micrococcus urinea and bacillus of yellow and green pus. 

Some one of the following bactericides should be administered 
internally to sterilize the blood and cut off, if possible, microbe 
nutrition in the bladder: sulphide of lime, dioxide of hydrogen, 
salol, naphthaline, creolin, sulphur water, uric acid solvent. 

The bladder should be injected daily with either a solution of 
resorcin or creolin, or iodol, or naphthaline. 

Patient should drink a tea daily made from one of the follow- 
ing herbs : either buchu, or uva ursi, or pareira brava, or queen 
of the meadows, or couch grass, or pipsissewa, or cleavers to 
astringe the walls of the bladder. 

General principles should guide ; every symptom promptly 
relieved 

Irritation of the mammary gland 

Inflammation of The is rarely met with unless the gland 

Breast. is in a state of activity. The state 

(yMannnitis) of development of the male breast is 

simply rudimentary, and it is rarely 

afflicted with inflammation. Infants, at birth, both sexes, often 

have one or both the breasts engorged with a secretion of milk. 

Highly organized sensitive ladies, during menstruation, and also 

from the period of conception until the birth of the child, suffer 

from a swollen, engorged state of the breasts. 

We are, however, safe in stating, that it is only during active 
lactation, that we meet with acute inflammation of the mammary 
gland or its nipple. 

In most modern ladies, there is a great development of the 
sympathetic, which is reflected chiefly over the left breast ; hence 
violent emotions, desires, affections, passions, grief, worry, give 
rise to a weakness or a predisposition, a debility. 



I 



BACTERICIDES. 



561 




The common exciting causes are cold, wet, exposure, blows, 
violence of all kind, irritation of corsets, all forms of external 
injury. The gland suffers re- 
flexly from the uterus, with which 
organ it is in direct sympathy ; 
besides, ovarian, gastric, hepatic, 
renal, intestinal irritation. It is 
met with in either the acute or 
chronic form. 

Symptoms. — In the acute form 
there is the shock, with pain, 
swelling, and induration of breast, 
rigors and a fever, with prostra- 
tion, rapid pulse, arrested secre- 
tions, often slight delirium. Ar- 
rest of secretion of milk and sup- 
puration soon follow. 

In the chronic form there is 
enlargement of the gland and in- 
duration ; milk is either wholly 
or partially arrested. It may 
follow an acute attack, or come 
on by itself. It is more likely 
to occur at other periods than 
pregnancy and lactation. It may 
also terminate in abscess. 

In acute inflammation of the breast, active treatment : fifteen 
grains of exalgine, twice daily ; open bowels with repeated doses 
of salines ; apply over the entire breast equal parts of the fl. ext. 
belladonna and glycerine. Milk to be drawn off at regular inter- 
vals by breast pump ; if skin is dry, administer comp. tincture 
serpentaria. 

If it is deemed best to arrest the secretion of milk altogether, 
then the following should be spread on linen and applied over 
the entire breast : belladonna ointment, two ounces ; iodide of 
potass and chloride of ammonia, of each four drachms. Mix. 

Gentle compression by means of a roller round the chest not 
to be overlooked. 

Subsequently tonics and nourishing food. 

If it is the chronic form, the best possible results are to be ob- 
tained from the boroglyceride paste applied to the entire breast 
over night, with fomentations of hot vinegar and nitrate of potassa 
during the day. In this form the internal use of phytolacca is 
most efficacious. The arm in a sling, compression of the breast 
with a roller always of utility. If rigors, softening or other evi- 

36 



Breast : A, lactiferous duels dissected out and 
injected; B, nipple, with bristles insected 
into the orifices of the lactiferous ducts. 



56: 



DISEASE GERMS. 



dences of suppuration can be detected, poultice freely, open in 
the most depending part as soon as fluctuation can be detected, 
so as to permit the escape of the bacillus 
pyocyaneus. 

Inflammation of the Nipple ^ whether it be 
from some irritation, or from some germs 
of amylobacta, burrowing and causing fis- 
sures, or cracks, or from disease germs 
from the child's mouth. 

The most common of these microbes 
which infest any crack or abrasion of the 
nipple is the oidium albicans. 

Any good bactericide, as resorcin oint- 
ment or jelly ; boroglyceride paste, creolin, 
etc., is effective in destroying this mi- 
crobe. 

'^t^:^^^,^^- Other germs are to be found in this re- 
atitis in the child of the gion, duc to microbcs carried there by the 
mouths of other children. 




Inflammation 

of the 

Cellular Tissue. 



The tissue between the skin and the 
muscles, termed the cellular tissue, is one 
of the very best absorbing tissues in the 
entire body, and it is quite extensively util- 
ized for injecting pure alkaloids, so as to 
obtain their action upon the organic tissues of the body. 

Inflammation of this tissue may arise from the microbe of ery- 
sipelas, from the germs of the cadaver in post-mortem examina- 
tions, from the bites of venomous reptiles. 

In addition to general erysipelatous inflammation of the skin, 
which gives rise to burning, tingling, we have, when the cellular 
tissue is affected, throbbing ; the swelling is stiff, brawny ; the 
absorbents are implicated, the nearest lymphatics take on the 
irritation, doughy swellings form on the chest and abdomen. The 
adenitis proceeds to rapid suppuration. 

There are violent rigors, fever, a low type of typhoid fever, 
with abscesses in lungs, liver and other parts. Perspiration is 
very offensive ; stools fetid, jaundice, stupor, delirium, difficulty 
of breathing, fatal exhaustion. 

In the treatment of such cases, free incisions, suction, cups, 
everything to encourage free bleeding from the part ; then the 
boroglyceride paste should be applied all over the affected part, 
or solutions of the paste in hot water applied by cloths ; the 



BACTERICIDES. 



563 



moment any swelling is detected it should be opened and boro- 
glyceride solution applied. 

Internally push bactericides and nourishment; peroxide of 
hydrogen, brewers' yeast, salol, resorcin, iodol. 

The indications, as they arise, are to be actively treated. 



Pelvic cellulitis is mostly met with 

Inflammation of the in connection with some tubercular 

Cellular Tissue disease ; it may be a result of blows, 

of the Pelvis. falls or other violence ; abortions, 

tedious labor, or some uterine or other 

disease. 

Symptoms. — Local pain, throbbing and tenderness, with pain- 
ful swelling, usually appreciable at lower part of abdomen, or by 
vaginal examination. Simultaneously with the local pain, there 
is nausea and vomiting ; great constitutional disturbance ; rigors, 
and a fever, with some pain in the head, back and aching pains 
in the limbs; difficult micturition and tenesmus. If case progresses 
to suppuration, the above symptoms increase in severity, with 
additional rigors, throbbing and tenderness ; neuralgic pain down 
the thighs, and if within reach, fluctuation can be detected. Pus 
channels may form in different directions, into bladder, vagina, 
rectum, colon, rarely into peritonaeum, generally finding their 
way externally. Nature is most provident of herself in these 
cases, by the formation of those sinuses almost invariably reach- 
ing the surface, and thus providing an egress for the staphylo- 
coccus pyogenes. 

Treatment. — Those cases require great tact and good judg- 
men ; the rectum and vagina should be injected daily with lin- 
seed-tea ; hot poultices should be applied ; fever controlled with 
aconite, opium, or morphia, to relieve pain. Belladonna and 
opium suppositories every night at bedtime. Quinine and aro- 
matic sulphuric acid and carbolic acid and tincture of iodine in- 
ternally; the patient regularly sponged ofl*. Most nutritious food, 
milk, raw eggs, beef-tea, juice of meat and animal food as soon 
as the stomach can bear it. If abscess point anywhere, it can be 
opened with advantage. As soon as the pus has been thoroughly 
evacuated, alteratives and tonics. 

The greatest possible care should be exercised during the 
stage of convalescence. Rest is an indispensable condition, to- 
gether with well-regulated secretions ; tonics, and the very best 
of blood-elaborating food. 



5^4 



DISEASE GERMS. 



The portion of the covering of the 

Inflammation of the eye ball next to the conjunctiva is 
Cornea. called the cornea, from its fancied re- 

(Acute Corneitis) semblance to a horn, transparent and 
^ nearly circular, forming the anterior 
sixth of the globe, a structure of exceeding low organization, 
very difficult to depress, by violence or contiguous inflamma- 
tion, unless the vital forces are greatly shattered and the bacillus 
of rheumatism, gout, tubercle or syphilis be present in the blood. 

Acute inflammation may be the result of injuries, cold, wet, 
exposure in depraved subjects, or inflammation from other parts. 
When it takes place, it renders the polished and transparent sur- 
face of the cornea hazy, dim, and rough, or to look like ground 
glass. 

Symptoms. — Dull, deep-seated pain in the eye ; intolerance of 
light ; abundant secretion of tears ; no muco-purulent discharge 
of any moment ; a concentric plexus of minute vessels can be 
seen passing from edge of cornea ; a zone of pink vessels in adja- 
cent sclerotic ; haziness of cornea, with opacity. Patient affected 
very tuberculous ; disease runs a very chronic course, lasting for 
months, leaving cornea permanently cloudy ; sometimes ends in 
suppuration, and softening is liable to take place, with perforating 
ulcer into cornea. One or both eyes may be affected. 

Treatment must consist in the administration of exalgine to 
reduce temperature and equalize the circulation. Stimulate the 
liver actively with leptandra and phosphate of soda ; apply two 
blisters to nape of neck just as soon as the active symptoms are 
controlled ; comp. saxifraga and phytolacca, the best of food and 
everything calculated to build up the vital forces, as avena, 
kephaline, cinchona. 

The same ideas must be followed in the chronic form, whether 
it be gout or the syphilitic germ which is giving rise to intersti- 
tial degeneration. 

Beyond all question, the diseases of 
Inflammation of the the auditory apparatus, which occur 
Middle Ear. m.ost frequently and possess the great- 

{Oiitis Media}) est interest, are the inflammatory affec- 

tions of the tympanum and middle 
ear. The middle ear properly consists of the membrana tympani, 
the tympanitic cavity, the mastoid cells, the chain of ossicles, and 
certain muscles, vessels, and nerves. In a small, confined space, 
we have a most delicate, intricate structure, performing impor- 
tant functions ; easily disturbed by the standard of health, by a 
variety of causes, and attaining increased importance from their 



BACTERICIDES. 



565 



■contiguity to such vital parts as the labyrinth, the internal jugular 
vein, the internal carotid artery, the dura mater, and several 
venous sinuses of the brain, so when we look at the parts impli- 
cated, there should be no apathy in our treatment, no ignorant, 
officious meddling. 

Causes. — It may arise from cold, damp, exposure, rheumatism, 
gout, boils, injuries, or accidents, injudicious tampering with the 
ear with hair-pins. It may also be due to extension of inflamma- 
tion inwards, or upwards from the pharynx, carrying the germs 
of scarlet fever, quinsy, diphtheria, measles, small-pox, hooping 
cough, catarrh, pneumonia, bronchitis, influenza, syphilis, mer- 
cury, tuberculse, and the use of nasal-douches. When the inflam- 
matory action reaches the throat, it travels along the eustachian 
tube, which is the channel designed by nature for maintaining a 
due equilibrium between the atmospheric and tympanitic air, and 
for draining superfluous mucus from the tympanum. When all 
is well it serves those purposes admirably, but when disease 
exists it serves as a channel for carrying diseased germs up from 
the pharynx. The tube is short, being one-and-a half inches in 
the adult, but its continuity of mucous membrane permits an 
easy road for the germs to travel, and more so if it is a young 
child, in whom the tube is much shorter and more open than in 
the adult. Dentition, first and second periods, are productive of 
inflammation of the middle ear. The vaso-motor impressions 
are readily conveyed from the inflamed gums to the correlated 
membrana tympani by the dental nerve, and the nervi-vaso- 
rum of the tympanitic branch of the internal carotid artery. 
There can be little doubt that the difficult or retarded dentition, 
due to a want of phosphates in the modern mother's milk, is a 
common cause of inflammation of the inner ear. It is impossible 
to doubt it when we look at the troubled little face, the resting 
of the head on the nurse, the thrill of agony that passes over its 
features, accompanied with piteous cries or shrieks when its posi- 
tion is moved, especially if done suddenly ; and, more than all, 
the constant raising of its little hand to the side of the head : all 
indicate the agonizing sufferings of earache. 

Of all living diseased germs, those of scarlatina are most de- 
structive to the ear, give rise to hopeless chronic affections, or 
drift into deafness. The ear, in scarlet fever, is about as obnox- 
ious to irritation as the kidneys, and we should bear in mind that 
every congestion of the lining membrane of the ear is a true 
periostitis, and every ulceration a caries of its osseous walls, so 
that, with better care, a true appreciation of germ-diseases, a more 
thorough antiseptic course, many lives might be saved, useful 
ears spared, and deaf-mutism become a rare exception. 



^66 DISEASE GERMS. 

Symptoms. — General symptoms of inflammation, headache, 
pain in back, legs, rigors, and a fever ; uneasiness in ear, followed 
by sharp, lancinating pain in the inner ear, increasing in severity ; 
there are also impairment of hearing, giddiness, a sense of fulness 
in the head, and an increase of pain in moving jaws, mastication, 
or swallowing, moving the head, or blowing the nose. On ex- 
amination of the membrana tympani, it is found red and con- 
gested. Beating noises in the ears : eyes become injected \ 
countenance anxious ; fever greater ; function of skin, kidneys, 
and bowels disordered. There may be delirium or convulsions. 
There is always great depression and despondency. If case is 
not seen to there may be facial paralysis, from a spreading of the 
inflammation, which is overcome when morbid action ceases. 
Should the attack be a slight one, or the vital force vigorous, 
and treatment appropriate, perfect resolution may take place \ 
but if powers of life are low, suppuration may take place, pent- 
up pus bursting on discharging itself, if in inner ear, by perfora- 
tion of membrana tympani ; or in more grave cases the inflam- 
matory process spreads into the mastoid cells internally, or by 
bony meatus to the periosteum, covering the mastoid process 
externally. 

In external otitis, perforation of the membrana tympani may 
take place, owing to the extension of inflammation from within 
outwards. 

The disease usually runs a very rapid course, suppuration 
often taking place in from twenty-four to forty-eight hours from 
its inception — a significant fact for rational and active treatment. 

Treatment. — The cause, if it can be removed, should be done 
promptly. Then patient should be put to bed in a warm room, 
70° F., moist atmosphere, well ventilated, comfortable, and free 
from all noise, no talking, the greatest quietness ; dry heat to 
the ear and side of head, such as hops, camomile flowers, bran, 
or salt, in bags or pillows, made hot in oven ; and permit no 
food requiring mastication, for moving the jaws interferes with 
the rest of organ. The fever, as well as the local inflammation, 
must be regulated by arterial sedatives. To do this effectually 
administer a saline purge, or cascara, or both, and enemata, if 
not soon moved; heat to feet; aconite, belladonna, and sweet 
spirits of nitre freely. If the skin does not become moist, com- 
pound tincture of serpentaria, so as to cause free diaphoresis ; 
hot drinks ; near night either chloral or Dover's powder, so as to 
get a long sleep. The dry heat is of primary importance, and 
should be watched with care. Never poultice either an eye or 
an ear is an injunction to be obeyed. The idea of this line of 
treatment is, if possible, to prevent the formation of abscess, or 



BACTERICIDES. 



567 



suppuration, as that is a result to be dreaded, as we never can 
know how, when, or where it may terminate, or to what it may- 
lead. Case otherwise should be placed upon alteratives and 
tonics. If there is a manifestation of gout or rheumatism, col- 
chicum, quinine, iodide of potass ; if upon teething, lance the 
gums ; as soon as fever, pain, etc., are relieved, alteratives and 
tonics. 

Inflammation and suppuration of the middle ear is one of the 
most common, dangerous and neglected of all- maladies. Bac- 
teriological investigations have revealed and unravelled its pa- 
thology and demonstrated that the streptococcus pyogenes is 
ever, though not exclusively, present in all cases. From what- 
ever cause the otitis has arisen, cold, germs of scarlatina, measles, 
etc., there are invariably present one or other of two kinds of 
discharges ; fetid and non-fetid; in the former both cocci and 
bacilli are found together ; in the latter cocci alone are present. 
In the offensive secretion, full-fled bacilli ; in the odorless dis- 
charge, cocci alone. The discharge is pathogenic of the disease, 
and is of special interest, as both forms are not devoid of danger ; 
the inner ear being largely infested with rapidly breeding microbe 
is a fact of great significance. 

The oil of mullein sterilizes and completely annihilates this 
microbe. 

This oil when properly prepared contains eight volumes of 
peroxide of hydrogen, and is a powerful bactericide, etc. Two or 
three drops introduced into the ear once or twice daily, imme- 
diately kills the bacilli and cocci, the entire microbial family, and 
keeps the ear free from all disease germs. 

To effect a radical cure the daily use of the oil must be fol- 
lowed up with tonics, alteratives and germicides, compound saxi- 
fraga, oats, kephaline ; and the blood kept in such a condition of 
purity by the daily administration of some ozonized preparation 
that no microbe can live in that vital fluid. 



Inflammation of the mucous 
Inflammation membrane of the eye-ball and 

of the Mucous Membrane lids is one of the most com- 
of the Eye. mon affections of every-day life. 

(^Ophthalmia.) From its very essence and char- 

acter it divides itself into distinct 
varities, each one having or acquiring its own special pathogenic 
microbe with peculiarities of each other ; all essentially conta- 
gious and infectious, they have, however, some symptoms in com- 
mon, as intolerance of light; a sensation of sand in the eye, a 
muco- or sero-purulent discharge, 1 oaded with microbes. 



56S 



DISEASE GERMS. 



Infantile Ophthalmia, so called because it occurs in infants 
from two to four days after birth. It usually commences at the 
eds^es of the lids and proceeds over the entire conjunctiva. 

The causes are often cold, light, irritating soaps, or some of the 
sebacious secretion from the skin of the child, by inadvertence 
of the nurse, got into the eye ; or it might arise from the 
entrance of either the leucorrheal or gonorrheal discharge from 
the mother's genitals. 

Symptoms, — A spasmodic closure of lids ; lashes stick together; 
hard crusts form at the edge of lids, which are red ; the redness 
and swelling increase, lids more swollen; the conjunctival sac be- 
comes filled with transparent, yellowish-colored serum and mucus; 
engorgement continues ;. then pus, or thick muco-purulent mat- 
ter makes its appearance ; the tumefaction of the conjunctiva is so 
great that the lids will scarcely close, and the discharge so copious 
that it runs down the cheek of the infant; the cornea of the eye 
looks depressed, or retracted, or hid; the surrounding conjunctiva 
fleshy and elevated, owing to its infiltration with red blood, serum, 
etc. This swollen condition of the conjunctiva, looking elevated, 
while the cornea looks depressed, is called chemosis. As the dis- 
charge is so loaded with bacteria and other diseased germs, if 
great care is not observed it may contaminate the other eye, or 
that of nurse or mother. If not actively seen to, the symptoms 
will increase in severity. The mucous membrane of the conjunc- 
tiva possesses a lamellated epithelium, and has the faculty, when 
so inoculated, of a proliferation of its epithelium, which is trans- 
formed into pus cells, which process of shedding gives rise to an 
enormous discharge, and a continual thinning or peeling of the 
conjunctiva of the ball of the eye, which becomes soft, and 
liquefies, and ulcerates, and contents of eye are liable to escape. 
Perforation is very liable to happen if allowed to run two or 
three weeks, especially if the lids are swollen and tight on ball. 
Should the eye escape disorganization, there is often opacity of 
the cornea left behind, or an opacity of lens, or some defect in 
vision. The greatest care is necessary in opening the eye ; it 
must be done with great caution and care. 

In the muco-purulent discharge are to be found quite a number 
of pathogenic microbes, as ordinary bacteria, bacillus, pyocyanes 
and micrococci of various kinds. 

In the treatment, examine carefully to ascertain if any piece of 
sebaceous secretion remain, if so, oil it well and have it removed ; 
then darken the room in which the patient is to remain ; open 
its bowels freely with oil ; control fever with aconite and sweet 
spirits of nitre. 

Administer one-eighth of a grain of quinine in fl. ext. licorice 



BACTERICIDES. 



569 



every four hours as the great eye tonic. Locally, wash out the 
eye with a saturated solution of boroglyceride, keep the same 
remedy applied all the time to the eye, and if matter accumulates 
between the lids, inject it underneath them. After dressing the 
eye, drop into the inner canthus of the affected eye a few drops 
of a solution of atropia — strength, two grains of the sulphate to 
one ounce of distilled water. Atropia has an antiphlogistic 
effect on the inflamed surfaces, dilates the pupil and relieves the 
tension of the eye-ball. Precautions taken lest the other eye be- 
come affected. Other bactericides sometimes used instead of the 
boroglyceride, lotions of aromatic sulphuric acid ; creolin, naph- 
thaline, resorcin, etc. 

Common acute ophthalmia is usually the result of colds, wet, 
foreign bodies, as sand, lime, changes of temperature, usually 
mild, often of a catarrhal form, involving the conjunctiva and 
meibomian glands. 

Symptoms. — Intolerance of light, pain in the eye, a sense of 
soreness or scalding, stiffness, dryness, a feeling of roughness 
about the eye, as if there was sand in the eye. This sensation 
is caused by the congested condition of the vessels of the lid and 
globe. They are tortuous, swollen ; red blood circulating where 
only white blood was wont to circulate ; roughened, and by rub- 
bing over each other, carry this sensation to the mind. These 
vessels can be seen, of a light scarlet color and irregularly ar- 
ranged, and can even be moved by the finger. In bad cases 
general congestion. The discharge is puriform at first, and then 
becomes muco-purulent. Exceeding microbial, and contagious 
and infectious. In some cases headache, rigors, fever. 

The treatment is the same as the following : 

Purulent Ophthalmia, a severe and dangerous form, due to 
bacteria ; more contagious and infectious than the former. 

Overcrowding of large bodies of men, women, and children in 
workshops, jails, reformatories, refugees' schools, and other in- 
stitutions. 

The emanation or miasma of our bodies is prejudicial to 
others, degrades the normal bioplasm -of the conjunctiva into a 
microbe of extraordinary power, vitality ; with great power of re- 
production in the mucous follicles of the conjunctiva. A school, 
a refuge, or shop, once infected, must be thoroughly disinfected 
by burning sulphur before the germs can be destroyed. 

Symptoms. — All the symptoms are well defined : the soreness 
or redness ; the intolerence of light ; the sensation of sand ; 
the copious or profuse muco-purulent discharge, with other 
severe symptoms, intense, with prostration, rigors, and violent 
fever ; the pain in head and eye agonizing ; and the amount of 



570 



DISEASE GERMS. 



discharge of thick, yellow, purulent matter immense. The con- 
junctiva of both lids and globes swell, so that it is with difficulty 
that the cornea and iris can be seen (cJieinosis) ; and the discharge 
flows on cheek. If disease does not yield to proper treatment, 
the inflammation will increase, spread to the cornea and deeper 
structures of the eye. When the internal textures become 
involved, constitutional symptoms are still more aggravated ; 
extensive sloughing takes place, and the sight, and often the eye, 
is lost. Sometimes one eye, in other cases two are affected 
simultaneously. 

Patient to be kept in bed, in a well ventilated, dark room ; 
with disinfectants exposed in the apartment ; bowels should be 
freely opened with comp. ext. colocynth and copious enemata of 
beef-tea ; surface to be bathed thrice daily ; exalgine in fifteen- 
grain doses, to keep pulse 70 ; hypodermic injections of pilocar- 
pin to keep up diaphoresis ; quinine ranging from three to five 
grains every four hours ; sulphonal in sufficient doses to procure 
sleep every night at bedtime ; two blisters to nape of neck, free 
suppuration from nape of neck. 

Wash out the eye carefully with either a lotion of borogly- 
ceride ; or creolin ; or resorcin ; naphthaline, or some other 
germicide. 

The eye itself should be carefully washed out with the boro- 
glyceride solution three times daily, and after each cleansing the 
atropia solution should be dropped into the corner of the affected 
eye. 

If the case yields to the above plan of treatment, the best plan 
is to hold the patient on those remedies for a few days, pushing 
nourishment very strong. 

By and by a general alterative and tonic treatment should for 
two or three months be resorted to, the best alteratives being 
saxifraga and phytolacca, and of tonics, cinchona and kepha- 
line. 

Whenever more than sixty children are congregated for five or 
six hours daily in a school-house, the microbe of this form makes 
its appearance at the roots of the eyelashes, and in the minute 
oil glands, excites an irritation, inflammation, causing a peculiar 
incrustation on the edge of the lids ; even in this slight form it 
gives rise to impaired vision in city children. 

Keeping a child at home, improving its general health by 
every possible means ; washing the eyes three times a day. 
Boroglyceride wash is usually sufficient. 

Gonorrheal opJithalmia is usually caused by the gross careless- 
ness of the affected individual, either by bringing the gonococcus 
from the orifice of the urethra to the eye by the finger, or a 



BACTERICIDES. 



571 




The gonococcus as seen 
in gonorrheal ophthal- 
mia. 



towel, or otherwise ; or it might be from a fellow boarder who 
has a running. 

The discharge from the eye contains the 
gonococcus, which is pathogenic of the dis- 
ease. 

The symptoms are about the same as the 
purulent, a trifle more intense. 

Treatment must be very prompt, even more 
active than the purulent ; the dose of quinine 
should be increased; more rigid nutrition; 
leeching must not be resorted to here, it is 
of no utility, spreads the microbe, being 
simply a zoological humbug. The all-prevailing idea is the 
destruction of the germ before it can cause disorganization of 
the eye. 

Tubercular ophthalmia is common from the period of dentition 

up to the tenth year, and even older in some cases. In such 

cases the entire body is literally eaten up with tubercular bacilli. 

The tubercular cachexia is usually present in a high degree ; 

the skin white and thin ; muscles soft and flabby ; hair as dry as 

tow ; torpidity of all the great 
secreting organs. 

Symptoms. — There is no sore- 
ness or rawness, no sensation of 
sand in the eye, no muco-puru- 
lent discharge ; but the intole- 
rance of light is very great, with 
spasmodic contraction of the 
lids ; there is a copious lachry- 
mal secretion ; irritability of the 
nasal and buccal mucous mem- 
brane ; fleshy redness is absent, 
but there is a very slight conjunc- 
tival and sclerotic redness, with 
formation of pustules or ulcers on 
cornea. Both eyes are usually 
affected. Hot tears profusely 
flowing over cheek cause an excoriation. There are often the 
thick lips, long eyebrows and eyelashes, eruption behind the 
ears, with disordered intestinal secretion, so often present in 
tuberculae. 

Treatment. — Eyes must be protected with a green shade ; and 
when not exercising for health in the open air, to lie down in a 
well-ventilated room, and a lotion or wash of common salt and 
water kept applied. The strength of this wash will depend on 




Bacillus tuberculosis in the blood in cases 
of tubercular ophthalmia. Usually in 
those ca^es the blood is so charged with 
the germ that its spores excrete through 
the eye coats. 



572 



DISEASE GERMS. 



the age ; it must be strong enough so as to barely feel it, not to 
cause the least smarting. It is the best of all local applications. 
This wash is to be kept on as much as possible, and changed 
every little while, as it becomes dry ; and cloths either washed 
or destroyed ; never allow it to become dry ; an emetic twice a 
week for six weeks, of wi^e of lobelia; encourage child to 
drink freely some tepid water with bicarbonate of potassa, and 
then follow with half teaspoonfuls of the wine every five minutes 
till free vomiting takes place. The reflex effect of this emetic on 
the eye is really wonderful ; it acts like a charm ; benefits at 
once, and the whole aspect of the disease changes for the better. 
Besides, in that class of children the mucous coat of the stomach 
is relaxed, sarcinae are present, and there is a large accumulation 
of mucus in that viscus, which, when thrown off, lets the natural 
appetite for food return, and more perfect digestion takes place. 
Bowels to be regulated with cascara ; bathing morning and 
night ; flannel clothing ; patient placed upon a general course of 
alteratives and tonics — saxifraga, phytolacca, in alternation with 
glycerite of ozone, avena, etc. 

The diet to be most nourishing, consisting of abundance of 
animal food, beef, mutton, poultry, eggs, milk, cream, oatmeal 
porridge and cream, boiled white-fish. 

Granular ophthalmia is often a result of the preceding forms of 
inflammation, or may come on of itself from the same causes, 
and consists in a low form of irritation of the conjunctiva, with 
effusion of lymph, which forms nodules or granules, rendering 
the conjunctiva uneven and granular. These granulations look 
like grains of sago, and consist of inflamed mucous follicles and 
papillae; they cause a good deal of irritation, and opacity of the 
cornea is the result. 

In the treatment, the patient should be placed upon comp. 
saxifraga, phytolacca, in alternation with tonics, as sulphate of 
quinine in glycerite of kephaline. 

It is rare for internal remedies to remove cleanly all the granu- 
lations, they do much good, but their action must be aided by 
introducing remedies into the eye that will strip off the granula- 
tions. 

Among recent remedies for this purpose infusion of the 
ground decorticated jequirity bean has been tried and proved 
effective. 

Eight beans, ground, infused for two hours in half a pint of 
distilled water, percolated, when sufficiently cooled dropped into 
the eye, will often in one application cause all the granulations to 
shell or peel off If it does not effect this at once, let matters 
rest about a week, try it again, when it can be made either 



BACTERICIDES. 



573 



stronger or weaker, to suit the case under observation. If this 
is not procurable, brushing over the eye solutions of iodide of 
potassa, variable strengths, from five to twenty-five grains to the 
ounce of water, as frequent, so no irritation be produced, or aro- 
matic sulphuric acid, according to age ; bowels regulated; best 
of nourishment; warm clothing. 

Rheumatic Ophthalmia consists in the bacillus amylobacta 
lodging itself in the white fibrous tissue of the eyeball (the 
sclerotic coat) and giving rise to organic changes. 

Symptoms. — Severe, sharp, lancinating pain in the eye and side 
of head. It is so agonizing that it depresses nerve centres, and 
there is more or less fever; the white of the eye looks a pale red, 
its vessels being arranged in a radiated or zonular form, and be- 
neath the conjunctiva; intolerance of light ; dimness of vision, 
from haziness of cornea and contraction of pupil ; the discharge 
from the eye is watery or serous ; there is 



conjunctiva, no muco-purulent discharge, / ^ f^\\ B i\ 



no sensation of sand, no fleshy condition of 
conjunctiva, no muco-purulent discharge, 
no soreness or rawness ; but a sharp, lan- 

nating pain, always worse at night. 

The general treatment for rheumatism 



must at once be adopted. ^ S 7 



cinating pain, always worse at night. t /^ ^ A 



Exalgine and quinine in sufficient doses 
to reduce temperature and pulse, then a Bacuius Amylobacta, spindle 

. ^ rnrii shaped lorms, including 

selection of some one or two of the follow- ovai spores The patho- 

,. 11 -1 .. 1- 1 . genie microbe of rheumatic 

mg remedies, made by the attending physi- ophthalmia, seen in the 
cian, and administered so as to kill the :;;Tn\racSttac£.^'' 
microbe amylobacta : salicylate soda in 

liquor ammonia acetatis, manaca, salol, casca sagrada lozenges, 
cimicifuga race., etc. 

The atropia solution must be dropped into the eye morning 
and night, and persistently dry heat, bran or camomile flowers 
warmed, applied to the eye. 

Several other forms might be enumerated, as the catarrhal^ 
reflex, or sympathetic, all of which should be managed upon 
general principles and bactericide remedies. 



In considering the subject of inflamma- 

Inflammation tion of an involuntary muscle like the 

of the Substance heart, we must look at its anatomical 

of the Heart. relations to the great sympathetic. This 

(^Carditis)) nerve in the Caucasian man of average 

civilization is perfectly developed, and is 

freely spread over the entire anterior cardiac surface, whereas in 

all other races and in the majority of women this nerve is merely 

rudimentary. 



cyA DISEASE GERMS. 

In the civilized Caucasian, the development of the great sym- 
pathetic is perfect, and as a result it is liberally scattered over his 
larynx, heart, lower lobe of right lung, spleen, left kidney, 
mesentery and abdominal viscera, so that when the vital forces 
are depressed by solar heat, privation, overwork, exhaustion, 
struggle for existence, prolonged exposure, grief, sorrow, use of 
tobacco or other narcotics, the individual is liable to have a weak 
heart, which is greatly aggravated if either the microbes of rheu- 
matism, or syphilis, or typhoid fever, or pyaemia be also present. 

This peculiar weakness of the heart, irritated by some special 
living poison, gives rise to a degradation of the living matter 
which nourishes the heart, hence, we have a micrococcus. 

The first symptoms, aside from the ordinary languor, lassi- 
tude, debility, general prostration, is a sudden seizure of violent 
steady pain in the heart, out of all proportion to any other kind 
of pain ; intense excitement, greatest anxiety ; features change 
rapidly, become ghastly or cadaverous ; tongue coats rapidly, 
brown, dry, darkish ; breathing difficult, irregular, labored ; 
action of heart violent but unsteady ; rigors heavy, frequent ; 
and a fever of the highest possible kind, with great oppression 
about the chest ; difficult respiration, dread of suffocation, alarm- 
ing palpitation, delirium, extremities become cold, fits of syncope, 
pain in heart all the time increasing in severity. 

Its duration is from twenty-four to forty-eight hours, invari- 
abty terminating in death. The proper treatment to try, if seen 
early, would be wet cups over region of heart, followed by hot 
poultices in which opium is abundantly diffused. Then there 
are three drugs that act well on this part of the nervous organ- 
ism, and they must be given often and in very large doses. 

Veratrum viride, five-drop doses, often and persistent. 

Pulverized opium in one-grain doses, but frequently, and 

Sulphate of quinine, in from ten to thirty-grain doses every 
three hours. 

The three drugs act harmoniously together ; the opium pre- 
vents the veratrum from prostrating, and retains the quinine in 
the blood. To be successful, case must be seen early. 



The endocardium, or the 

Inflammation of the serous membrane which lines 

Internal Lining Membrane the interior of the heart, and 

of the Heart. which by its reduplication as- 

{Endocarditis}) sists in the formation of the 

valves, and covers them com- 
pletely, is frequently the seat of inflammation. 



BACTERICIDES. ^^5 

The predisposing causes are the use of tobacco and other 
stimulants ; over- work, nervous exhaustion, worry, grief, sorrow. 
The exciting cause is rheumatism or gout, or both, which give 
rise to the evolution of the micrococcus. 

Micrococcus Endocarditis. — A pathogenic microbe, a degrada- 
tion of the complex bioplasm, which nourishes the heart-muscle 
into a disease germ. It is found as a streptococcus, massed upon 
the thickened valves of the heart, small chains three or four 
irregularly linked together. They often assume the form of a 
zoogloea, and are found congregated together, and form plugs in 
the vessels of the muscular tissue of the heart. In the detritus 
of the ulceration which follows, they are found in chains. 

The microbe and its micrococci are found chiefly in the heart, 
spleen, liver, kidneys, lymph canals, blood. 

The micro-organism bears cultivation well in beef tea. 

The same disease germ is present in acute laryngitis. 

Sy7nptoms, — In the acute form, there are the ordinary symp- 
toms of languor and debility, with a deep-seated, sharp, lancinat- 
ing pain away down deep, as the patient expresses it, in the 
heart, with great oppression and uneasiness over the region of 
the heart ; rigors and a fever ; pulse small, feeble and intermit- 
tent ; patient very restless and anxious ; prefers to lie on back ; 
great difficulty of breathing; jactitation, cold sweats, fainting fits. 

If the vital power is greatly depressed, or constitution depraved, 
there may exist a true typhoid condition, with all its varied train 
of symptoms. If the endocarditis is of the subacute form, or 
what is more common, of a low chronic type, the symptoms will 
be less prominent, milder and more obscure, so much so, that 
patients attacked with rheumatic fever have endocarditis without 
being aware of its existence ; nevertheless, it is apt to leave 
structural changes on the valves that give rise to trouble. 

That portion of the endocardium lining the orifices and cover- 
ing the valves most frequently attacked ; the left side of the heart 
more generally implicated. It is seldom directly fatal ; its effects, 
effusion of lymph, and its organization into cartilage or bone, or 
the effusion of urate of soda in gout, and its degeneration into a 
chalky concretion, most to be dreaded ; invariably gives rise to 
valvular disease. 

Place the hand over the region of the heart, it experiences a 
vibratory thrill ; no increased area of dulness ; place ear over 
heart, a soft, mitral, blowing murmur can be easily detected. 
Its duration may be months or years ; but its inevitable termina- 
tion is thickening of the valves, general loss of tone_, obstructed 
circulation, impoverishment of blood, dropsy and sudden death. 
To sterilize, or annihilate the microbe, concentrated ozone diluted 
with chloroform over region of the heart. 



5/6 



DISEASE GERMS. 



Internally, try either digitalis, or- strophanti! us, or ozone water,, 
or simabicidia, or ammonia, in alternation with quinine; liquor 
ammonia acetatis and salicylic acid; perfect rest of mind and 
body ; nothing to fret, worry or cause anxiety ; diet to be good^ 
light, nutritious ; treatment for rheumatism or gout to be carried 
carefully out ; convalescence to be established on vegetable 
alteratives, with iodide of potass and tonics ; guarding against 
that twin-monster, rheumatic gout, by keeping the body covered 
with flannel, and avoiding everything likely to debilitate. Forbid 
tobacco, alcohol, tea, excess, debauchery, etc. 

The very best of diet should be given, consisting of a mixed 
animal and vegetable kind ; and if unable to exercise, massage 
should be resorted to morning and night. 



The iris, suspended like a curtain, with a 
Inflammation circular opening in its centre, lies between the 
of the Iris. cornea and crystalline lens ; and bathed on 
(^Iritis?) both sides by aqueous humor, serves to regu- 

late the amount of light that is admitted into 
the retina. It divides the cavity containing the aqueous humor 
into anterior and posterior chambers. The iris is composed of 
delicate bundles of fibrous tissue, or circular and radiating, in- 
voluntary, muscular fibres, and of pigment cells. In some cases 
it is absent, or exists in a rudimentary form. In the Albino, the 
iris is of a rose-color, while the pupils present a deep red appear- 
ance, owing to absence of opaque pigment. In coloboma, the 
two halves of the iris have failed to unite, in consequence of an 
arrest of development, which gives the pupil an elongated form. 
Inflammation of the iris exists in a variety of forms, and is asso- 
ciated or dependent on low states of vital power. The different 
forms of iritis are divided into (i) hyperaemia of iris; (2) 
plastic iritis ; (3) serous iritis; (4) parenchymatous iritis ; (5) syphi- 
litic iritis. 

Causes, — Syphilis, gout, tuberculae, mercury, are the primal 
causes, but exposure to sudden changes of temperature, cold 
draughts, or severe drenching, together with grief, anxiety, 
sleeplessness, may induce it Tf the predisposition exists in a 
depraved constitution. 

Symptoms. — There is lancinating pain, situated at first, in the in- 
terior of the eyeball ; then it extends to the forehead, temple and 
gums, and other parts of the fifth nerve. Throbbing is an unfavora- 
ble symptom. Pain increases towards evening and lasts till morn- 
ing, when it has assumed a dull aching in the eyeball, and oc- 
casionally it is of lancinating character. The nocturnal attacks 



BACTERICIDES. 577 

of pain are very apt to cause fever and impaired appetite. In- 
tolerance of light and lachrymation are rarely absent, but very 
slight. Now examine the eye. Direct your attention to its 
color ; compare it with the healthy iris, and see if it has not 
undergone some change, for inflammation changes blue into 
greenish, brown into reddish, gray into greenish yellow color; 
and if blood is effused into the anterior part of vitreous humor, 
it presents a green color. The arterial distribution accounts for 
those changes. There is also contraction, dryness and irregu- 
larity of the pupil, dimness of vision and sometimes total 
blindness. 

The different forms depend upon the cause ; the syphilitic form 
is the most common, and is usually associated with other symp- 
toms, r.s chief distinctive characteristic is that instead of the 
whole iris being studded over with excrescences, the inflamma- 
tion is confined to one or two single spots, while the rest is 
normal. One-fourth or one-half of the iris is changed in color, 
and swollen. 

Treatment. — This embraces general principles ; aconite for 
fever; morphia for pain; free action of bowels and skin; nour- 
ishing food, etc. 

Our effort must be directed to the eye to obviate the tendency 
to adhesions, or break them down ; for this purpose, a solution 
of atropine breaks them up if fresh, and puts the eye in a 
favorable condition toward resolution. The solution formerly 
given should be dropped into the eye thrice daily. Then the eye 
kept covered with a solution of boroglyceride. 



Inflammation of the substance of the 
Inflammation kidneys, or acute nephritis, is a compara- 

of the tively rare affection. 

Kidneys. It is predisposed to by debility, or a 

{Acute Nephritis) tubercular diathesis, poor living, mental 
depression. Its exciting causes are 
cold, damp, exposure to vicissitudes of weather, mechanical in- 
juries, lifting, hoisting, strains, blows ; to the presence of calculi 
or gravel in the kidneys ; excessive beer or whiskey drinking ; the 
drastic action of such drugs as turpentine, balsam copaiba, can- 
tharides, and it is also caused by diseased germs. 

Symptoms. — In addition to the usual symptoms of languor, 
lassitude, debility, there is great constitutional disturbance, head- 
ache, pain in the back and legs, rigors, fever, nausea, vomiting ; 
hard, frequent, but small, wiry pulse; constipation and a localized 
pain over the region of the kidneys, increased by pressure and 

37 



578 



DISEASE GERMS. 



movement ; pain is permanent and severe and often extends down 
the ureter to the bladder, groin, scrotum, or testicle; besides, 
there is numbness of the anterior portion of thighs, retraction of 
the testicle, and tympanitis ; frequent micturition, a desire to void 
water when there is none in the bladder, or passed in drops ; 
often suppression of urine, and if there is any passed it is very 
high colored and contains casts of the kidney tubes, or blood in 
large or small amount, or pus. If the urine is suppressed there 
will be uraemia, with coma or convulsions. If recovery follow it 

is liable to leave the kidneys 
weak for some time. Besides 
resolution or recovery, the 
case may terminate in a vio- 
lent attack of haematuria, and 
get well ; or in effusion of lymph 
and abscesses of variable sizes, 
which are very destructive to 
the body of the kidney. 

These abscesses are likely 
to lead to ulceration, perfora- 
tion of capsules and renal fis- 
tula, and estabHshment of the 
muco-purulent discharge ; 
often fatal hectic associated 
with those abscesses. In favor- 
pus is evacuated, the kidney heals up and a good 
cure takes place. Besides being a result of inflammation, abscess 
may be due to the presence of a stone in the kidney, obstruct- 
ing and irritating the passages. 

Treatment. — If seen early, administer an emetic ; follow with 
aperient and enemata and alcoholic vapor bath ; then put patient 
to bed, between blankets ; apply mustard sinapisms over kidneys 
and over stomach ; when a very decided redness is produced, hot 
linseed poultices ; disturb patient as little as possible in their ap- 
plication. Administer aconite, tincture of green root gelsemium 
and digitalis, in small doses, frequently repeated till pulse reaches 
60 ; then, at longer intervals. Those three arterial sedatives 
operate well, and should be given for sometime in smaller doses, 
at longer intervals. If there is the slightest tendency to ursemic 
symptoms, hypodermic injections of one-third of a grain of pilo- 
carpin. Low diet, milk and lime-water, beef tea. No drink, 
nothing to give kidneys \york. If case progresses favorably, 
apply irritating plaster over kidneys, and administer either quinine, 
with aromatic sulphuric acid, or compound tincture of cinchona 
with nitromuriatic acid. For two or three months patient 




Renal hyperaemia in acute nephritis. 

able cases the 



BACTERICIDES. ^^^ 

should use, three times a day, either an infusion of buchu, or uva 
ursi, or queen of meadow, or pipsissewa, or cleavers, or pareira 
brava, to restore tone to kidneys. 



Tubular nephritis, or acute 

Inflammation of the albuminous nephritis, is an afifec- 

Interstitial Tubes. tion of the kidneys, greatly on 

{Acute Interstitial Nephritis}) the increase, and forms what is 

known as acute Bright's disease. 
Its chief characteristics are excessive proliferation of the con- 
voluted tubes of the kidneys, with congestion of the malpighian 
tufts, an exfoliation of the walls, and the white blood escapes. 
The shedding, or shelling, or peeling of the tubes in the process 
of proliferation, by which they lose their epithelial lining, chokes 
up the tubes, obstructs secretion. The morbid process is tubu- 
lar, interlobular, interstitial, commencing at the surface, and pro- 
ceeding inwards, leaving the cortex pale. In this process the 
walls of vessels usually give way, and the serum and white cor- 
puscles mingle with the urine, rendering it albuminous, the fibrin 
coagulates in the tubes, and forms casts. The malpighian bodies 
form bright red points, pyramids, dark and congested ; kidneys 
much enlarged. 

Causes.— Yr\v2!aoxi, exposure to wet or cold, but especially 
when the nerves of the kidney are weakened, and there is a union 
of the urate of soda with lithic acid from beer or ale-drinking, 
and especially the germs of scarlatina. 

Symptoms, — There is a sudden seizure of chilliness, rigors, 
fever, with headache, thirst, vomiting, restlessness, with pain 
and tenderness over region of the kidneys ; frequent micturition ; 
urine scanty; of a dark, smoky color, persistent and highly 
albuminous, with abundance of fibrinous casts, epithelial casts, 
renal epithelium, blood casts, and few blood corpuscles; dropsy 
of the cellular tissue, general oedema, face puffy, hand swells if 
it hangs down ; dropsy and anaemia ; a strong tendency to effu- 
sion of serum from membranes of brain, peritoneal coat, pleura. 

There are cases occasionally met with of general dropsy and 
albuminuria, without a desquamation or peeling off of the renal 
epithelium, called ^^t'/^-desquamative disease of the kidneys. 
This is apt to occur in bad cases of blood-poisoning, owing to a 
failure of vital power to eliminate morbid material from the system. 

A favorable sign is free and copious urination without albu- 
men ; an unfavorable indication is scanty, or total suppression of 
urine, aggravated dropsy and effusion into the serous cavities, 
pleura, pericardium, and peritonaeum. 



58o 



DISEASE GERMS. 



Treatment. — If the result of intemperance, active measures, 
as cupping over the kidneys ; open bowels quickly with elaterium ; 
alcoholic vapor bath ; then put to bed between blankets ; mus- 
tard, followed by hot poultices over kidneys ; very free diapho- 
resis, with jaborandi or pilocarpin ; try first infusion of digitalis 
and nitrate of potass ; and if that fail, citrate of potassa in infu- 
sion of hair-cap moss, and general treatment as laid down under 
Bright' s Disease. 

In the little child, whose kidney tubes are peeling off and 
exfoliating, our treatment must be more gentle, and still effi- 
cient, but different from the above — warm baths ; confinement to 
bed ; dry heat to kidneys, in the form of camomile flowers or 
bran in a bag, heated in an oven ; to lie between blankets, and 
give most nutritious diet of beef tea, milk, eggs, etc. Try infu- 
sion of digitalis and sweet spirits of nitre, in alternation with 
quinine and aromatic sulphuric acid. Open bowels with com- 
pound licorice powder. The infusion of digitalis is our best 
remedy ; but if it fail, try infusion of asparagus-tops and nitrate 
of potassa, or infusion of parsley-root and citrate of potass. Per- 
severe with the quinine and aromatic sulphuric acid. If those 
remedies do not avail, then try nitro-glycerine — a two per cent, 
solution, in one-drop doses, every four hours. Most excellent 
results have followed the use of the remedy in this form of acute 
interstitial nephritis ; it relieves every symptom, the oppression, 
the vascular tension ; the kidneys resume work, peeling is 
arrested, and we are soon gratified with a copious secretion of 
urine free from albumen and tube casts. There are no cases but 
what are relieved, if not cured, by the action of this drug. Im- 
provement inevitably follows. 



Chronic desquamative nephritis, or 
Chronic Interstitial contracted granular, or gouty kidney, or 
Nephritis. more commonly termed Bright's disease, 

is a true interstitial degeneration or 
breaking-down of the epithelium of the convoluted tubes; an ex- 
foliation, or shedding, or peeling of the walls of vessels, which 
lose their epithelial lining, owing to a true inflammatory process 
^r partial death. 

This interstitial irritation causes the interior of the kidneys to 
collapse, become filled up with broken-down debris or rubbish ; 
choke up the tubes, and obstruct secretion. This interlobular 
death causes them to contract. Nature makes efforts at revival 
again and again; but this shedding of renal epithelium continues; 
and besides blocking up the kidney, appears in the urine in a 



BACTERICIDES. 



581 



more or less disintegrated form. The tubes lose their lining 
altogether, and either collapse or become filled up. This denud- 
ing process permits the liquor sanguinis, or serum, or albumen 
of the blood, to escape in the urine, so that the urine is persis- 
tently albuminous, of low specific gravity, and contains granular 
casts and epithelium. 

Varieties, an excellent etiological classication has been pro- 
posed, to wit, which corresponds to the facts of clinical obser- 
vation, as well as to pathology. The following are the proposed 
divisions : 

1. Febrile nephritis. 

2. Toxaemic nephritis. 

3. Obstructive nephritis. 

The first division includes all those cases of acute or chronic 
nephritis occurring as a result of acute or chronic febrile disease, 
as is engendered either by the microbes of measles, variola, scar- 
latina, hooping-cough, mumps, rheumatism, or the bacillus of 
tubercle, cancer, syphilis, anthrax, erysipelas, etc., or by the mi- 
cro-organism of diphtheria, typhoid, malaria, pneumonia, ulcera- 
tive endocarditis, pyaemia, etc. 

The second division includes the great group of essential 
chronic cases due to lithaemia, an irritation of the kidneys by the 
excessive elimination of poisons of which uric acid is the type. 
It includes the nephritis of gout, the poisoning by animal, vege- 
table or mineral poisons, but more especially the toxaemic effects 
of beer, which gives rise to an excess of uric acid in the blood 
and its prolonged elimination through the kidneys. 

The third division includes all cases dependent upon obstruc- 
tion to the outflow of urine, as stricture, enlarged prostate, cystitis 
in men, and uterine, ovarian tumors, pregnancy, procidentia uteri 
in females. 

Predisposing cause may be enumerated thus: neurasthenia or 
poverty of nerve force; the intense struggle for existence; vari- 
able temperature, highly oxygenized atmosphere ; suppression 
of the perspiration, followed by increased acid of the urine, with 
diminished alkalinity of the blood, leading to the accumulation 
of uric acid in the blood. The left kidney being freely covered 
with the great sympathetic, demonstrates most clearly how over- 
mental work, or worry, or grief, damages that kidney, and gives 
it a predisposition, a weakness to any irritating agent. Residence 
amidst a halo of sewer gas impairs the integrity of the organism, 
and is often a primary cause. Frequent chilling of the body in- 
creases the formation of uric acid. Climate, individual conforma- 
tion, occupation, habits as to food and drink ; the presence of 
pre-existing disease of the heart and liver ; the failure of the kid- 



582 



DISEASE GERMS. 



neys to eliminate, owing to some obstruction, as stricture, enlarged 
prostate, tumor, pregnancy, ovarian enlargement. 

Exciting causes. The most common are the presence of disease 
germs in the blood, and their elimination, dead or alive, by the 
kidneys. Where there is an inherent weakness of organization, 
the microbes of malaria, the bacillus of diphtheria, the vibrios of 
typhoid fever; the amylobacta of rheumatism, the amoeba of 
catarrh, the germ syphilitica act as exciting causes. The in- 
discriminate use of such drugs as mercury, balsam copaiba, 
turpentine, cantharides, juniper berries, acetate of potassa, 
etc., often give rise to it. Bad living, constant exposure to wet 
and cold, to atmospheric changes, deleterious trades, and intem- 
perance, are common causes. Out of every one hundred persons 
who indulge in beer arid other alcoholic compounds, and thus 
lay the elements of gout and rheumatism in their blood, eighty 
per cent, are affected, more or less, with desquamative nephritis. 

The union, therefore, of the urate 
of soda, with lithic acid in a weak- 
ened kidney, or in gout, is the 
most common of all causes. In 
this enumeration, previous dis- 
ease, blows, lifts, strains, etc., are 
not to be overlooked. 

The distinction between gout 
and rheumatism does not essen- 
tially enter into the exciting 
cause. In rheumatism we have 
the uric, lactic, butyric acids, the 
latter forming or entering the into micro-organism (bacillus amy- 
lobacta), gout, with the same compounds and urate of soda. 

The inhibition of lead, phosphorus, mercury, leads to the accu- 
mulation of uric acid in the kidneys, by depressing the function 
of the liver or forming insoluble urates. 

Permanent hardness in drinking water, due to the presence of 
lime salts, is often a predisposing cause. 

Beer drinking owes its ill effects more to the acid it contains 
than the alcohol. Whiskey drinking causes cirrhosis of the 
liver, organic changes in the great urea-forming organ of the 
body, indirectly causes the formation of uric acid. 

The excessive use of animal food increases the raw material 
from which uric acid is formed, and also by the large amount of 
salts contained in it. 

Sudden changes of temperature are a fertile cause of this 
disease. 

Prognosis. — The chances of recovery from an acute attack of 




Section from the cortex of a contracted kid- 
ney, showing two glomeruH. 



BACTERICIDES. 



583 



Bright's disease are decidedly favorable, for we rarely have a 
fatal termination unless egregiously mismanaged. We cannot 
speak so confidently of the ulterior result, for once the kidneys 
are damaged, they are difficult to repair. 

All circumstances must be well balanced in the mind, if the 
urine is to be kept well persistently loaded with uric acid (lithse- 





Section of the cortex of the kidney in 
chronic interstitial nephritis. 



Fatty degeneration, the result of interstitial 
nephritis, due to beer drinking. 



mic nephritis), such as we have in gout, in habitual beer drinkers, 
whose blood is inflated, may, actually irritated by the dyscrasia, 
our prognosis is not good, as we have the prolonged action of 
the uric acid in paasing through the kidneys. 

Age modifies this morbid condition. 
It is rare under twenty ^years of age, 
indeed not common up to forty, very 
prevalent after that period is passed, 
after fifty still more common, so much 
so that one-third of all persons dying 
above that age show more or less 
signs of its action on their kidneys. 
With reference to sex, all statistics 
show that the contracting type of 
kidney is less common in females 
than in males, being one female to 
two males. It attacks all classes, 
but is especially common among 
workers in lead, miners, brewers, and 
frequency among females may be due to 
sympathetic, and to their exemption from 
avocations of life. 

Pathology. — As. the mortality from this disease shows a pro- 
gressive increase, co-equal with civilization, it is interesting and 
important to note its pathology. 

During life, uric acid, the normal product of dis-assimilation, 
plays a most important part. 




Waxy kidney, common in the tuber- 
cular, a sequela of chronic inter- 
stitial nephritis. 



beer 



drinkers. Its in- 
their rudimentary 
the more 



rugged 



584 DISEASE GERMS. 

Hypertrophy of the heart exists in seventy-five cases out of 
one hundred ; atheroma of the aorta, coronary arteries, ossifica- 
tion of the valves, with evidence of fatty degeneration in all cases. 

Of 250 cases observed, 176 were men and 74 were women. 
The cyanotic kidney was found chiefly in young and middle- 
aged men, and the oedematous form chiefly in old men and in 
women. Six-tenths of the cases showed a fatty liver, not affected 
with fibrosis. As regards the general pathological conditions 
found in the 250 cases, the following may be stated : the alco- 
holic kidney was found 248 times ; large, fatty liver, 220 times ; 
chronic and acute cystitis, 170 times; a mammelonated condi- 
tion of the stomach, 150 times ; excess of blood in the brain and 
oedema, 1 50 times , simple hypertrophy of the stomach, 90 
times ; arterio-sclerosis, 50 times ; acute gastritis, 50 times ; 
Bright's disease and phthisis, 20 times ; hemorrhage in the 
brain, 10 times ; and cirrhosis of the liver, 6 times. The changes 
found in the stomach, liver, and brain are of very great interest. 
The extreme frequency of fatty liver, with the infrequency of cir- 
rhotic liver, is certainly very remarkable. 

In all cases either a waxy or fatty degeneration of the kidneys, 
with atrophy or hypertrophy. 

Many complications of chronic interstitial nepJiritis are liable to 
take place, chiefly due to the presence of an excess of urea in 
the blood, all embraced under " urcemia',^ these are hyperaesthesia 
of the skin ; deposits of crystals of urea on the skin ; symmetrical 
gangrene; vomiting and diarrhea; hiccough; difficulty of breath- 
ing ; headache; deafness and blindness; hemiopia ; hemi- 
plegia ; delirium ; coma ; twitchings ; convulsions ; epilepsy ; 
hemorrhages ; oedema of the glottis ; congestive oedema of 
the lungs. 

Symptoms, — General languor, lassitude and debility existing 
for a long period, even for years, may exist without the true 
nature of the affection being suspected, but by and by the debility 
increases, and the weakness becomes associated with loss of flesh, 
prostration, vertigo ; specks and spots before the eyes ; noises in 
the ears, and the skin assumes a uriniferous appearance and 
odor; the conjunctiva becomes a pearly white, the tongue large 
and flabby with the diagnostic kidney tracts, with feeble pulse, 
cold extremities. 

There may or may not be pain over the region of the kidneys ; 
usually, however, a sense of weight or weakness. Urine is 
usually free and very copious, pale in color, and of a very low 
density, but persistently exhibits traces of albumen in large or 
sma'l aii')ants, and soon becomes loaded with casts from the 
kidney. 



BACTERICIDES. 



585 



Interstitial death or collapse progresses onwards, the above 
symptoms become more intense, aggravated, then dropsy, more or 
less oedema, puffiness of eyelids, general anasarca, with effusion 
into the serous sacs, with some oedema of the glottis and lungs, 
with symptoms all the time growing worse, degeneration of the 
kidneys appear, or structural changes in the form of fatty or 
amyloid usurpation. The blood becomes very impure, loaded 
with urea ; there is an innate or inherent power of resistance to 
the circulation of contaminated and deteriorated blood through- 
out the vessels, whence arises the high tension in arteries ; hyper- 
trophy of the muscular coat of the arterioles, and enlargement 
of heart ; often organic disease, especially valvular. This impure 
blood acts badly on nerve centres ; retinitis and other signs of 
degeneration often appear. 

Diagnosis. — The history of the case may exhibit a diathesis 
inherited or acquired ; if not the presence of some source of irri- 
tation of the kidney with that terrible feeling of goneness. The 
skin has a uriniferous aspect ; the saliva and sweat contain urea. 
The blood is anaemic, haemoglobin and red corpuscles diminished, 
while the water of that fluid is increased. The truly diagnostic 
symptoms are, the pearly lustre of the eye ; longitudinal fissures 
on the tongue ; the persistent presence of albumen in the urine ; 
the anasarca ; retinitis , polyuria ; dilatation, followed by hyper- 
trophy of the heart ; tube casts in urine ; of mucus, epithelia, 
blood; or occasional hemorrhages take place contracting kidney. 

Progress and Distinctive Features of the Disease. — The presence 
of albumen in the urine, or an albuminous body, which is coagu- 
lated by heat or precipitated by neutralization, was once regarded 
as of primary import, but later observations has caused it to lose 
its original meaning. The number and variety of pathological 
relations, under which albumea may appear in the urine are 
numerous. It is invariably present in inflammation, congestion, 
changes in the mechanical circulation, microbes in the blood cir- 
culating through the kidneys ; disease of the heart or lungs, or 
morbid states of the liver, peritonitis ; pregnancy, abdominal 
tumors. It is often present in tubercle, syphilis, cancer, purpura, 
scurvy, anaemia, diseases of the brain and spinal cord, in epilepsy, 
chorea ; cutaneous affections. 

It is also present in active or arterial congestion, from a 
chill to the skin in bathing ; from exposure to cold ; 
from the elimination of some irritant through the kidney, 
as alcohol, uric acid, phosphorus, lead, cantharides, copaiba ; 
but especially are the microbes of scarlatina, variola, diphtheria 
and erysipelas disastrous to the kidneys, as well as the vaso- 
motor paralysis which their presence induces. 



^S6 DISEASE GERMS. 

Venous congestion induced by cardiac, pulmonary disease, 
goitre. Degeneration of the arterioles, changes in the composi- 
tion of the blood. 

Besides, there is a common form of albuminuria, which occurs 
in young men and young ladies, victims of self-abuse, or sexual 
excess, whose reproductive centre is exhausted ; who suffer 
from languor, headache, weakness of the back and knees, indi- 
gestion, neurasthenia, without a sign of organic lesion ; it is re- 
mittent in type, and named cyclical albuminuria, or that of 
adolescence. 

So we meet with albumen in the urine, from innumerable 
causes, which are not to be regarded as diagnostic of Bright^s 
disease. 

The mechanism by which albumen persistently passes in the 
urinary secretion is essentially one of inherent debility, organic 
change, permeability in the walls of the glomerule, by or through 
which the white portion of the blood exudes, by transudation or 
exosmosis. 

Next to the persistent presence of albumen in the urine, 
dropsy is a most striking symptom. This consists in an accumu- 
lation of serous fluid in the lymph spaces of the subcutaneous 
cellular tissue and in the three great serous cavities of the body. 
This fluid is derived from the capillaries, and under normal cir- 
cumstances is poured out into those spaces, but taken up again 
by the venous and lymphatic radicle, as fast as it is poured out. 
For the production of dropsy this equilibrium must be upset, 
either by an increase in the outflow of the fluid, or in a failure 
on the part of the veins and lymphatics to take up the effused 
fluid. 

A weak or obstructed kidney, with watery blood, increased 
permeability of the capillaries ; a defective pumping arrange- 
ment ; organic changes in the brain, blood and capillaries 
generally gives rise to an increased outflow, a decreased 
taking up. 

Albuminuria is invariably present in all states of damaged 
kidneys, in all grades of renal debility, or irritation, or where the 
kidneys become clogged up with diseased germs. 

This state of partial death of the renal organs, existing for 
some time, soon gives rise to the presence of tube casts in the 
urine. 

Casts of the renal tubes are usually one or other of three 
kinds : blood, epithelial, and hyaline. 

Blood casts are evidence of hemorrhage from the glandular 
structure of the kidney, epithelial and hyaline casts, evidence of 
active inflammation. 



BACTERICIDES. 



587 



Nephritic debility gives rise to increased permeability of the 
glomerular walls and epithelium, and these structures further 
stunned by the presence of an excess of uric acid, gives rise to 
^'polyuria''' where we have increased blood pressure, dilatation of 
efferent vessels, with destruction of capillary areas beyond the 
glomeruli. 

Cardiac hypertrophy is invariably present in all forms of per- 
sistent albuminuria, even in acute nephritis, but most common in 
contracted kidney, and is due to stimulation of the heart, to irri- 
tation produced by the microbes in the blood, to the presence of 
uric acid or urea in the blood, to increased capillary resistance, 
due to the density of the blood plasma, and the high tension 
pulse to the acquired increased energy of the heart, with greater 
capillary resistance. 

The chief retinal changes are due to neuritis, which is caused 
by the disordered state of the blood, and invariably indicates 
grave organic changes. 

A partial death of the kidneys always gives rise to an excess 
of urea in the blood. Uraemia is a generic name given to a 
large host of symptoms which occur in the onward progress ot 
the disease, due to a failure on the part of the kidneys to elimi- 
nate this agent, hence the skin and breath have a uriniferous 
odor ; the brain is poisoned with it, hence the headache, the ver- 
tigo, delirium, intoxication, convulsive attacks, chorea and epi- 
lepsy ; the asthma, paralysis. 

Indeed such patients present themselves under the most varied 
semciological conditions, they may complain of bronchitis, 
asthma, pain at the praecordia, palpitation, epistaxis, vomiting, 
diarrhea, giddiness, headache, neuralgia, affections of sight or 
hearing, apoplexies, convulsions, coma. 

Treatmejit. — The successful management of Bright's disease 
depends a good deal upon the physician being a man of exten- 
sive experience, sound common sense, and upon a thorough 
understanding of the disease. Fortunately for all patients, the 
true nature of the malady is yearly becoming better appreciated. 

A patient can do much also to improve his condition, main- 
tain and preserve his vital force ; in no way, neither with work 
nor excess of exercise, should he do anything to weaken his con- 
dition, all his efforts should be directed to adopt a mode of life 
which will lead to the acquisition of more strength. 

It is not always in the power of patients to choose their resi- 
dence in strict conformity with medical advice, but when possible 
a warm, dry climate should be selected for the winter, and the 
highlands in the summer. 

The clothing, day and night, summer and winter, should be 
woolen. 



588 



DISEASE GERMS. 



Tepid bathing should be resorted to daily, followed by brisk 
friction or massage, cold baths or sponging should never be 
permitted. 

Once a week, if the case permits, an alcoholic vapor bath 
should be taken. 

This is the most accessible, and for general utility, one of the 
best forms of bathing, and every family should be familiar with 
its use. In the first place any tinsmith will make a convenient 
lamp, like an oyster chafing-dish, with five wicks, each the thick- 
ness of a quill, and large enough to hold alcohol to burn three- 
quarters of an hour. In the centre, over the five flames, a deep 
plate, large enough to hold water to boil for forty-five minutes. 

The whole, for safety, might 
be placed inside of an iron 
pot, which is to be placed 
underneath the chair on 
which the patient is to sit. 
The patient is then to be 
divested of all clothes, and 
sit down on the chair un- 
der which the spirit-lamp 
is placed. This chair must 
have a thick, wooden bot- 
tom, and there must be 
some protection, either a 
piece of wood, or blanket, 
placed in front to prevent 
undue heat on his calves. 
The patient, sitting down, 
must be carefully envel- 
oped in blankets pinned 
tightly around his neck, and lying on the floor, and be careful that 
on crevice, or hole, or outlet exists to let the vapor escape. The 
patient being thus duly enveloped and covered up, the lamp and 
saucer which had been previously fixed, the former with alcohol, 
and the latter with water, the five wicks are ignited. In a few 
minutes he begins to experience the glow of the burning alcohol, 
and by and by the steam begins to rise. Some recommend giv- 
ing a cup of hot boneset, or pleurisy-root tea, but it is unneces- 
sary — the best drink is abundance of cold water. With this 
bath there is a determination of blood to the skin ; it relieves 
cerebral, lung, and visceral congestion ; induces a healthy action 
of the skin and mucous membrane ; eliminates noxious matter 
from the blood, and imparts a sense of elasticity and vigor to the 
system. It is useful in both health and disease, but especially in 




Alcoholic vapor bath. 



BACTERICIDES. 



589 



colds ; congestion of the lungs, liver, kidneys ; dropsy, gout, and 
rheumatism, neuralgia. No tendency to catch cold after it. It 
will break up all fevers. It should be given upon an empty 
stomach, and never to pregnant women, or those who are men- 
struating. It can also be used for medicated vapor baths, by 
adding iodine, or other chemical agents to the water in the 
saucer, so that the patient is exposed to the influence of three 
agents, heated air, or alcoholic vapor, steam, and the medicinal 
agent used. 

After one-half an hour spent in the alcoholic bath, with 
copious perspiration, the light should be extinguished, and the 
blankets pushed down, the body well rubbed and dried, and then 
the lower half; a dry shirt put on, and placed in bed for several 
hours, or over night. It is much superior to either the Turkish 
or the Russian bath, and costs little. No family should be with- 
out it. 

The duration of this bath should never exceed thirty minutes. 

Daily exercise, but never so much as to induce the slightest 
fatigue. 

Diet is to be generous and nutritious, embracing, as far as 
possible, fowl, game, eggs, cream, cereals, as oatmeal, wheaten 
grits; sweet-bread, tripe, calf 's-head ; white-fish; fresh vege- 
tables and fruit, with farinaceous food. 

Tea, coffee, chocolate are permissible, but beef, mutton, cheese, 
saccharine fatty food forbidden ; a liberal diet, but rigidly de- 
prive the patient of all slops, even milk, beef-tea, soups. Beef- 
tea is a chemical composition, closely resembling urine, and all 
soups or broths partake of the same character. Nevertheless, 
the patient's health and strength must be maintained. 

Malt liquors forbid, if anything in this line be necessary, let it 
be good whiskey in ApoUinaris or Vichy water. 

In all cases the patient should be placed upon a general tonic 
and alterative course for months or years. 

Such tonics as matricaria comp., comp. tincture cinchona and 
aromatic sulphuric acid ; quinine and mineral acids ; ozone 
water ; glycerite of ozone, or a mixture containing benzoate of 
soda and digitalis, thus, benzoated soda, five grains ; tinct. digi- 
talis, eight drops ; infusion of gentian, one ounce. Mix. Take 
a dose thrice daily. For alteratives, comp. saxifraga and Phyto- 
lacca, are invaluable ; still, such vegetable extracts as corydalis, 
stillingia, are not to be overlooked. 

Over both kidneys, some stimulant should be kept constantly 
applied; the common irritating or tar piaster is the most 
efficient. 

While pursuing the general alterative and tonic course, it is 



5Q0 DISEASE GERMS. 

well to change them once a week, so that the patient does not 
become habituated to any one drug. 

An important indication in all cases is to keep the bowels in a 
soluble condition, the intestines form an important channel of 
elimination. If the peristaltic wa\^e is arrested, poisons, or pto- 
maines are formed, which aggravate the existing state of things. 
If constipation does exist, very gentle, but efficient measures 
must be adopted. 

The cascara lozenge should be tried, being a tasteless, tonic 
laxative ; stimulating digestion, promoting nutrition and assimi- 
lation, one or two after each meal ; or small doses of the kola- 
nut, or if very obstinate, a pill containing one grain of euony- 
mine ; two grains of the extract of aloes, and one-eighth of 
a grain of belladonna. Mix. Make one pill. Take at a dose. 

Besides adopting a general treatment as here indicated, there 
must be a special course of remedies used to meet the three 
prominent indication* which are invariably present. * 

To arrest or check the flow of albumen we must be solemnly 
impressed with the idea that there are no specifics in medicine ; 
that we profess no drug which has a definite, decided control 
over the excretion of albumen by the kidneys. The action of 
any drug upon a diseased organ is always obscure, invariably an 
element of uncertainty about it. 

Some of the following remedies should be selected and tried, 
say, for forty-eight hours ; and if no check, another substituted : 
Gallic acid, in fifteen-grain doses thrice daily, in a tablespoonful 
of port wine ; tincture or infusion of digitalis, ten drops of the 
former, or wineglassful of the latter, thrice daily ; iron in tinc- 
ture, or iron-alum, oil of erigeron, ergot, matico, mineral acids. 

Tannate of soda, thus, tannic acid, bicarbonate of soda, of each 
ten grains ; glycerine, twenty drops ; add to and mix in one 
ounce of water. Administer thrice daily. 

Nitro-glycerine, most invaluable drug. A one-per-cent. solu- 
tion most available, in doses of from one to more drops added to 
water three or four times daily, is the most effective remedy we 
possess, it props up the collapsed kidneys, and as we have to deal 
with heart failure, this remedy while checking the escape of al- 
bumen gives backbone to the heart, imparts to it increased 
energy. 

Oil of erigero7t is superior to terebene, and deserves an occa- 
sional trial, its use in five-drop doses on a lump of sugar every 
three or four hours, lessens greatly the amount of albumen, 
lowers vascular tension, and improves the general condition. It 
has also a most favorable influence on the headache, nausea and 
other symptoms of a uraemic character. 



BACTERICIDES. 



591 



It is in no sense a curative drug, but it undoubtedly palliates 
this state in a most admirable manner. 

Some claim that the glucoside from eupatorium purpureum, 
combined with chloride of sodium, the former in five, and the 
latter in ten grains, are successful; we have increased the dose 
greatly, and have met with no success with the combination. 

Ballota Suaveolens is of great efficacy where the kidneys are 
blocked up with uric acid, in itself it is a powerful diuretic, dis- 
solves the uric acid lodged in the kidney, removes congestion, 
checks the escape of albumen, and eliminates morbid matter. 
This is an invaluable remedy. An acetic tincture of the ballota 
and senega root, makes a most efficient astringent diuretic. 

Occasionally we have found five grains of the syzygium jam- 
bolanum, thrice daily, of great efficacy in arresting the escape of 
albumen, it is the best by far of the class designated astringent 
diuretics. 

Iron is a remedy sometimes of great utility. A good formula 
for its administration is the following : liquor ammonia acetatis, 
two ounces ; dilute acetic acid, one ounce ; tincture of chloride 
of iron, four drachms ; water, one ounce and a half. Mix. 
Teaspoonful for a dose. 

With regard to all drugs, small doses, frequently repeated, are 
the best ; do much better than large ones. 

To remove effusion, dropsy of the cellular tissue, or in the three 
serous cavities. 

Infusion of digitalis, or strophanthus, to unlock the absorbents, 
followed by diuretics, diaphoretics, hydragogue cathartics. 

An infusion of digitalis, made fresh daily, has a marked action 
on the brain, the heart, the arteries ; it often arrests the escape of 
the albumen itself; it unlocks the absorbent system, and is a 
most serviceable drug. Many are, and have been, disappointed 
in its action, simply from inattention to its proper mode of 
infusion. It deserves a fair trial, properly prepared. 

Strophanthus if tried, must be used in tincture form, one to 
two or more drops, then follow in with special remedies. 

Caffeine might be tried thus : citrate of caffeine ; pulverized 
digitalis; pulverized squills, of each one grain. Make into one 
pill. Administer one every three hours. 

Bitartrate potassa, half an ounce, to a pint of boiling water, to 
be used as a drink, has a most remarkable action in flushing the 
kidneys ; or it could be administered thus : bitartrate potassa, 
one drachm ; nitrate potass, ten grains ; pulverized mandrake, 
three grains. Mix. Make one powder. Give one once, twice, 
or thrice daily, so as to cause two or more motions of the bowels 
in the twenty-four hours. 



592 



DISEASE GERMS. 



Ulexine, an elegant alkaloid possessing powerful diuretic prop- 
erties, in doses of one-fortieth of a grain three times a day. 

An infusion of the hair-cap moss often does good work, it is an 
efficient diuretic. 

Hydragogue cathartics, that is the stimulation of the entire 
serous coat of the bowels, with one-twelfth of a grain doses of 
elaterin ; or some remedy of a like character. 

The sonchus oleraceus, or rather the gum obtained from the 
milk of the plant by evaporation, is the part used, and is best ad- 
ministered in small doses combined with either manna, anise 
seed, or carbonate of magnesia. It is quite as powerful as elate- 
rin, but not so exhausting. It is always safe to promote a dis- 
charge from the intestinal canal, with due caution that they do 
not become excessive, so as to pass into a permanent diarrhea. 
Frequent passage from the bowels rid the intestinal tract of 
ptomaines, urea, and other toxical substances. 



Inflammation 

of the 

Larynx, 

Acute. 



Acute laryngitis is a rare disease, being 
confined almost exclusively to adult males ; 
women and children almost exempt from this 
form of inflammation. A slight inflammation 
or congestion of the mucous membrane of 
the larynx is common in all ages and in both 
sexes, as the result of cold, damp, etc.; symptoms being, sore- 
ness, or rawness, hoarseness and a dry, harsh cough. But acute 

laryngitis is a grave, formidable and fatal 
affection, when it occurs in men whose 
nervous system has been shattered by 
worry, care, struggle for existence, and 
involves the mucous and sub-mucous 
coats. It is a paltry piece of human 
mechanism that is attacked, perhaps 
merely the fraction of an inch, but the 
inflammation is terrible and rapid in its 
results; congestion first, effusion of plas- 
tic lymph obstructing the chink of the 
rima glottis, preventing the ingress of air. The predisposing 
cause is, depression of the great sympathetic, whose branches 
freely cover the larynx in adult males ; the depression being some 
emotion, desire, affection, passion ; the exciting cause, exposure, 
fatigue, wet, poisons. 

Laryngitis, then, being peculiar to persons of a shattered 
nervous system, comes on very insidiously. At the end of a 
few hours, violent rigors, fever of a high grade, fauces red, 




A vertical section of the mucous 
membrane in acute laryngitis. 



BACTERICIDES. ^q^ 

swollen ; pain over the cartilaginous part of the throat ; great 
difficulty of breathing and swallowing ; patient very anxious ; 
hoarseness, and complete loss of voice; spasmodic exacerbations, 
with paroxysms of threatened suffocation ; long inspirations ; 
peculiar wheezing sound as if air was being drawn through a 
narrow tube; harsh, brassy cough; difficulty of swallowing; 
liquids more difficult to get down than solids, as they bring -the 
circular muscular rings into active exercise. Face and neck first 
flushed, then livid, subsequently purple ; eyes protruding ; pulse 
hard and frequent ; great distress. Larynx and trachea move 
rapidly upward and downward ; all the respiratory muscles 
brought into powerful action, so the chest heaves violently. Pa- 
tient grasps at his throat, gasps for breath, gets out of bed, will 
thrust his head out of the window. He soon becomes delirious 
or comatose, and dies from non-oxygenation of blood. The 
duration of the affection is from forty -eight to seventy-two hours. 
Almost invariably fatal. 

Treatment. — The importance of active treatment cannot be too 
strongly insisted on. Immediate relief is indispensable. Rest 
and quiet; forbid talking. Air of room to be kept at 75° Fahr., 
very moist, with warm vapor. Extract of belladonna in hot 
linseed poultices to throat. Inhalation of warm vapor of tinc- 
ture belladonna and iodine. Diet : cream, raw eggs, extract of 
raw beef 

Veratrum viride in three-drop doses every twenty minutes ; 
from twenty to thirty grains of sulphate of quinine every two 
or three hours, between which from a quarter to a half grain of 
sulphate of morphia. If necessary, open bowels with beef tea. 
No debilitating treatment to be used in acute laryngitis ; make an 
effort to guide patient over third day and run it into chronic 
laryngitis, from which he will recover. 



This is a very common form of 
Inflammation of laryngitis. Membrane lining laryngeal 
Larynx. cartilages becomes thickened, ulcerated, 

{^Chronic Laryngitis}) also involving the fauces and uvula. 

It may be caused by cold, damp, ex- 
posure, exertion, inhaling noxious gases, etc., and those condi- 
tions intensified by disease germs in the blood, as tuberculae, 
syphilis, mercury, lead, amoeba of catarrh. 

The ordinary symptoms are, general debility, cough, expec- 
toration, hoarseness, loss of voice, with ulceration of the mucous 
membrane of the larynx, fauces. The different varieties are to be 
recognized by the following landmarks. 

38 



^Q^ DISEASE GERMS. 

Simple chrofiic laryngitis, by soreness, rawness, redness. 

The syphilitic forrriy by its copper-colored appearance, and dry 
huskiness, microbe syphilitica. 

Mercurial form, by its dingy, metallic hue, and peculiar fetor 
of breath. 

Tubercular form, by its mottled appearance, bacillus tubercle. 

The profession or avocation of the patient will guide us as to 
the variety. Either of the forms may give rise to thickening, 
warty excrescences, and small polypi on different parts of the 
larynx, which aggravate the difficulty, cause impediment to the 
entrance and exit of air, and impairment or loss of voice. The 
sputum of chronic laryngitis is loaded with amoeba, which would 
necessarily cause it to be contagious and infectious. 

Treatment. — General principles must guide us in its different 
forms. Skin to be attended to by daily baths and friction ; bowels 
to be seen to, clothing to be woolen ; appetite to be stimulated, 
and diet to be rich in blood elements and very generous. Mouth 
and throat gargled with a wash of boroglyceride, chlorate or 
permanganate of potassa, three times a day. Atomized spray, 
warm vapor once a day, consisting of terebene, creolin, resorcin, 
or chlorate of potassa, or some other antiseptic. The use of 
demulcents, as gum-arabic water, elm water, flaxseed tea, marsh- 
mallow, white of eggs and common salt are to be recommended. 
Alteratives, as compound syrup of yellow dock, ozonized saxi- 
fraga, phytolacca, iodide potassa, and tonics, as cinchona, gly- 
cerite of ozone, ozone water, nux vomica. Tonics before meals, 
alteratives two hours after. Two points of suppuration to be 
kept active by the irritating plaster on side of spine below the 
nape of neck. 

Special Treatment as to Cause. — Muriate of ammonia, tere- 
bene, in the simple form ; iodide potassa, nitric acid and com- 
pound tincture cinchona, compound saxifraga and phytolacca in 
the syphilitic ; glycerite of ozone, compound hypophosphite of 
potassa, tincture iodine in the tubercular; iodide of potassa in 
the mercurial ; ozonized catarrh fluid, if due to catarrh. If no 
cause can bf^ ascertained, then a general alterative and tonic 
course should be inculcated and carried rigidly out; change of 
air, locality, diversity of scene, every possible means adopted to 
build up the general health. 

All cases of chronic laryngitis, irrespective of their cause, are 
greatly benefited by the comp. oxygen treatment — the remedy 
being an active microbicide — at the same time a powerful vital- 
izer of the larynx. It stimulates, aids a renewal of life in the 
various structures of which it is composed. 



BACTERICIDES. 



595 



Inflammation of the 
Liver. 

{Acute Hepatitis.) 



Partial death of the Hver may result 
from some obstruction through the 
hepatic and portal veins, as occurs in 
some forms of valvular disease of the 
heart, or morbid state of lungs, im- 
peding the passage of blood through the pulmonary artery ; or 
in diseases that diminish the capacity of the thoracic cavity ; or 
from violent exercise, or tight lacing; conditions that lead to 
diminished excretion of bile, so that the ducts become engorged 
with it, and thus cause biliary congestion. 

%^, Suppose this condition to progress, the patient receiving some 
mechanical shock over the liver, or that some diseased germs in 
the blood took up their abode there, or that it was subjected to 
the influence of solar heat, malaria, or to some depressing pas- 
sion or other nervous influence, or excessive eating and drink- 
ing of carbonaceous food, as fat, sugar, starch, alcohol, with 





Section of the liver in passive hypersemia. Hypersemia of the liver in the 

incipient stage of hepatitis. 

sedentary habits, a state of active congestion will set in ; other 
conditions might be enumerated, as the action of mercury, which 
produces atony of the walls of the vessels of the liver. 

From these remarks it will be readily seen that the causes 
of acute inflammation of the liver are varied and numerous, 
embracing mechanical irritation, obstruction from morbid 
changes, heat, malaria and other germs, carbonaceous food, 
drugs, mental depression ; in other words, anything that tends to 
devitalize. 

Symptoms. — General symptoms of languor, lassitude, debility, 
mental depression, loss of appetite or dyspepsia, tongue coated 
heavy brown coat, skin jaundiced, yellow conjunctiva, bowels 
constipated or irregular, a sense of constriction and weight over 
liver at first, it greatly enlarges from congestion, and the area 
of hepatic dulness increases ; liver extends below the ribs and 
across the hypogastrium ; headache, pain in back, calves of legs, 



596 



DISEASE GERMS. 



rigors, followed by high fever, which sometimes assumes a low 
type ; pain over region of liver, aggravated by pressure ; cough, 
deep inspirations, inability to lie on left side ; the coat on tongue 
becomes heavier, conjunctiva tinged with bile; there is nausea, 
vomiting, cough, difficulty of breathing, hiccough, pain in right 
shoulder and clavicle ; if the left lobe of liver suffers there may 
be pain in the left shoulder, dulness of the upper lobe of left 
lung ; urine is always scanty, high colored, loaded with bile pig- 
ment and traces of albumen. The variation and intensity of 
symptoms will depend a good deal as to whether the peritoneal 
investment or substance of the gland suffers most. Most gen- 
erally it is the substance of the gland that is affected. 

If the inflammation or .partial death is great it may lead in a 
short time to extravasation of blood into the hepatic tissue, or 
beneath the capsule, the result of great congestion, as takes place 
in bilious, malignant, remittent, or yellow fever. The extravasa- 
tion may be from the size of a pea to that of a duck egg ; in 
some cases the blood is infiltrated through its entire substance, 
converting the tissue into a pulpy mass. In less severe cases, 
even with the morbid action diffused through the entire organ, 
effusion of lymph may take place, which may lead to induration, 
with atrophy or enlargement, and ultimately softening or abscess. 

The formation of abscess is ushered in with distinct chills 
after the inflammatory stage has proceeded some time, with hec- 
tic fever, great disturbance of the stomach, with extreme pain 
and tenderness over both liver and stomach and abdominal 
walls; feeling of weight about the liver, emaciation, prostration, 
diarrhea or dysentery. 

Treatment. — Inculcate the general principles of treatment for 
fever, complete rest in bed, sponging the entire body three times 
daily with some aqua ammonia and tepid water, drying and rub- 
bing well, and then sponging with nitro-muriatic acid water, heat 
to feet ; first apply a large mustard plaster over region of liver 
and stomach, and as soon as erythema or redness is produced, 
paint over the inflamed part with croton oil, and over that a hot 
flaxseed-meal poultice ; change poultices every three hours. As 
the stomach is irritable, lime-water and milk ; control fever with 
very large doses of the tincture of green root of gelsemium with 
veratrum and aconite ; as soon as pulse is about 70 leave vera- 
trum and aconite out, and hold on to gelsemium ; as soon as 
stomach will contain drink, oatmeal-gruel and phosphate of soda, 
and six-drop doses of nitro-muriatic acid in water every three 
hours. If stomach is persistently irritable, use small quantities 
of ipecac and morphia ; if there is dysentery give one or two 
large doses of quinine, and to render the stomach more tolerant 



BACTERICIDES. 



597 



add about a grain of pulverized opium to the dose ; get control 
of the more acute symptoms, and never mind diet, and even 
when given it must be greatly restricted. If there is constipa- 
tion, enemata, or a small dose of compound licorice powder, or 
a drink of the acid tartrate of potash. 

Great care and good discrimination are necessary in the selec- 
tion of the proper remedy and dose. 

If case progresses favoradfy, establish conv3ilQscence upon com- 
pound tincture cinchona and nitro-muriatic acid, fluid extract of 
chionanthus virg., and nux, or leptandra and salines. 

If suppuration takes p/ace, support the powers of life with most 
nutritious food, cinchona and mineral acids, quinine ; poultice 
assiduously. The peritoneal coat of liver becomes adherent to 
the abdominal wall at points, and, as a general rule, it is best to 
let it burst spontaneously; they do better than those that are 
punched by grooved needles, or trocar and canula, or even the 
aspirator. 

Chronic inflammation of the liver may 
Inflammation of be a sequel of either active or passive 
The Liver. congestion ; it may present itself with 

{CJironic Hepatitis}) either hypertrophy or atrophy, but in 
either case indurated or hard. Various 
names have been applied to it, as indurated liver, interstitial 
hepatitis, granular liver, gin-drinker's liver, hob-nailed liver, from 
the fact that the capsule of the gland is 
drawn in here and there over it, owing 
to contraction of thickened connective 
tissue, giving it the appearance of hob- 
nailed ; and some call it cirrhosed iver, 
because on slicing it after death it pre- 
sents the grayish yellow color of impure 
-J beeswax. The term chronic inflamma- 

tion is the best. 
Section of the liver in chronic Caiises. — Solar hcat, malarial germs, 

^'^^^^^'^- carbonaceous food, disease of the heart, 

lungs, etc. ; mental depression, articles of dress, as tight lacing, 
violent muscular exercise, use of mercury, whiskey or beer, which 
retards its function, and excites irritation directly in its substance; 
impure air, inattention to bowels and skin, want of exercise. 

Symptoms. — There is a general lethargy of the entire body ; 
skin is sallow — in rare cases sHghtly jaundiced ; the white of the 
eye tinged with bile ; tongue coated with white and brown coat ; 
breath fetid ; copper taste in mouth ; usually constipation and 
clay-colored stools; urine scanty, high-colored, with bile pig- 




598 



DISEASE GERMS. 



ment and traces of albumen ; skin is dry and harsh, burning in 
hands and feet ; often sweaty feet, with pungent odors ; sebaceous 
glands of nose, axilla, groin, active, giving those parts a greasy 
feel ; skin not only sallow, but assumes an unhealthy look. 
After disease has lasted some time, dyspepsia, flatulence, consti- 
pation, with feverishness by spells and headache. There may be 
nausea or loathing of food — a sense of constriction and weight 
over liver ; there is an increase or decrease in size, usually the 
former, from effused lymph in its interstitial structure. This 
lymph blocks up, interferes with the flow of portal blood and 
escape of bile. In enlargement, area of dulness greatly in- 
creased ; if it contracts and lobules atrophy, the gland diminishes 
in size ; piles, enlargement of spleen, pain, perhaps, over region 
of liver ; if not, then it will be experienced in right shoulder and 





Cells filled with pigment matter, in yellow 
atrophy of the liver. 






Hepatitis suppurative, where, the inflam- 
mation has terminated in multiple abscess. 



clavicle. Passive congestion of the upper lobe of right lung, 
and dulness on percussion ; irritative cough. As the case pro- 
gresses, symptoms become more aggravated, and debility, with 
loss of flesh, takes place. An increasing contraction or obstruc- 
tion from effused lymph takes place, and dams back portal circu- 
lation, and ascites supervenes. Jaundice is now decided ; dilata- 
tion of the veins of abdominal walls ; hemorrhage from nose, 
stomach and bowels often present; indeed, a bleeding from nose 
and stomach might be an early symptom, and often occurs be- 
fore the disease is suspected. 

After the disease has lasted from a few months to more gen- 
erally ten or twenty years, the debility and anaemia become great, 
dropsical effusions in the abdomen and limbs increase, and death 
takes place either from exhaustion or some complication, as 
pneumonia, peritonitis, jaundice, toxaemia, diarrhea. 

Treatment. — Medical statistics exhibit the fact that nearly two- 
thirds of our entire population, young and old, men and women, 
are affected with chronic inflammation of the liver. Now, this is 



BACTERICIDES. 



599 



due in a very great measure to our hot, or tropical climate, ma- 
larial atmosphere, excessive struggle or brain work, whiskey and 
beer-drinking, hog-eating, starchy and saccharine feeding, 
tobacco-chewing, mercurial drugging. Our first aim in a cure, 
therefore, consists in discarding all these agents ; forbid mental 
anxiety, a total disuse of fat, sugar, starch, whiskey or beer, 
tobacco, mercury, etc. ; and besides, tea, curry and all high- 
seasoned dishes. Plain animal food, milk, eggs, white-fish, fruit, 
and vegetables ; daily bathing, flannel clothing, open-air exercis- 
ing, horse-back exercise ; well ventilated apartments ; bowels to 
be opened once or twice daily ; irritating plaster to be worn 
pretty steadily over liver ; an alterative and tonic course incul- 
cated ; such alteratives as saxifraga, tag alder, alums, comfrey, 
dulcamara, elecampane, blue flag, leptandra, podophyllin, stillin- 
gia, iodide of potassa, and iodide of sodium; and as tonics, cin- 
chona, mineral acids, hydrastis, columbo, collinsonia. Besides 
general alteratives, all bearing upon the liver, stimulating a re- 
newal of life in that gland, the tonics should be selected with the 
same view, the alteratives administered two hours after meals, 
and the tonics half an hour before — both freely diluted with 
water, and changed weekly. Digestion should be looked to, and 
gentian and pepsin and other remedies to strengthen .the stom- 
ach. The special remedies that stimulate the liver, break down 
and absorb lymph, can usually be run in either in the alterative 
or tonic form, such as 

Phosphate of Soda : Used in all articles of diet instead of com- 
mon salt, is invaluable in promoting a free flow of liquid bile ; it 
should never be omitted in treatment. 

Nitro-muriatic Acid: One of the very best of liver stimulants, 
in six-drop doses in compound tincture cinchona ; used for 
about a week, discontinued for a few days, and then re-com- 
menced ; its action on the connective tissue of the liver is in- 
valuable. 

Sulphur : Always and persistently from one form to another ; 
an invaluable liver stimulant. 

Chionanthus Virg., or fringe tree, is superior to all vegetable 
liver stimulants ; much superior to mandrake, blue flag, leptan- 
dra, taraxacum ; very mild in its action. Phytolacca is an ad- 
mirable cholagogue in small doses. 

Nux vomica is not to be discarded. Iodide potassa, ozonized 
glycerine, ozone-water, should be given all through the case. 

In addition to the special treatment for rousing up the liver 
with special remedies, I have found the use of the white mustard 
seeds of great value in doses of from one to two teaspoonfuls of 
the seeds whole — never pulverized— in a little water or muci- 



5oO DISEASE GERMS. 

lage one hour before each meal. It is an invaluable remedy 
when the liver and stomach are sluggish ; when there is great 
debility, loss of appetite, failure to sleep, depression of the nerves. 
The mustard seed gives new life to the liver ; promotes a good 
biliary secretion. In that form of chronic inflammation of liver 
due to the use of whiskey, and when the stomach coats are 
pretty well eaten, it can be used with splendid success. In the 
malarial form its action is beyond description. Its use should 
be continued for six or more months after recovery has taken 
place. 

Kiirchicine is another remedy of inestimable value in the 
chronic inflammation of liver due to heat, malaria, and carbon- 
aceous food or drink. It is extensively used for those terrible 
forms of bilious fevers so common in the swamps of Hindostan. 

When degeneration of hepatic cells is suspected, iodoform 
ointment, instead of irritating plaster, ozonized glycerine and 
water, nitro-muriatic acid; and if stubborn, apply ozonized clay. 

If there is hemorrhage, the sulphuric acid and turpentine 
mixture, gallic acid. 

For ascites, general treatment for dropsy — digitalis, squills, 
pilocarpin, diaphoretics, diuretics, etc. (See Dropsy}) 



Inflammation of the substance of 

Infliammation of the the lungs is one of the most com- 

Substance of mon affections that we meet with, 

the Lungs. especially in the spring, fall, and in- 

(^Acute Pnenino7tia) deed at all seasons of the year. 

The predisposing causes are in- 
tense nervous depression, especially of the great sympathetic, 
debility, exhaustion. 

The exciting causes are cold, wet, inhalation of irritants, 
mechanical violence. 

The usual point of microbe evolution is just where the 
branches of this nerve are most numerous, to wit, the lower lobe 
of the right lung. 

Inflammatory action and microbe evolution may be limited 
there, or it may spread in every possible direction. 

One of the most important micrographic discoveries of the 
present time is that a microbe is always present in inflammation 
of the lungs or pneumonia. 

The microbe of pneumonia is found in the lungs of pneumonic 
patients, either detached or encysted in the lymphatic cells, and 
in the blood and sputum. Under a strong magnifying power this 
micrococcus is seen to be shaped like a lance head, and short 



BACTERICIDES. 



60 I 



W^^t 



V-V^i-yX- 



^fi^ 



Interstitial pneumonia 



rods terminating- in a cone, are found wi h it. The micrococcus 
is the early form of the microbe, which becomes a bacillus in the 
adult form. 

The presence of a microbe in pneumonia explains many facts 
which have hitherto remained obscure in this disease, especially 
epidemics, also the remarkable resemblance between that of man 
and the contagious pneumonia of cattle. 

The origin of the microbe of pneumonia in man is no doubt 
due to intense nervous strain, worry, exhaustion, especially neu- 
rasthenia of the great sympathetic, which is so freely reflexed on 
the face, larynx, heart, lungs, spleen and internal viscera of the 
Caucasian ; that owing to some adverse 
state or condition, the bioplasm, the living 
matter of nutrition of the great sympathetic 
is either changed, or altered, or degraded 
into other living matter, a disease germ, the 
microbe of pneumonia, which is capable of 
prodigious growth, and multiplication, an 
independent existence in or out of the body 
if warmth and some nutritious pabulum be 
present. 

Once it has suffered evolution and become a microbe, it can be 
propagated by contagion and infection, Uke all germ diseases. 

The partial death of the great sym- 
pathetic induces the evolution. 

Cultivations of the pneumococcus 
on boiled potatoes and in meat juice 
yield immense crops, which if in- 
jected into or are fed to any animal 
produce pneumonia. 

The career of this germ does not 
differ, when it is the sequel of other 
maladies, such as typhoid, etc. 

Later on, when the lungs or lobules 
have become transformed into a solid 
structure, gray hepatization, masses 
of micrococci may be found in the air 
cells, even growing into the blood 
vessels, in which stasis had set in. 

Aside from the pathogenic microbe, 
we find in the sputa, blood, mucus, 
epithelial cells, granular protoplasmic masses, elastic fibres, etc. 
None of these bear cultivation. 

All cases are ushered in with a rigor less or more violent. 
Pneumonia is met with in the foUowincr forms: Acute, sudden 




Perfect adult form of the pneumococcus 
magnified 2000 diameters ; A and B, 
thread forms ; C, D and E, rod forms ; 
G, aiplococci ; H, cocci, I, strepto- 
cocci. The pneumococcus consist of 
cocci, ellipsoidal or round, single or 
in pairs fdiplococci), rods and thread 
forms, all enclosed in a cell membrane 
or gelatinous capsule. 



6o2 



DISEASE GERMS. 



in its seizure, and attended with fever; sub-acute, of the same 
character, but the vital forces of the patient being vigorous, resist 
the local irritation, consequently there is no fever ; or chronic^ 
which may be a sequel of either of the former, or come on of 
itself from slight irritation in patients whose constitutions are 





Micrococci of the pathogenic ; microbe 
of the pneumococcus seen in differ- 
ent stages of growth in the prune 
juice ot the sputum prior to the 
rigor. 



The appearance of the pneumococcus prior 
to the rigor in acute pneumonia. The 
microbe will disappear from the sputum 
in less than two hours with concentrated 
ozone ove; the germ.-smitten lung. Inha- 
lation of comp. oxygen. 



feeble. It is called lobular, when confined to one lobe ; single, 
when confined to one lung ; double, when both lungs are involved ; 
pleural, when the violence comes from without and proceeds in- 
ward, affecting the pleura first, then the lungs; and typhoid 





The micrococci, as seen microscopically in the prune juice sputum of pneumonia ; b, d, free or 
encysted in expectorated lymphatic cells. 

pneumonia, when the powers of life are low, and the typhoid 
germ is developed, giving us inflammation of lungs with typhoid 
fever. 

A case that is permitted to run its course has three distinct 
stages, viz. — congestion, red hepatization and gray hepatization. 

General Symptoms in First Stage. — Great nervous prostration, 
with pain in the head, back, calves of the legs, with cough, short- 
ness of breath, rusty, or prune juice sputum, or streaks of blood, 
or hemorrhage, restlessness and anxiety, violent rigors and high 
grade of fever, with aggravation of symptoms ; pulse 140 to 160, 
heat 105° Fahr., respiration 40; flush on cheek or cheeks, nostrils 



BACTERICIDES. 



603 



dilated, tongue coats heavily with a brown coat, nausea, great 
thirst, loss of appetite. Cough becomes worse, sputum viscid 
and bloody, pain in the affected lung, with frequent but dis- 
tressed breathing, skin has a dry pungent heat, sometimes 
delirium. 

As this is the stage of filling up or engorgement, the affected 
lung which was clear and resonant gradually becomes dull on 
percussion, and crepitation to a variable extent is distinctly 
heard. If the pleura is involved, friction sounds can be detected ; 
there is exudation into the air-cells and proliferation of their 
lining epithelium. This stage may last a few hours to a week or 
longer. 

General Symptoms in Second Stage. — If the inflammation pro- 
ceed, it passes into the stage of red hepatization, in which all 
the symptoms of the first stage are still present and more decided ; 
there is in addition likely to be blueness or lividity of the skin, 
delirium or coma from non-aeration 
of blood. The air-cells are choked ^*§ 

by coagulated exudation of blood ^ ^ ^ ^ ^ 
and lymph ; the spongy character ^ o • '^ o O 

of the lung is quite lost, and it ^ \;) ^ ^ ® a 
becomes solid as a liver, neither ^ ^ , ^ ^ /^ 

minute crepitation nor vesicular '^^ ^ ' jf J^ '^s 



murmur can be heard. There is /fj •*«» ^ 3 

perfect dulness on percussion and ^ ^ a ^\ *" 

no intercostal movement ; bron- / • ^ 

chial or tubular breathingr, with Some cf the pnt^umococcns in the secon 1 

, . ° - stage, surrounded by a capsule. 

vocal vibration communicated to 

the walls of the chest by the solidified lung and felt by the hand 
over the ribs unless there be water in the cavity of the chest. 
The duration of this stage is from a week to a longer period. 

General Symptoms in the Third Stage. — If the inflammation 
still progresses, and the patient does not die in the second stage, 
then the third or gray hepatization supervenes ; then we have a 
complete change of symptoms. Fever abates ; heat, pulse and 
respirations often low ; rigors ; profuse colliquative sweats are 
common ; the flush .on cheeks and other physical signs disap- 
pear, and it looks as if amelioration was taking place ; whereas, 
we have the grave process of suppuration of the substance of the 
lung ; diffuse suppuration of pulmonary tissue, with parts re- 
maining dense and impermeable; it is hard to drag through 
with incessant cough ; thick, ropy, tenacious pus. In some cases 
the pus liquefies, and is expectorated, air begins to re-^nter the 
affected lung, and resonance and a healthy vesicular murmur is 
restored. Often cases will, during the first and second stage. 



6o4 



DISEASE GERMS. 



take on a typhoid condition. The tongue will become of a buff 
leather appearance, very dry and parchy, or it may become red, 
like a piece of raw beef, or simply red aftip 
and edges, with elevation of papillae; the char- 
acter of the pulse changes to small, wiry and 
frequent ; bowels generally in pneumonia are 
constipated, but when typhoid symptoms 
threaten, diarrhea, sordes on the gums, petechia 
on skin, eyes sunken, nostrils pinched, face 
white, gurgling in right iliac, and tympanitic 
state of the abdomen. 

No definite rule can be laid down as to its 
duration. About two-thirds of cases run thus: 
a week of infiltration or filling up, a second 
week in perfect consolidation, and a third in 
gray hepatization, which terminates in suppura- 
tion, extending over a period of months. 

In any of its stages it is easily recognized ; 
in the early stage its history, flush on cheek or 
cheeks, the rapid mal-assimilation, the anxiety 
or distress, the cough, difficulty of breathing, 
the rusty sputum or blood, pain in side, dul- 
ness on percussion at base of lung proceeding up, lack of inter- 
costal movement, tubular breathing, rigors, fever, purple or livid 
appearance of skin, delirium, coma, etc. 

As a very vital organ is smitten, pneumonia must be regarded 
as a grave affection, if it has passed the first stage ; imperfect 




Diagram showing; red 
hepatization of the 
lung: pneumococcns 
changing into the 
streptococcus pyo- 
genes. 




% 



*i^l^^gpp^ 




Capillary net-work in the human 
lung. 



Section of lung, showing a single 
alveolus in red hepatization. 



oxygenation of the blood gives rise to so many complications, 
besides delirium, coma and lividity of the lips, nose, hands, 
face, as embolism in brain and heart, that render all cases very 
dangerous, and our prognosis must be guarded. 

In ppite of the great improvement in modern therapeutics, the 
death rate of pneumonia has been steadily on the increase. The 
pathology of the disease must be better appreciated ; we have 



BACTERICIDES. 



605 



not only a vital organ smitten by a deadly microbe-infarction ot 
the lung by the micrococci, non-aeration of the blood the result ; 
skin, kidney, and other excretory organs, imperfectly, feverishly 
perform their work; springs feeding the smaller and larger 
glands run dry ; the feverish nerve centres repel the vital atoms 
of the great sympathetic, are wrecked by germ evolution. The 
blood requires aeration, oxygen, ozone. 

In all cases of acute and chronic pneumonia, there are to be 
found in the blood, in the infiltrated lung, in the sputum, and all 





Section of lung in the second stage of lobar 
pneumonia, showing the pneumococcus 
aggregated together in patches. 



Vertical section of the lung as seen in 
the second stage of pleuro-pneumo- 
nia. 



the glands of the body the microbe pathogenic of the disease ; 
even the sputum in the early stages is loaded with the micro- 
cocci, which gives it the peculiar characteristic brownish prune- 
juice tint. This is most common the first seven days from the 




Lobular pneumonia, alveolus from lung; 
the capillaries distended with the mi- 
crobe. 




Section of lung, second lobar 
pneumonia ; the pneumo- 
coccus actively throwing off 
spores. 



rigor, later on they decrease in number, until about the four- 
teenth day when their presence is usurped by vibrios. 

Treatment. — Perfect rest in bed in a room whose atmosphere 
is kept moist by steam, and at a temperature of 70° Fahr. If 



6o6 



DISEASE GERMS. 



there be constipation, enemas and a dose of castor oil. Having 
ascertained the extent of the damaged lung, wet cups should be 
freely and closely applied over the part, and free bleeding from 
cups encouraged by hot fomentations, and then followed by hot 





Section of lung, showing a single alveolus in the 
first stage of pheumonia, with the pneumo- 
coccus actively sprouting. 



Section of lung, with the 
streptococcus pyogenes ; 
third stage of pneumo- 
nia. 



poultices of flaxseed meal. This is a better local stimulant than 
turpentine or mustard. Poultices shoulci be changed every three 
hours, spread about half an inch thick, and in size to cover a 
little beyond affected part, so that if both lungs are affected it 
will form a regular jacket. Poultices should be covered by oiled 
silk. Over and above all, there should be a firm flannel roller, 
wide enough to extend from the arm-pit to the bottom of chest. 





Pyaemia (streptococcus pyogenes) ; 
abscess in the lung. 



Microbe of croupous pneumonia in mem- 
branous croup. 



It should be pinned evenly and firmly, beginning at neck, insert- 
ing a pin every inch, and proceeding down to the bottom, so as 
to confine the ribs, stop intercostal movement, and cause the pa- 
tient to breathe by the diaphragm. Outside of all, bladders 
filled with hot water should, as far as practicable, be placed at 



BACTERICIDES. 



607 



the sides, so as to keep heat in poultice. Patient must not be 
permitted to lie too long in one position, as it gives the blood a 
tendency to gravitate into the weakened lung structure and con- 
geal ; a change is very beneficial every two or three hours ; 
heat to feet, and general treatment for fever ; diet, warm milk, 
with about five grains of bicarbonate of potassa to the half tum- 
bler full, instead of lime-water, and warm beef tea, one or other 
at regular intervals every hour; no other diet of any efficacy ; 
eggs and oysters strictly prohibited ; drinks are to be warm, and 
mucilaginous, as flaxseed, etc. 

There are, now, three drugs that must be unsparingly and 
persistently given, and these are, veratrum viride, opium and 
sulphate of quinine. 

A tablespoonful of tincture of veratrum viride, same amount 
of sweet spirits of nitre in four ounces or half a tumbler of 
water, of which one teaspoonful should be administered every 
half hour till pulse reaches sixty-five, and then at intervals of 
two or three hours, so as to check the current of circulation, so 
that when it passes through a weakened tissue effusion cannot 
take place; a balance maintained, a heart controlled, and by its 
influence on the connective tissue of lungs, prevents inflamma- 
tory action spreading into fresh parts. In some cases it is 
advantageous to combine a teaspoonful of tincture of aconite in 
the mixture ; to be continued as long as there is any fever. 

Opium or its alkaloid should be given in every case of pneu- 
monia. It aids the action of the veratrum, prevents irritation, 
and so neutralizes the action of that drug that we are enabled to 
give it in larger doses. Besides, opium acts as a stimulant to the 
great .sympathetic that so fully covers the lower lobe of the right 
lung and heart. As soon as the veratrum is commenced, begin 
with the opium every three hours, and continue at regular inter- 
vals. The painful oppression of the chest and hacking cough 
soon disappears ; the noisy and frequent respirations soon become 
quiet and slower ; the cyanosis of the face and lips gives way to 
flush; the dry, scorching skin becomes cool and moist; the 
heart regains its normal force and regularity ; its impulse, its 
sounds, its murmurs with the lung difficulty subside almost com- 
pletely. It also counteracts the abnormal quantity of carbonic 
acid in the blood, and with the attainment of that object, languor 
and drowsiness disappear. Whether the crude drug or its alka- 
loid is selected, it must be borne in mind that the condition of 
the stomach is such that absorption is slow and imperfect ; so to 
obtain readily the desired effect, it is best to administer it with 
an alkali ; to facilitate its absorption and soften the effused pro- 
ducts in the lung, such as opium pulverized, ten grains ; Dover^s 



6o8 DISEASE GERMS. 

powder, thirty grains ; nitrate of potass, one drachm. Mix. 
Make twenty powders ; one every three hours ; or if the alkaloid 
is prefefred, take one ounce of lemon juice ; carbonate of potassa, 
enough to saturate ; add to one ounce of cinnamon-water, to 
which add one grain and a half of morphia. Dose, one tea- 
spoonful instead of the opium. The effects of potassa on the 
lungs is very marked indeed. 

The next drug is quinine, without which there can be no suc- 
cessful treatment of pneumonia. Its action on the brain and 
great sympathetic is good, but in pneumonia the size of the red 
corpuscles of the blood is diminished. Quinine restores them 
to their normal shape. Its presence in the blood is most salu- 
tary, when loaded with carbonic acid, in diminishing tempera- 
ture. The dose should be such as will give a result, and con- 
tinued, as it is freely eliminated by the kidneys, in alternation 
with the opium. 

To relieve cough, a mixture of equal parts of syrup ipecac, 
squills, wild cherry and tolu, with muriate of ammonia, in half- 
teaspoonful doses. If there is tremor of hands, quivering of 
tongue, or delirium, alcohol in the form of brandy and milk or 
wine must be given. 

The important micrographic discovery has been made that a 
microbe is always present, hence the necessity of a more efficient 
bactericide treatment, which we hereby submit : 

Germicidal Remedies which have been demonstrated to cause total dis- 
appearance OF the Pneumococcus from the blood, sputum, lunc. 



Internal Remedies. Local Remedies ovei' the Gervi smitten 

I.ung. 

Exalgine, sufficient doses and frequency 

to keep pulse at 65 or 70. Concentrated ozone painted over the area 

The gluc< side baptisin, triturated with of dulness and beyond, followed with 

an equal quantity of sulphate of qui- hot linseed meal poultices in which 

nine added to aromatic sulphur and resorcin and boroglyceride and opium 

water. are freely incorporated, changed fre- 

Ozonized tar syrup, or the syrup of quently. If this is not applied, ozon- 

Tolu with chloride of ammonia, resor- ized turpentine, till an erythema is pro- 

cin, benzoate of soda, opii et ipecac et duced, followed with hop poultices in 

camphora et resorcin. The combina- which resorcin and peroxide of hydro- 

tion administered in small doses fre- gen are incorporated lodol incorpor- 

quently repeated, so as to maintain a ated in ozone ointment rubbed into the 

sort of comatose condition, during chest, and also spread on leather ap- 

which the germ dies. plied. 

Comp. concentrated tincture of kurchi- A jacket of resorcin jelly is most effica- 
cine, no fluids permitted, micro-organ 



cious. 



isms disappear. Kurchicine con. con- 
tains 20 atoms of carbon and is more 
powerfully germicidal. 



BACTERICIDES. 



609 



Compound oxygen, administered by the atomizer, is of infinite 
value, as by this method we bring it into immediate contact with 
the seat of the disease, thus carrying out the principle of direct 
medication, and thus sterilizing the micrococcus in the pulmonary 
tissue. The results obtained by its use are immediate, eminently 
gratifying and satisfactory to both patient and physician. In the 
first stage of pneumonia, when the prune-juice sputum is abun- 
dant, it should be inhaled every half hour or hour, according to 
the urgency of the case. Do not wait until cyanosis appears. 
A few inhalations lower heat, quiet the heart, diminish the rapid 
respirations ; thus enabling the patient to breathe easily, promote 
free and abundant expectoration. 

To obtain good results in chronic lung affections, as in asthma, 
bronchitis, tuberculosis, inhalations for twenty minutes, three 
times a day, are best. 

The action of the compound oxygen is that of a germicide, 
by either the sterilization or annihilation of the microbe, sub- 
stantial results are obtained ; the germs become passive or dead ; 
the embarrassment in breathing is overcome ; free and abundant 
expectoration takes place ; the cough becomes less and less ; 
the obstructed germ-laden air cells become clear ; the cold is 
cleared up ; additional breathing areas are opened up, and. respira- 
tion becomes full and deep. 

The inhalation of this remedy reddens up the blood, frees it 
from the presence of all disease germs, even neutralizes the 
ptomaines of numerous microbes ; thus the nervous system 
becomes rejuvenated ; appetite is stimulated in a most re- 
markable degree. 

Delirium, coma, blueness or lividity of skin due to deficient 
aeration of blood; tincture of belladonna with a solution of ace- 
tate of ammonia to maintain fluidity. 

With the above treatment, during the stage of congestion 
and the early part of red hepatization, all signs of consolidation 
of the lung will give way and become absorbed, leaving the 
walls of the air cells unimpaired and elastic as before. Re- 
covery is perfect, the breathing being mechanically and physio- 
logically performed as in health. Neither is the interlobular 
structure altered, and there is no permanent thickening of the lung 
or bronchial tubes. 

The products of inflammation in a congested lung consist 
chiefly of exudation of fibrine, with liquor sanguinis, white and 
red corpuscles, and perfect absorption takes place. But some- 
times cases have progressed too far, and about the end of the 
second week a change takes place ; temperature goes down ; 
there are rigors and sweats, and there is thick, viscid or muco- 

39 



5io . DISEASE CiERMS. 

purulent matter expectorated, and the physical signs tell us that 
the lung is still solid but undergoing grave changes; the air 
does not penetrate ; bronchial breathing still continues, but 
changes which indicate softening and ulceration begin to 
appear. 

Now our treatment must be changed to an alterative and tonic 
course, including iodide of potassa, tincture of iodine and am- 
monia ; irritating plaster, so as to keep an open discharging sore 
over the consolidated part ; diet changed to milk, cream, raw 
eggs, animal food. 

If during an acute attack there are the slightest indications of 
typhoid symptoms, antiseptics at once ; brewers' yeast in milk, 
tincture of iodine and carbolic acid, as in typhoid fever ^ every 
hour. 

The degraded living matter in pneumonia is the pneumococcus, 
which is to be found all through the case in different stages of 
growth and development. 



In a large number of cases patients, 

Inflammation of the when properly cared for, will recover 

Substance from acute pneumonia apparently 

of the Lung. well, but with some portion of lung 

{^Chronic Pneiunojiia) damaged; that is, weakened, or he 

may recover with a lobe perfectly 
consolidated, in which condition it may remain for years; or the 
products of inflammation may break down and recovery take 
place ; whereas, in another class of cases, the non-aeration of 
blood and local irritation tells badly on the nerve-centres, and a 
degradation of living matter takes place, and we have the tuber- 
cular germ, or in other words, the ulcerative process of pneu- 
monia changes into that of consumption of lungs — tubercular. 
It makes little difference how the inflammation originally started ; 
its termination, unless managed with the very greatest nicety, is 
apt to take that course. 

The treatment of chronic pneumonia is the same as should 
take place following any and every case of acute until the lung 
clears. Diet nutritious and generous, flannel clothing, daily 
bathing, followed by inunction of oil; bowels regulated, appetite 
stimulated with tonics ; irritating plaster to be kept all the time, 
if possible, over the seat of consolidation. Encourage free suppu- 
ration. Iodide of potassa, carbonate of potassa in alteratives. 
Expectorants in sufficient quantity to keep down cough. In 
other words, a tonic and alterative course. 



BACTERICIDES. 



6ll 



The very great prevalence of purulent 
Inflammation ophthalmia and stomatitis among the 
of the Mouth. children of the crowded sections of our 
large cities and our public schools demand 
mare than a passing notice. Both affections are either directly 
due to a special degradation of bioplasm, or to contagion and in- 
fection; in the eye, the normal elements of nutrition are changed 
or altered into bacteria proper, whereas in the mouth, though 
the bacteria be abundant, the 
degraded elements are the 
oidium albicans. 

The causes which give rise to 
a partial death of mucous mem- 
brane of the mouth are the de- 
pressing effects of insanitary 
states, and the crowding of large 
bodies of children into small 
areas with meagre or insuffi- 
cient, bad or deleterious food, 
bringing about a perversion of 
nutrition, the degradation, the 
germ, and then its spread by 
contagion and infection, espe- 
cially by the indiscriminate use 
of drinking vessels. 

Inflammation of the mouth or 
stomatitis with its special micro- 
organism is met with in three 
forms or stages which are simply 
degrees of microbe growth. In 
the primary or first state, the 
diseased germ aggregates in the 
follicles of the mucous mem- 
brane of the lips, cheeks, gums, 
fauces, and appears in the form 
of little vesicles or blisters, and 
is termed follicular ; when those vesicles rupture, the germs are 
let loose and spread in all directions, hence it is termed ulcera- 
tive ; if vital force is decidedly lower, insanitary surroundings 
wretchedly bad, the ulcerative patches may become gangrenous. 
The symptoms which attend this degradation and germ evolu- 
tion in the mouth are general prostration and debility, with in- 
flammation of the mucous membrane of the oral cavity, tender- 
ness, the formation of vesicles, on lips, cheek, gums, tongue, 
lauces — the encysted germs in the follicles or vesicles rupture 




'^'''^^^m^^' 



The mouth widely opened so as to show the 
palate; i, i, the upper, 2, the lower lip ; 
3, 3, hard palate; 4, 4, soft palate; 5, 
uvula : 6, 6, the arches of the soft palate ; 
7, 7, the tonsils ; 8, the tongue. 



6l2 



DISEASE GERMS. 



their sacs and spread (if vital force be low, surroundings bad,) in 
every direction, giving rise to phagedenic ulceration. There is 
usually a copious flow of saliva, amounting to salivation ; great 
fetor of the breath, mal-assimilation, restlessness, fever, loss of 
appetite, and as the germs descend into the stomach and bowels, 
most offensive stools. The patches in the mouth are covered at 
first with a dirty, yellow plough ; subsequently, the patches of 
infiltrated mucous membrane are purplish, and the ulcers covered 
with a layer of pulpy grayish matter ; if the disease is permitted 

to progress, the germs become 
spongy, teeth loose. 

As the affection is essentially 
one of germ evolution, the great- 
est precautions should be ob- 
served in isolating the patient, 
in surrounding him with an at- 
mosphere of germicides. 

The essential points in treat- 
ment are to kill the germ, and 
by every possible means raise 
the standard of vital force, so as 
to prevent its further evolution 
and growth. 

The mouth should be washed, 
throat gargled about every hour 
with either a teaspoonful of a 
saturated solution of borogly- 
or potassa added to half a tum- 
bler of tepid water or infusion of sage or thyme, and internally 
every three hours, five or ten grains of resorcin dissolved in 
water; or a few drops of peroxide of hydrogen. 

A good blood-elaborating diet, embracing cream, eggs, beef 
juice and other nourishment. 




The oidium albicans present' in stomatitis. 

ceride, or chlorate of carbon 



Onychia, or inflammation of the root 
or matrix of the nails, may arise from me- 
chanical injuries, as contusions, spicula of 
bodies penetrating the mother of the nail, 
corns, etc. ; or it may arise from greatly 
broken-down states of the constitution, as 
in tuberculosis. 

Symptoms. — Pain, swelling, and suppuration at the root of 
nail or nails, and about the surrounding texture. Exudation of 
sanious, or purulent discharge, on pressure of the nail ; ulcera- 



Inflammation 

of the 

Matrix of Nails. 

{Onychia}) 



BACTERICIDES. 



613 



tion ; nail becomes raised and finally detached, revealing a foul 
ulcer, with the most intense fetor. The disease-germ, oidium 
albicans is present, — a true rot. Ulcer becomes glazed, irritable, 
eating and spreading in all directions, even down to the bone, 
when the vital forces are at a low ebb. 

Treatment. — Poultice with linseed and yeast ; wash, by drip- 
ping hot permanganate of potass lotion on the ulcer, by com- 
pressing a sponge, morning and night. Remove nail as soon as 
possible ; continue cleansing sore, morning and night, with 
permanganate wash. Dress during the day with either the 
black salve, vaseline, or ozone ointment, iodoform. Place pa- 
tient upon a general course of alteratives and tonics with nour- 
ishing food, fresh air, hygiene, etc., when the difficulty can be 
traced to tuberculae, glycerite of ozone especially ; if to syphilis, 
ozonized phytolacca, and iodide of potass ; if to mercury, tonics 
and iodide of potass. 



The causes of catarrh, or common 
Inflammation of the cold, may be grouped under two 
Lining Membrane main divisions — y\z., predisposuig -axvA 
of the Nose. exciting. Among the former must be 

mentioned youth ; for it is a well 
known fact that old persons are practically exempt from this 
malady. Many individuals appear, moreover, to possess a cer- 
tain idiosyncrasy as regards the affection. It is not uncommon 
among the gouty, and in persons whose nervous system is in a 
condition of unstable equilibrium, and among those with a 
strumous diathesis, or predisposed to asthma. Hay fever would 
often appear to be a connecting link between asthma on the one 
hand, and catarrh on Mie other. Climatic conditions and sudden 
changes of temperature, not necessarily from heat to cold, but 
sometimes the reverse, must also be noted. 

The most common exciting cause is without doubt the action 
of damp cold, more particularly if the body be heated and per- 
spiration active. Sometimes simple transition from warm to cold 
air will be enough to induce an attack ; at others the prolonged 
action of cold is required, especially on the feet, and in bald per 
sons on the head. Heat, either as solar heat, or the elevated 
temperature of a warm room, may produce similar results. In 
the former case it has been suggested that the catarrhal effects 
may be due either to direct irritation, or may be of a reflex 
character, dependent on undue stimulation of the retina. In the 
latter case the coryza is generally observed in persons in a de- 
pressed condition of health, and in those who have been the sub- 



6 14 DISEASE GERMS. 

ject of previous attacks. The influence of irritating vapors, and 
of certain medicinal substances, such as iodide of potassium, and 
of the pollen of many plants in producing nasal catarrh, has long 
been known. 

The earliest symptom of an attack of acute inflammation of 
the lining membrane of the nose, is a feeling of chilliness and 
fever, a sense of w^eight and pain in the forehead, dryness of the 
nasal membrane, itchiness, accompanied with sneezing, nasal 
fossa becomes blocked, an irritating watery discharge appears, 
which subsequently becomes muco-purulent. 

Both taste and smell diminish in catarrhal attacks, and may 
even disappear. The voice becomes distinctly nasal in its tones. 
This is due to the fact that when the anterior nares are blocked 
the nasal cavities can no longer act as reverberating chambers. 
On the other hand, when the stoppage of the nostrils is chiefl}' 
posteriorly, articulation becomes defective. 

The second stage of coryza is marked by an increased secre- 
tion of alkaline serum, which may cause erosion of the nostrils 
and upper lip. This discharge may be so copious as to necessi- 
tate the constant use of the handkerchief, and may even be ac- 
companied by slight hemorrhage. During sleep the secretion 
is arrested wholly or in part. The nostril opposed to that of the 
side on which the patient lies may become dry and free, to be 
affected in its turn by any change of position. 

Pathology. — The only actual lesions found in coryza are such 
as are common to all inflamed mucous membranes, and are 
superficial and unimportant The initial stage is active conges- 
tion of the pituitary mucous membrane, followed by serous exu- 
dation. The exuded fluid contains epithelial cells more or less 
altered, which increase in number as the catarrh advances, to- 
gether with blood corpuscles, pus globules, and micrococci. 
These latter are the real cause of the trouble. It is not quite clear 
whether the inflammation attacks exclusively the respiratory 
tract, or both it and the olfactory region. The latter appears 
the more probable, seeing that the inflammation not uncommonly 
extends to the cavities accessory to the nose. 

Treatment. — In the majority of cases a common cold will cure 
itself with little aid from medicine, but at times, whether from the 
severity or the frequency of the attacks, treatment becomes ad- 
visable. This may be either stimulant or derivative. Of all 
stimulants, opium, either in the form of pulv. ipecac, co., or tinct. 
opii., is the best. Doses of from five to seven drops of the lat- 
ter, taken at the commencement of an attack, will often cut it 
short. But this treatment need not be continued after the 
second or third day. General principles in all cases. 



BACTERICIDES. 615 

A peculiar inflammation of the pituitary 
Rhinitis, mucous membrane, due to irritating vapors or 

(Traumatic.) particles of dust. 

Etiology. — In addition to the generally irri- 
tating effects of dust on the nasal mucous membrane as seen in 
millers, sawyers, brushmakers and other trades, there are certain 
nasal lesions more especially found in connection with workers 
in chemical manufactories. This is especially the case among 
workers in bichromate of potash, yellow chromate, arsenical and 
mercuric preparations, and generally in those exposed to caustic 
dusts and vapors. Snuff-takers enjoy almost complete immunity 
from the affection. 

The earliest symptoms are much akin to those of coryza, but 
instead of being merely temporary, persist for a varying length 
of time, in proportion to the rapidity with which the inflamma- 
tory process is evolved. To the earlier symptoms of pricking 
and smarting there is gradually added discharge passing from 
serous into purulent. This dries and forms crusts, which are cast 
off with more or less hemorrhage. The next and last stage is 
ulceration of the bone and cartilage, with perforation of the 
septum ; without, however, any offensive odor. The sense of 
smell is rarely affected. Ulceration of the inferior portion of the 
turbinated bone may take place, and be followed by perforation. 
Owing, however, to the fact that the anterior portion of the septum 
is not involved, no deformity follows. 

The immunity enjoyed by snuff-takers may be explained by 
the excessive activity of the nasal secretion, and by the fact that 
the nose is so frequently blown. Hence, no irritating matters 
can long remain in contact with the mucous membrane, which, 
moreover, by the chronic thickening it undergoes, is rendered 
less sensible to external irritants. 

Prognosis. — The portion chiefly affected is the septum, and 
little practical inconvenience ensues from its perforation. 

The treatment should be mainly prophylactic. Frequent spray- 
ing with alkaline solutions will keep the nostrils clean, while 
wearing plugs of wadding will effectually prevent the entry of 
irritating particles. When the disease has been fairly established, 
local detersive treatment with boroglyceride or resorcin injections 
are useful. To these should be added tonic and hygienic mea- 
sures for the general health. 

Our best tonics in rhinitis are the comp. tincture of matricaria, 
phosphated tincture of oats, glycerite of kephaline. These 
remedies should be persevered with for a few months, adminis- 
tered in alternation. 



6i6 



DISEASE GERMS. 



Inflammation of the pericardium, or the 

Inflammation white fibrous tissue, in which the heart is en- 

of the cased. This is one of the most highly or- 

Pericardium. ganized of all the white fibrous tissues of the 

(Pericarditis^ body, and when weakened by any cause, is 

the favorite location of the bacillus amylo- 

bacta, the urate of soda of gout; the pus microbe, uric acid, etc. 

The most common predisposing causes are tobacco, alcohol, 

tea, sexual excesses, nervous exhaustion, diseases of brain, 

struggle for existence, worry. These and like causes weaken the 

cardiac plexus of nerves, which, if once enfeebled, 

are very liable to be irritated by morbid states 

of the blood. 

The common exciting cause is the presence 
of the bacillus amylobacta, the urate of soda and 
other states in which the living germs of disease 
appear in the blood. 

Symptoms. — There may be a general attack 
of rheumatism or there may not. An acute 
attack of pericarditis is usually ushered in with 
all the symptomis of fever ; first languor, lassi- 
tude, debility, with sharp, lancinating pains in 
the pericardium ; pain in head, back, calves of 
legs ; rigors, and a fever of high grade ; tongue 
coats heavily, urine loaded with uric acid ; the 
sharp, lancinating pain in the heart darts through to the scapula 
upward to the left collar bone and shoulder, down the arm ; the 
action of the heart becomes violent, tumultuous ; its action ir- 
regular ; the difficulty of breathing is often extreme ; inability to 
lie on affected side ; very much anxiety ; features become con- 
tracted ; there is great giddiness, noises in ears, bleeding from 
nose. As the case progresses there is extreme debility, cough, 
suffocative paroxysms, fainting fits, redema of the face and feet ; 
often great restlessness, delirium, distortion of the features, 
spasms or convulsions. 

In sub-acute and chronic cases the symptoms are so slight as 
scarcely to be suspected; just a little pain, sharp, darting to 
shoulder blades, but effusion of lymph, which causes adhesions 
between the pericardium and heart, and organic disease ; or efifu- 
sion of serum, which, if copious, may fill up the pericardium and 
compress the heart, impede its niovements, completely muffling 
its sounds to the hand or ear. 

It is easily recognized in any of its three forms by the pain — 
sharp, lancinating, darting in acute cases through to the shoulder 
blades up to the clavicles. In the acute and sub-acute form a 




The microbe of peri 
carditis. * 



BACTERICIDES. 



617 



friction sound can be felt by the hand and heard by the ear; 
or if not that, an alternate rubbing to and fro sound ; friction 
sound, attended with valvular murmurs and excitement of heart. 

In the chronic or declining stage of an acute attack, serous 
effusion often takes place, when no friction sound can be heard, 
nor even the sounds of the heart itself, being muffled by the water 
or fluid, which, if great, may compress the heart, so as to cause 
weakness or paralysis. 

The duration of pericarditis depends much upon the treat- 
ment. With such improved remedies as we now have it should 
be short. 

In the acute form, it should be treated in precisely the same 
manner as a case of acute rheumatism — by rest in bed, between 
blankets, heat to feet, open bowels with cascara sagrada lozenges; 
malted sterilized milk and beef essence for diet; local stimulation 
over the heart with concentrated ozone, subsequently dry heat. 
Administer at once opium in small but frequently repeated doses 
until there is a perfect freedom from cardiac pain, such as the fol- 
lowing : 

Opium pulverized, 10 grains; Dover's powder, 30 grains; 
nitrate potass, 60 grains. Mix. Make 20 chart. Give one every 
hour, till relief is afforded. This is most important. 

If fever is running high, aconite and veratrum ; or better still 
would be quinine, administered in small but repeated doses. 

A selection of some remedy to kill the bacillus amylobacta 
should at once be made and the patient placed upon it. 

The special- bactericides to completely annihilate that germ 
are : 

The glycerite of wintergreen ; the salicylate soda in liquor 
ammonia acetatis ; fl. ext. manaca ; salol; and other germicides. 

Whenever the tongue cleans speedily under any one remedy, 
that is the one to adhere to and push with vigor. 

The irritating plaster should be placed over the region of the 
heart as soon as the more urgent symptoms seemed to be re- 
lieved and a general course of alteratives and tonics prescribed. 

On no account is the bactericide to be dropped; that must be 
persevered with till every vestige of the amylobacta is wiped 
from the body. 

In the chronic form, pretty much the same treatment should 
be carried out, avoiding all causes that would be likely to enfeeble 
the heart. 

Here general alteratives and tonics should be administered, 
until the peculiar diathesis is wiped out. Comp. saxifraga and 
Phytolacca are our best alteratives; and for tonics, comp. matri- 
caria is the most efficient. 



6l8 DISEASE GERMS. 

A partial death of the ovary may 
Inflammation of the arise from a long, tedious, harassing 
Ovary. labor ; from the use of instruments in 

{Acute Ovaritis.) producing abortion ; from the inject- 

ing of fluids into uterine cavity ; from 
absorption of lochial products, or other debris ; from the use of 
caustic to the neck of uterus ; from dilatation of the os uteri ; 
from violence, falls, blows ; also from sudden suppression of the 
menses from cold, or wet, or shock ; from gonorrhea, excessive 
sexual intercourse, or sexual intercourse within six weeks after 
miscarriage; masturbation. Usually left side, unless due to 
movement of right leg. 

Symptoms. — There is the shock, with localized pain over the 
region oi the ovary, aggravated by pressure or movement, with 
aching or numbness, or pain in the inside of the thighs, with re- 
peated rigors and a fever. The features are anxious, tongue 
coated, nausea, vomiting, pulse frequent and wiry ; great restless- 
ness and loathing of food ; bowels constipated ; urine very scanty, 
scalding, and high-colored ; patient lies on back with knees 
drawn up. In some cases the pain in the ovary is intense, caus- 
ing a bearing-down like labor pains ; in other cases it is of a dull, 
aching character, with paroxysms of occasional sharp, lancinat- 
ing attacks. Besides the intense pain in the ovary or gland, 
there is quite considerable pain in the groin and thigh corre- 
sponding to affected ovary. Bladder is always irritable. The 
peritoneal covering always sympathizes and often becomes 
involved. Passage from bowels gives great distress, the hard- 
ened faeces passing along in the distended bowel presses hard on 
the ovary. Besides, the ovary can always be detected exces- 
sively tender, swollen, or puffed up. If the case is a severe one, 
or treatment inefficient or shilly-shally, it may terminate in peri- 
tonitis, or in the breaking down of the effused lymph 'n\ the 
ovary, and suppuration. If the latter, there will be rigors ; the 
pulse will become feeble ; there will be great nausea and vomit- 
ing, tongue will become red and glazed ; there is weight and 
throbbing in the ovary. In favorable cases abscess will burst 
into vagina or rectum ; in unfavorable cases, into peritoneal 
cavity, giving rise to peritonitis and death. When openings or 
sinuses form, the case becomes very tedious, opening and closing 
again and again. 

Treatintnt. — The moment a case is made out, apply turpentine 
over affected ovary ; as soon as redness is bright, hot poultices 
of linseed meal ; as soon as it becomes pale, a reapplica- 
tion of the turpentine, or else croton oil, and follow with hot 
poultices and opium. At the same time open the bowels with 



. BACTERICIDES. 6l^ 

copious enemata of linseed tea and laudanum, and place patient 
upon opium or morphia and gelsemium, in doses often and re- 
peated until there is absolute relief from pain. If this does not 
succeed quickly, introduce pastiles into vagina and suppositories 
of belladonna and opium into rectum. If skin does not become 
moist and be considerably better in a few hours, substitute aco- 
nite for gelsemium, and with it give jaborandi. In addition to 
the poultices and stimulants over ovary, cushions or small pillows 
of hops, baked in an oven, hot over pubes, vulva, hips. If in 
this manner inflammatory symptoms can be held in abeyance 
for four or five days by establishing a renewal of life in the 
ovary, then begin with the iodide of potass with bicarbonate 
very cautiously; by and by iodide of lime, and later on ozonized 
glycerine. The irritating plaster can be substituted for the more 
active agents, spreading it fresh every morning and applying. 
The diet all through the attack should be meagre, and confined 
to milk and lime-water, and beef tea ; bowels opened daily with 
warm enemata of linseed tea. 

If there are elements of venereal poison in the case, tepid in- 
jections of solutions of borax, or permanganate, should be used 
thrice daily. 

As the progress of these cases is essentially slow, great cau- 
tion is to be observed in resuming exercise, diet, and ordinary 
mode of life. Even a tonic course, so essential for recovery, is 
best delayed till all pain has ceased. Usual uterine tonics. 



One of the most common affections 
Inflammation of the of modern ladies, during the period 
Ovary. of sexual vigor. Essentially a very 

{^Chronic Ovaritis}) chronic disease, consisting in a low 
grade of irritation of one ovary orboth. 
Causes. — Suppression of the menses by cold, damp, fright or 
passion. Masturbation, use of sewing-machine ; violence, exer- 
cise too great, as dancing; tight lacing; sexual incompatibility; 
excessive sexual intercourse ; producing abortions with sounds, 
whalebone, knitting-needles ; retention of puerperal products, as 
clots and pieces of placenta; the use of sponges, pessaries, rings, 
uterine supporters ; sexual congress within six weeks after con- 
finement ; use of caustics ; gonorrhea ; fictitious literature ; 
rheumatism and gout, etc. 

Symptoms. — There is general languor and debility, an unde- 
fined sense of weariness ; a nerve-tire, with a pale, dry, white, 
doughy skin, torpid bowels and irritable bladder, with scanty 
urine, and irritation of stomach, nausea, indigestion, flatulence, 



620 DISEASE GERMS. 

with decided hysteria. There is a dull, continuous pain over 
the affected ovary, aggravated by pressure, movement. In some 
cases neuralgic shooting pain in addition ; besides this steady 
pain in ovary, there is also tenderness in the groin, in the sacral 
region and in the upper part of the thighs. There is trouble of 
some kind with the menses, usually scanty and painful. Pain in 
sexual intercourse ; likely to be some puffing or swelling of 
ovaries; also tumefaction and tenderness of one or both breasts. 
Nymphomania is a common symptom, and it may even merge 
into a more decided form of insanity, or peculiar strangeness of 
conduct. Often in defecation, if stools are hard, pain is great. 
In all cases the ovary can be detected sensitive or tender, either 
over ovary, or by vagina or rectum. 

TreatiJient. — For three weeks during every month the treat- 
ment can be carried on with vigor, but during menstrual period 
ii must be entirely suspended, with the exception of local stimu- 
lation over affected ovary. The points to observe are : ascer- 
tain the causes, and remove them by daily bathing, hip-baths ; 
regular evacuation of bowels ; gentle walking exercise ; warm 
flannel clothing ; excite appetite and give best of food, followed 
by pepsin ; solid diet of animal food, white-fish, oatmeal por- 
ridge and cream, eggs, etc. ; avoid slops. Then general course 
of vegetable alteratives and tonics, such as compound syrup 
Phytolacca and iodide of potass, Iodide and bromide of potass 
in the viburnum compound, or in stillingia compound ; iodide of 
lime ; port wine and Peruvian bark ; sulphate quinine and aro- 
matic sulphuric acid; glycerite of ozone, ozone-water. Besides 
these, the following acro-narcotics have a remarkable sedative 
action on the ovaries : tincture digitalis, tincture belladonna, 
tincture cimicifuga. 

Those drugs have an effect to soothe and even prevent the 
evolution of the ova if long continued. Pastiles and supposi- 
tories every night at bedtime of belladonna and opium, if neces- 
sary. The above can be so regulated as the tonic can be given 
before meals, alteratives after, and the other remedies between. 
The irritating plaster to be kept continuously applied, keeping 
an open sore about the size of a hen's &gg. It will be necessary 
to keep up this alterative and tonic treatment for some months, 
and while so taking treatment the vagina should be washed out 
at least twice a day with tepid water and borax, or an infusion of 
golden seal and borax or sage tea. In chronic irritation of the 
ovary, the marvellous absorbing power of the mucous membrane 
of the vagina should be taken advantage of for administering 
remedies ; pastiles of cocaine, atropia, boroglyceride do good. 



BACTERICIDES. 521 

The parotid suffers from irritation. 

Inflammation of the inflammation, from the localizing in 
Parotid Gland. its substance of a pathogenic microbe 

[Mumps) of mumps. 

This very fact renders inflamma- 
tion of this gland a dangerous and a highly contagious form of 
inflammation. The microbe is freely distributed on the tongue, 
mucous membrane of the cheek, gums, saliva, breath ; seeks the 
parotid only when that gland is weakened or devitalized, for if 
we raise the standard of vitality by applying stimulants, the mi- 
crobe leaves, seek analogous structures, as the mammae, ovaries, 
testes, brain. 

At all periods of the attack the micro-organisms are to be 
found in the blood. 

Usually a period of incubation, with the ordinary symptoms 
of fever, debility, inflammation, with pain in head, back, and 
Hmbs ; p^in and swelling over one or both parotids, stiffness of 
jaw, some soreness in swallowing. Fever and inflammation 
reaches its height in four days and then declines, occupying 
about a week in all. 

Treatment consists in rest in bed, warm room, open bowels, 
heat to feet, aconite and belladonna internally, nourish with 
warm beef tea, malted milk. To destroy germ in the blood and 
mitigate its severity, administer syrup of tolu with either resofcin,. 
creolin, or naphthaline. 

No local application over parotid. 

Inflammation of the parotid may arise from cold, or from the 
presence of the bacillus of tubercle, scarlatina, syphilis^ cancer, 
etc., and demands a very different form of treatment. 

If acute, exalgine, followed up with general alteratives, saxi- 
fraga, phytolacca ; locally, concentrated ozone, followed with dry 
heat to the parotid. 

Inflammation of the pleura or serous 
Inflammation of the covering which invests the lungs and 
Pleura. inner surface of the thorax ; is met 

[Acute Plejiritis.) with either in the acute, sub-acute or 

chronic form ; confined to one side or 
to both. 
The cause is usually exposure to wet or damp or cold, or frac- 
tured ribs. 

The symptoms in the acute form are languor, debility, pain in 
head, back and calves of legs, chilliness, rigors and a fever, with 
hot, dry skin ; temperature not so high, unless pneumonia, to a 
limited extent, exists — ioi° to 103° F.; cheeks flushed; hard 



622 



DISEASE GERMS. 




Acme pleurisy, 
showing the 
microbe at 
work. 



and quick pulse; increased frequency of respirations; an acute, 
lancinating pain in the side, called a stitch or catch, commonly 
below the nipple, over attachment of diaphragm on front of chest. 
This stitch or pain is aggravated by expansion of the lung in 
inspiration, coughing, or moving, or lying on 
affected side, and by pressure. A harsh, dry 
cough, with frothy expectoration ; anxiety and 
restlessness; scanty and high-colored urine. 
Over the seat of stitch or pain can be detected, 
quite early, a friction sound, caused by the in- 
flamed, congested and roughened surfaces of the 
covering of the lung rubbing against the pleura 
of the ribs. This rubbing resembles the rubbing 
of two pieces of brown paper or stiff silk against 
each other ; generally best heard and even felt by 
the hand forty-eight hours after rigor, often earlier. 
It ceases when inflammatory action is arrested, or 
when the two surfaces become moist and smooth 
by effusion of serum, or when adhesions by bands of lymph 
take place from the afifected surfaces, or when effusion is in great 
abundance. 

The duration of an attack of pleurisy should be but a few days 
if properly treated ; but if mismanaged, it may be run into some 
of its terminations or effects, or into a chronic form. 

Effusion of serum may take place, to the amount of a few 
ounces or of several pints. It may be pure serum, liquor san- 
guinis, or serum and blood. When excessive it compresses the 
yielding lung, suspends its functions, displaces the heart, and 
somewhat distends the thoracic walls. 
This effusion is called hydrothorax. 

When pleurisy terminates in a break- 
ing down of lymph, or suppuration or 
pus, which accumulates in the cavity of 
chest, it is called emphyema. When 
this occurs constitutional symptoms 
are more serious — rigors, febrile dis- 
turbance, often of a hectic character; 
tongue brown, dry and thickly coated; 
pus sometimes forms a bulging tumor 
in intercostal spaces; fluctuation can be detected, or sinuses 
may form at distant parts, and it may be evacuated ; or ulcera- 
tion of costal pleura may take place, pus finding its way through 
muscles and skin, and forming a fistula in the chest; or, more 
rarely, the covering of the lung may be perforated, and the pus 
find an entrance into the air cells, and be expectorated. 




Acute inflammation of the pleura, 
showing the microbe of pleu- 
risy in nests. 



BACTERICIDES. 



623 



Whatever the nature of the effusion, serum, or serum mixed 
with blood and Uquor sanguinis, or lymph broken down (pus), 
it will cause, according to its extent, dulness on the lower part 
of the chest, extending upwards. The respiratory murmur of 
the luno- is diminished. The chest may be so filled up that the 
lung may be compressed, so that little or no air can enter the 
bronchial tubes, so that no murmur can be heard. The fluid 
also prevents any intercostal movement. Patient cannot lie 
down. 

Treatinent. — Acute pleurisy should be treated with great 
energy, in order to prevent such grave complications. Wet cups 
or turpentine to redness over the seat of pain, followed with hot, 
moist linseed poultices, in which tincture of opium is freely in- 
corporated ; changed frequently. A flannel roller should encase 
the chest from the axilla; down to the base of ribs over poultice; 
the latter can be kept hot by bladders of hot water. Patient put 
to bed, perfect rest, avoidance of talking or full, deep inspiration ; 
breathe chiefly by diaphragm, so as to prevent friction between 
inflamed surfaces. Then one tablespoonful of tincture veratrum 
viride, tincture of aconite and sweet spirits of nitre in half a tum- 
bler of water, of which one teaspoonful should be given every 
hour till pulse reaches 70 ; then at intervals of two or three hours 
apart. Give half a grain of pulverized opium, five of Dover's 
powders in an infusion of pleurisy root every three hours, or 
double the quantity if there is not a speedy relief. Open bowels 
if confined ; keep heat to feet. If the skin does not perspire well 
with pleurisy root tea, add compound tincture of serpentaria in 
half- teaspoonful doses. If symptoms are urgent, inject hypo- 
dermically one-third of a grain of pilocarpin ; when it acts there 
is immediate relief and a cure ; so it is unnecessary to lay down 
rules for diet or drink, which should be gruel, milk, broths, 
cream of tartar, water or lemonade. 

With such new and definite remedies, we have the means of 
geUing rid of all acute and sub-acute cases in twenty-four or 
forty-eight hours. Tonics, good, nourishing food during conva- 
lescence ; quinine, in alternation with iodide of potass, is espe- 
cially valuable. 



Chronic inflammation may follow an 

Inflammation of acute attack, or it may come on of itself. 

the Pleura. There is no fever, rarely friction sound, 

[Chro?iic Pleuritis^ but more generally efliisions of lymph, 

with adhesions in the form of threads, 

bands, or ribbon-like exudations between the two pleuras, which 

interfere with respiration, especially if deep, or with movements, 



624 



DISEASE GERMS. 



as raising hands to face, turning sideways when the characteristic 
stitch is experienced. 

As there is in all cases of chronic pleurisy adhesions going on, 
the best method of treatment is to build up the general health 
by good substantial food, well-regulated secretions, woolen 
clothing, rest for a few months. If that is not practicable, an 
avoidance of positions in which the catch is experienced ; then a 
general alterative course, with iodide of potassa in alternation 
with tonics. Over the seat of adhesion, which is readily known 
by the stitch in certain postures, the irritating plaster should be 
kept constantly applied, spread fresh every morning, and if sup- 
puration is not free, occasionally rub over with croton oil. The 
irritating plaster has a better resolvent action than repeated fly 
blisters or iodoform ointment. Usually about three or more 
months are necessary to break down a pretty firm adhesion. 

The obstacle to free, deep inspiration, and that peculiar retrac- 
tion of chest will disappear as soon as the adhesion gives way. 

To Promote the Effusion of Serum in the Cavity of Chest. — 
The best of diet to raise the standard of blood; tonics to stimu- 
late appetite. Try first infusion of squills and digitalis, followed 
with diuretics, diaphoretics and hydragogue cathartics; those 
failing, alteratives and iodide of potass ; all remedies useless, tap 
the chest between sixth and seventh ribs, two-thirds the distance 
from the spinous process of vertebrae to middle of sternum. The 
old-fashioned trocar and canula is better than the aspiration. In 
emphyema, aspiration should be performed several times. The 
thorax to be tapped long before difficulty of breathing, or threat- 
ened suffocation takes place. 



A partial death, or inflammation, of the 
Inflammation serous membrane lining the abdominal cavity 
of the and investing the viscera ; a white fibrous tissue 

Peritonaeum, of very low organization. Nothing so likely 
Acute. to ward off any depressing influence as strong 

(^Peritojiitis?) vital force, and this is especially true with 
reference to the peritoneal membrane, for we 
find in a large per cent, of all cases that it is predisposed to b}' 
some depression of the sympathetic system, and that the com- 
mon exciting causes, such as minor injuries, would be insufficient, 
were it not on account of this nervous depression. In the condition 
of partial death of this structure there is" also a degradation of 
its normal living matter into a micro-organism or diseased germ, 
for we find that if a physician is attending a case of acute peri- 
tonitis in a male, and by chance becomes the attendant in a case 



BACTERICIDES. 



625 



ot parturition, the lady will become affected with peritonitis, 
severe or mild, according to her vital stamina, so that thus far 
there seems to be a living poison present. The general causes 
are injuries, perforation of stomach and bowels, strangulated 
hernia, damage done to organs in the abdominal cavity, as 
stomach, uterus, liver, etc. 

Acute inflammation of the peritonaeum is one of the most grave 
and serious calamities that can befall a human being. When not 
due to wounds, it is generally caused by injuries to organs, as 
the uterus, beginning as a case of metritis, or inflammation of 
that organ, and spreading over every organ in the visceral 
cavity. Originating in that manner it is called metro-peritonitis. 

Symptoms. — Chilliness or violent rigors, accompanied with 
severe, sharp, lancinating pain, extending over the entire abdo- 
men, with high fever, small, hard, wiry pulse, abdomen swells, 
becomes exquisitely tender on pressure, even sensitive to the 
slightest pressure, as bed-clothes, or movement of abdominal 
muscles ; patient lies on back, with knees bent, legs drawn up ; 
abdomen becomes more enlarged, tense and hot, tympanitic or 
drummy ; motionless in respiration ; features become sharp, ex- 
pressive of anxiety and suffering ; the tongu^e is sharp-pointed, 
dry, with a variable coat, according to the location of inflamma- 
tion ; nausea, vomiting, constipation ; skin very dry and burning ; 
pulse becomes more rapid ; respiration hurried ; often hiccough. 
If case drags, the abdomen ceases to be tympanitic, but remains 
enlarged from effusion of serum. If the injury is irreparable, or 
treatment ineffective, and the case about to terminate fatally, ab- 
domen becomes more distended, pulse thready and quick, but 
intermittent; face becomes of a ghastly expression, cold, clammy 
sweat, pain suddenly ceases. Unless due to perforation of 
stomach or bowels, the ordinary duration of peritonitis is about 
one week; when due to perforation, twenty-four or forty-eight 
hours. After sudden cessation of pain, Avhen about to terminate 
fatally, patient may live twenty-four to thirty-six hours. 

Treatment. — The aim of treatment is to establish a renewal of 
life in the affected membrane. For effecting this purpose narcot- 
ism with opium, or its alkaloids, is our only resource. The first 
difficulty we have to contend with is in selecting the form, 
whether it be crude or pulverized opium alone, or with Dover's 
powders, or as paregoric, or the sulphate of morphia in cinnamon 
wat^r. The best plan is to try the crude pulverized alone or with 
Dover's powder every half hour in. half-grain doses. If it an- 
swers the purpose of causing the patient to sleep, then push it; 
if it stimulates, try other forms until you find the one that 
answers the purpose. In conjunction or in alternation, a few 
40 



526 DISEASE GERMS. 

drops of tincture; of green root gelsemium. If stomach is re- 
jecting everything introduced, same remedies in suppositories or 
capsules per rectum, in double doses. At the same time the 
attending physician or nurse must select one of three remedies 
and apply over the entire abdomen ; either a fly blister for six 
hours, or until it causes redness, or turpentine applied until the 
same effect is produced, or tartar emetic ointment rubbed in over 
the entire abdomen. There is to be no blistering, as that is 
injurious, barbarous, draws off the liquor sanguinis of the blood. 
Whichever is applied, must be followed with large linseed meal 
poultices made with glycerine and one or more ounces of tincture 
of opium incorporated in it. Change every two or three hours. 
If there is any delay in procuring the above articles put on hot 
poultices of anything that will hold heat and moisture, until 
proper remedies can be procured. 

Local stimulants to the entire abdomen are of the greatest 
value ; they promote vitality, create a renewal of life ; their use 
is founded on sound principles, for it is a law of physiology that 
when two parts are nervously in sympathy with each other, 
if we excite a greater action in the nerves of one, we distract 
action from the nefves of the other. The blister or turpentine 
to erythema is a powerful means, it cures by withdrawing nervous 
action from the nerves of the part, and followed by hot poultices 
induces contractility of blood vessels and a renewal of life. 

Turpentine, of all stimulants, is perhaps the best in puerperal 
peritonitis, and one which, from its action on the skin and kidneys 
materially helps in the elimination of the materies rnorbi from the 
system in such cases. Moreover, from the rapidity wath which 
in many instances the symptoms of peritonitis may subside under 
treatment by this drug, it would apparently seem to have some 
direct germicide effect on whatever micro-organisms may be con- 
nected with the development of puerperal septica^mic fever or 
metria. In other cases of the same kind muriated tincture of 
iron, more especially when given in combination with quinine 
and liquor ergotae, and given in full doses, appears to act in a 
similar way, and may be tried either with the turpentine, or in 
its stead, as long as tolerated by the stomach and bowels. It too 
often happens, however, that vomiting and diarrhea are promi- 
nent symptoms in these cases ; and, under such circumstances, 
the remedies just referred to are obviously out of the question, 
and we must then fall back on the various preparations of opium 
and its alkaloids, from the administration of which, concurrently 
with free stimulation and the use of the hot pack — that is, by 
swathing the patient in mustard or turpentine stupes until reac- 
tion is established, and gastro-intestinal irritation allayed; re- 



BACTERICIDES. 



627 



coveries occur in cases of puerperal peritonitis in which all 
hope had been previously abandoned. As soon as the skin 
begins to pour out a copious sweat, and stertorous breath- 
ing take place, patient must be turned over on right side, 
carefully watched, and as a rule ten to twelve hours of nar- 
cotism is sufficient. Then waked up and a little barley-water, or 
lime-water and milk given. If there are any indications of sink- 
ing, aromatic spirits of ammonia. The opium, gelsemium and 
hot poultices should be continued for about a week, the two 
former in small doses, at intervals of three or four hours apart. 
Cautiously and carefully begin with a little diet, as milk and 
water, beef tea, essence of beef Enemata ot warm castile-soap 
water daily, to remove all fecal accumulation in colon or rectum. 
A cradle over abdomen to support bed clothes ; most perfect 
quiet obtained. The best of nursing and care, air of sick room 
to be kept warm and pure ; carry case over seventh day, then 
treatment for chronic peritonitis should be adopted. 



Chronic peritonitis may be the 
Inflammation of the sequela of an acute attack ; more 
Peritonaeum. frequently an independent affection. 

{Chronic Peritonitis.) It may arise from cold, suppression of 
menses, miscarriage, mechanical vio- 
lence, such as blows, rheumatism and gout, ovarian irritation. 
In children, it is associated with deposit of tubercle. 

Symptoms. — General languor, lassitude, debility, with abdomi- 
nal pain, sharp and lancinating, tender to pressure, and con- 
siderable swelling of abdomen ; sometimes slight fever, with 
obstinate diarrhea, nausea, wasting and prostration. If case 
progresses, a good deal of abdominal tension ; often effiision of 
lymph, with adhesions, which give rise to colic. In some cases, 
effusion of serum or ascites is immense. In chronic tubercular 
peritonitis in children, there is usually enlargement of mesentery. 
Treatment. — Patient should go to bed for a few weeks, until 
every vestige of pain has disappeared ; being treated in the same 
manner as if the case was acute, with opium, gelsemium and 
local stimulants. As soon as pain has disappeared, alteratives 
and tonics, as ozonized saxifraga, iodide of potassa, ozonized 
glycerine, cinchona and mineral acids, tincture of white bryony. 
To the abdomen, ozonized clay, if effusion of lymph is suspected, 
or iodoform ointment, or ozone ointment, iodide of cadmium 
ointment ; and over all a flannel roller ; great attention to the 
bowels and diet ; milk and lime-water, raw eggs, raw extract of 
meat. 



628 DISEASE GERMS. 

Inflammation of the pharynx is a 
Inflammation of the very rare form of disease. We meet 
Pharynx. with it occasionally in terribly broken- 

down conditions, where the vital 
forces are at a low ebb, mal-nutrition and mal-assimilation ex- 
treme, as we often find it in the degrading haunts of poverty and 
vice ; and when it occurs, it is mostly erysipelatous or bacterial, 
and is attended with great prostration, low fever, and difficulty in 
swallowing. Death takes place from exhaustion. 

Our remedies, then, are to get the patient into a better atmos- 
phere ; abundance of antiseptics or disinfectants around. Ad- 
minister quinine freely ; give brewers' yeast in tepid milk every 
three hours. Diet, beef tea with barley, raw eggs. 



A partial death of this gland may 

Inflammation of the be induced by violence, blows, kicks, 
Prostate Gland, falls; by gonorrheal inflammation 
Acute. proceeding upwards; by the use of 

strong caustic injections into the ure- 
thra ; excessive venery, masturbation, disease of rectum ; a 
metastasis of the poisons of gout or rheumatism in that class of 
subjects exposed to cold or wet : to the action of such drugs as 
cantharides, turpentine, balsam copaiba, etc. 

Symptoms. — Pain in the perinaeum, very excruciating, with 
sense of heat ; frequent painful micturition, often inability to 
urinate; great pain and distress in defecation; a feeling of weight 
and fulness about perin<tum and rectum ; suffering increases ; 
rigors and a fever set in, and difficulty of micturition increases. 
The insertion of finger up the rectum gives great pain, but by it 
the gland can be felt, hot, extremely sensitive, and enlarged. 
The greatest kind of suffering is experienced if a catheter is in- 
troduced ; aching in hips and thighs, with dragging in back. If 
case is not actively treated, often progresses on to abscess. 

Treatment. — Hot hip-baths, followed with suppositories of 
belladonna and opium, or enemata of the same remedies. Then 
perfect rest in bed, with either hot poultices or fomentations' of 
lobelia, keeping perinaeum smeared with belladonna. 

Treat fever with aconite, and as large doses of green root 
tincture of gelsemium as can be borne, with bromide and bicar- 
bonate of p^tassa, every three hours. If there is inability to 
urinate, draw off with ^catheter. As soon as fever abates, add 
iodide of potassa to the bromide and bicarbonate. 

Infusion of one of the astringent diuretics as a drink, to which 
sweet spirits of nitre can be added to keep urine alkaline. Uv^a 



BACTERICIDES. 



629 



ursi or hydrangea is the best. As case progresses, alteratives 
and tonics, iodide of potassa to be the principal. If abscess 
form, incision over fluctuation, followed with poultices, nourish- 
ing food, tonics. 

Forbid, during treatment, all stimulating articles of diet, 
feather beds, sexual intercourse, liquors, as priapism is often 
pr-esent. If there are elements of gout, colchicum and quinine. 



In inflammation of the substance of the pros- 
Prostatitis. tate, besides the symptoms of granular prosta- 
Sub-Acute. titis, there are aching or stabbing pains in the 
anus, sacrum, or perinseum ; pain at the supra- 
pubic region is a common sign. There are also radiating lum- 
bar or femoral pains after exercise or long journeys, general 
languor, malaise, or depressed spirits. Increased frequency of 
micturition is often absent ; when present, it is felt by day, not 
by night. The flow of urine is altered by delay at the begin- 
ning, which may amount to retention. Dull pain after micturi- 
tion, sometimes spasm at the end of the flow, with a sense of 
more to come, are complained of In cases of long standing, 
micturition during sleep is a symptom, — constipation is almost 
invariable. When the congestion is great, there is pain during 
defecation and between the acts a sense of w^eight at the anus or 
in the perinaeum. Pain in the testes when it occurs is simply a 
neuralgia. There is constantly hypersecretion of mucus. 

In some patients, the organ recovers its natural condition in a 
•few w^eeks ; but usualh' the disease drags on a course more or 
less wearisome ; thus the termination is very uncertain. Re- 
lapses are almost sure to foUov/ if the patient exceed in his diet 
or regime. In relapses small abscesses often collect in obstructed 
ducts, which usually empty themselves through a duct before 
accumulating much. Sometimes the inflammation spreads to 
the parenchyma, and the prostate then becomes unyielding to 
the touch, hard and sensitive. The enlargement of the organ 
may last long. The increase in size may be symmetrical, or 
only affect one part, giving the sensation of irregularity or lobular 
form when felt by the finger. In course of time, the nodules, 
may disappear, and the organ regain its natural size, or even 
shrink below it, and feel quite firm and smooth. 

The treatment of all forms of prostatitis is always obstinate 
and tedious — of the many remedies in use, few are trustworthy. 
General treatment assists the local remedies. General alterative 
and tonic course. Indigestion must be overcome by comp. tinc- 
ture matricaria ; bowels regulated with the cascara lozenge, and 



630 



DISEASE GERMS. 



the best tonics, embracing cinchona, mineral acids, nux vomica, 
gelsemium and belladonna are very valuable, if troublesome 
micturition be a symptom. Ergotine and damiana are specially 
useful if there be enlargement, or if there be pain or aching ex- 
cited by walking or standing. 

When the organ is enlarged, flabby, soft, or tender, a good 
remedy is the cold sitz bath, taken at first for a few minutes,, 
then prolonged to fifteen minutes, of cold spring water. The 
cold douche on perinaeum and rectum are also of utility. Cold 
enemata are extremely useful ; four ounces of cold water and 
one ounce of distillation of witch hazel form a good injection ; 
it should be retained, and used at least twice daily. Among the 
best recognized remedies. are the insertion of a cocaine supposi- 
tory at bedtime, and we have great faith in its efficacy. An in- 
jection often or twenty drops of the undiluted distillation of the 
eucalyptus is a good preparation. This has to be repeated fre- 
quently. 

Prostatitis from Masturbatioji or Excessive Venery,- — Masturba- 
tion' is a frequent provocative of prostatitis, sometimes in the 
acute form, more often in the sub-acute or chronic" forms. In 
the mildest form of prostatitis through masturbation, the prostate 
bleeds easily, the urine is often tinged with blood, smoky, or 
even coffee -colored. If felt per rectum, the organ is found but 
little changed from the natural condition. General malaise, in- 
appetency, and slight elevation of temperature usually accom- 
pany the bleeding. Bleeding from the congested prostate may 
be copious in young men when it follows prolonged venereal ex- 
citement and excessive copulation. Commonly very copious 
when thus originated, it may be profuse for an hour or two, and 
exhausting. 

In those affections nothing can excel the glucoside of the 
black willow in the form of a suppository per rectum, the ozo- 
nized extract should be given in drachm doses thrice daily. It 
has a marked effect in checking the involuntary emissions, and 
thus prevents the irritation, exhaustion, and neuralgia which is 
often experienced. 

Sequelce of Prostatitis. — Persons who have suffered from a con- 
gested prostate are liable to too speedy ejaculation during copu- 
lation.- This may be so rapid, and erection so fugitive, that 
effective coitus is impossible. For such cases the ozonized ex- 
tract of damiana has sometimes a powerful effect. But cure is 
almost hopeless if continence is neglected. Some persons give 
way to the sexual appetite without limit. Then follows a condi- 
tion of great helplessness. The intense neuralgia of the lower 
extremities which follows the shortest walk renders exercise im- 



BACTERICIDES. 



63 > 



possible. Pain is rarely absent, even when at rest ; it extends 
from the sacrum along the spinal column to occiput. The diges- 
tion is deteriorated. Topical treatment, after the mucous catarrh 
and chronic inflammation of the prostate is quelled, must be laid 
aside. The best remedy is a life of quiet, absence of exertion of 
any kind ; a long sea-voyage is one of the best remedies. In 
rare cases chronic parenchymatous prostatitis excites temporary 
mania, which has erotic irritation for an early or leading symp- 
tom. It disappears if the patient recovers from the physical 
affection. 

We have found in such cases a most excellent cerebral tonic, 
prepared from the orange wine of Florida Vinum Co* green 
coca leaves and the peroxide of hydrogen, alternated with avena 
sativa. 



Or, as some term it, chronic enlarge- 
Inflammation of the ment of the prostate, is very common ; 
Prostate Gland, not as a result of the dignity of a 

Chronic. hoary age, but rather of the defects 

and vices of modern civilization. The 
character of the gland is such that vnth a slight degree of irrita- 
tion, its different lobes become rapidly filled up with lymph, and 
thus become greatly hypertrophied. The enlargement is due to 
effused lymph, the result of inflammation, which, in old age, 
undergoes calcareous degeneration. Of the male population of 
North America, it is estimated that eighty per cent, of all over 
thirty- five years of age suffer more or less from chronic prostatitis. 
Causes. — It may be a sequel of an acute attack, or may come 
on from the same causes, such as mechanical violence, gonorrhea, 
irritating injections, diseases of rectum ; but by far the most 
common causes are sexual excesses; masturbation; imperfect 
copulation, in withdrawing the penis in the act of ejaculation, so 
as to prevent impregnation ; in having sexual congress with 
women of large or dilated vaginas, or affected with leucorrhea, 
in whom the contractility or grasping power of vaginal walls is 
impaired, and the tonic action of the sexual act on the male is 
destroyed : the wearing of condums ; the want of compatibility 
in the sexes. These, and similar conditions, prevent the secre- 
tion of the prostate, as well as the semen from the testis, from 
being thrown off; the result is, it remains in the ejaculatory 
ducts and excites inflammation; in other words, they are im- 
perfectly emptied of their natural secretion ; sedentary habits ; 
incessantly in the saddle, as in riding ; strictures ; the debasing 
or demoralizing effect of our modern sexually exciting literature; 



632 



DISEASE GERMS. 



drugs that cause a determination of blood to those parts ; over 
stimulation in eating and drinking. 

Those are a few of the most common causes of devitalization 
of this gland, the cause of premature decay, loss of national 
vigor or manhood. Although we have stated the disease to be 
of such prevalency and early occurrence, it is usually at a later 
period of life that decided symptoms make their appearance, 
although the enlargement begins earl}\ The increase in size is 
due to a true hypertrophy of the normal structure of the gland. 
This hypertrophy may affect the whole gland, or only a lobe, or 
the two lateral lobes alone, or the middle alone may be affected. 
Again,* there may be a separate tumor of prostatic tissue em- 
bedded in the substance of the gland, or pedunculated growths 
may spring from the surface of the gland and project forward on 
the bladder or back to rectum, often mistaken by the ignorant 
for piles. 

The effects of chronic prostatitis on the spinal cord are bad ; 
on the brain even worse; and as a mechanical impediment to 
the bladder, of the gravest kind ; alters the course of the ure- 
thra, lengthens its vesicle end, increases the curve, and dimin- 
ishes the calibre of the canal ; besides, the cavity of the bladder 
may be intruded on by the size of the gland ; its muscular coat 
thickened by frequent straining to void water, and later on the 
ureters may, with the kidneys, become affected. Chronic inflam- 
mation of the bladder may take place, and its capacity be dimin- 
ished, or it may become sacculated. Although we have stated 
thirty-five as the period in our country of its appearance, still,.as 
the symptoms are obscure, patients ma)^ not seek relief for many ' 
years thereafter. It is a slow, insidious, but progressiv^e disease. 
The production of prostatic inflammation must be regarded as 
the result of ignorance and wilful violation of natural laws, and 
not as the calamity of age. 

Symptoms. — The symptoms of chronic inflammation of the 
prostate in the early stage are not of a prominent kind ; indeed, 
the gland may attain considerable size without giving rise to 
much trouble. But decided when there is weakness in erectile 
power, or seminal losses, or obstruction to urinating, or urine 
escaping with the stools, stream weak, more difficulty in turn- 
ing it on or off, besides increased frequency in micturition, with 
more irritability of the gland; if unmarried, nocturnal emis- 
sions, one after the other, or a morbid desire for sexual inter- 
course ; often a slight gleety discharge, which keeps the urethra 
red, tender, or sore. The enlargement causes a mechanical 
impediment to the function of the rectum, as well as the bladder ; 
stools are flattened like a ribbon ; constipation ; a feeling as if 



BACTERICIDES. 633 

tlie bowels were not perfectly evacuated. The frequent calls to 
make water become a serious item, disturbs the patient at night, 
and interferes with his comfort during the day. Continence or 
incontinence is Hkely to take place; if the latter, the urine drib- 
bles away. As the case progresses, there is more irritation of 
the bladder, urinary misery becomes greater, and fits of reten- 
tion may take place from the slightest exposiire to cold, or ex- 
cess. The reflex symptoms are often distressing-^languor, 
lassitude, debility, nervous prostration, derangement of spinal 
cord, brain, stomach, liver, and especially in a young patient, a 
morbid condition of the mind. 

With all these and other symptoms, there should be an exam- 
ination per rectum with the forefinger of right hand, and in all 
cases the gland can be felt, laro-e, hot, tender. The examination 
should be made with patient on his back, finger-nail filled with 
soap, and the finger, well oiled, should be introduced very slowly 
and gently, so as not to excite spasm of the sphincter. 

Treatment. — As soon as the disease is clearly made out, and 
the necessary arrangements made, begin with a general vege- 
table alterative and tonic course, as ozonized phytolacca and 
iodide potass, ozone-water, glycerite of ozone, gentian, columbo, 
or some other better tonic. 

Instruct patient that cure is slow, but positive, unless very old. 
Inculcate good diet ; attend to skin ; daily bathing and flannel 
clothing; bowels to be opened daily* a cold water hip-bath, 
morning and night, for fifteen minutes each time ; forbid tea, 
coffee, tobacco, and all kinds of alcoholic drinks ; recommend 
exercise, an avoidance of unhealthy literature, and for a few 
months at least, a suspension of sexual congress. Patient should 
sleep on hair mattress, on his right side. While this treatment 
is being carried out, the special f^^atures of the case should be 
attended to. 

Jo Arrest, Clieck, or Control tlie Morbid Sexual Desire, or Emis- 
sions. — Try first thirty drops of tincture of green root gelsemium 
at bedtime, and increase dose if necessary. Or tincture digitalis, 
drops eight. Or tincture belladonna, drops five ; begin in after- 
noon, and give three doses before bedtime. Or tincture ery- 
throxylon coca in sufficient doses. Or lupulin and lactucarium. 
Or black willow extract. Or, best of all, the spermatorrhea pill. 
The salts of bromine are efficient, and, if used, let it be for a 
little while. 

To Promote Absorption of Effused Lymph in Prostate. — The 
patient is on iodide potass in his alterative ; so, to aid its action, 
try every night at bedtime a cocaine suppository, with infusion 
ot hydrangea; or cleavers; or uva ursi. Or muriatic acid in 



634 DISEASE GERMS. 

five-drop doses, thrice daily, in water ; and, in addition to either, 
a suppository of belladonna and iodide of potassa. 

To OveTcoine Inflaiiiniaiion of Prostatic Portion oj UrctJira. — 
Use every other night a gelatinized bougie of iodol. 

For Retention of Urine. — The ordinary means, warm hip-bath, 
belladonna suppositories, and gelsemium internally; failing, urine 
should be drawn off daily with a catheter. This is a good plan 
if there i§ the least inability to empty the bladder completely, as 
it is of primary importance that at least once in the twenty-four 
hours the bladder should be thoroughly emptied. If this is not 
attended to, it may bring about paralysis of the organ, with the 
loss of the power of voluntary micturition, and cystitis. For 
this purpose, a No. 12 silver catheter is better than a smaller 
instrument ; it goes in easier, is less likely to do damage. Keep 
the point of the instrument on the upper wall of urethra, and, 
above all things, use no force. In a short time, even in old cases, 
the patient will be able to get along. An alterative and tonic 
course should be persevered in. 

The sequela of this inflammation, if not cured, is enlargement 
of the prostate. 

Rectitis, without the affection termed 
Inflammation dysentery being present, is a rare form of 

of the Rectum, disease, but it may be caused by violence, 
{Rectitis.) or fhe introduction of foreign bodies into 

the bowel. 

The Symptoms are the same as dysentery : rigors, fever, great 
constitutional disturbance, intense heat and soreness about the 
anus ; severe shooting pain up the back and sacrum ; spasmodic 
contraction and excessive tenderness of the sphincter ani ; tenes- 
mus, with passage of muco-purulent matter and blood ; irritable 
bladder, with a train of reflex symptoms, and the same microbe 
appears as in dysentery. 

The treatment should consist in the most absolute rest in bed ; 
stimulants, such as mustard plaster over the entire abdomen ; 
followed with hot poultices of linseed meal, changed frequently ; 
drink, water acidulated with aromatic sulphuric acid ; enemata 
of starch and tincture of opium every three hours into the 
bowel ; antipyrine, fifteen grains, every four hours for fever, dis- 
solved in water ; a selection of some of the following formuLie 
may be made : 

Iodol, one drachm ; solid extract of belladonna, five grains ; 
pulverized opium, twelve grains ; butter of coca, a sufficient 
quantity to make twelve suppositories. Insert one every four 
hours. 



BACTERICIDES. 



63s 



Subnitrate of bismuth, sixty grains ; iodoform and resorcin, 
of each ten grains ; muriate of hydrastin, five grains ; sweet 
almond oil, one ounce. Inject at once and repeat. 

Infusion of slippery-elm, one ounce ; add to it twenty grains 
of resorcin, with one grain pulverized opium. 

Green root tincture of gelsemium operates like a charm. 

Follow with small doses of peroxide of hydrogen and mineral 
acids ; stone crop, as the case progresses to recovery. 

Diet very light and bland, as chicken, toast, arrow-root. 



Inflammation of the delicate net, or web, or 
Inflammation membrane, called the retina, is rare, al- 
of the Retina, though it sympathizes with all the inflam- 
{Retinitis.) matory conditions of the eye. 

Causes. — Exposure to vivid light ; such 
as the glare of snow, the white sand in tropical latitudes, large 
fires in foundries, and molten iron. 

Symptoms. — Acute, deep-seated pain in the eyeballs, extending 
to temples and forehead ; great intolerance of light ; dimness of 
vision ; frequent sensations of flashes of light ; pupil contracted 
to a pin-point ; iris loses its brilliancy and becomes motionless ; 
some vascularity of sclerotic and conjunctival coats; constitu- 
tional disturbance ; high fever, and delirium. If not carefully 
managed irreparable blindness liable to^take place. 

Treatment. — Perfect rest in a dark room ; veratrum, aconite, 
for fever; morphia, or opium, or hyoscyamus for pain, w^hich is 
to be relieved at all hazards ; bowels to be freely opened ; skin 
stimulated by frequent bathing and jaborandi ; heat to feet — 
after mustard. To nape of neck, a four-inch square mustard 
plaster, followed with croton oil, then poultices, and latterly 
irritating plaster. To the eye, warm fomentations of opium and 
tepid water, or infusion of poppies; alteratives and tonics, iodide 
potass and quinine. 

As to the great value of stimulating applications to nape of 
neck, there can be no doubt in all eye affections. The optic 
nerve originates in the spinal cord and medulla, so that a good 
stimulant at root induces contractility and normal vigor in the 
main trunk, and in its finer mechanism or reflexion in the opti- 
cal instrument, the eye. In all eye diseases, aside from children,^ 
our motto is active stimulation to its origin. 

We cannot urge too strongly the use of quinine in glycerite 
of kephaline as our best tonic in retinitis. It should be adminis- 
tered in half grain doses thrice daily. 



636 



DISEASE GERMS. 



Inflammation 

of the Stomach. 

Acute. 

( Gastritis.) 



The stomach being a very vital organ, 
anything which gives rise to a partial 
death of that organ is attended with ex- 
treme danger. 

Causes. — The ordinary causes are the 
introduction of irritating agents into the 
stomach, such as poisons, arsenic, caustics, mercury, acids, 
emetics, whiskey, and other irritants ; or it may be caused by 
blood poisons or disease-germs, as in yellow and puerperal 
fevers ; or by inflammation spreading from other parts, as in in- 
flammation of the uterus and peritoneal coat; it often spreads to 
or involves the stomach. 

Syniptoms. — Nausea and vomiting; burning soreness or raw- 
ness in the stomach, accompanied with a pricking or lancinating 
pain, very tender to slightest touch, or even pressure of bed- 
clothes; intense thirst; great desire for cold drinks, which when 

swallowed, are almost imme- 
diately rejected ; tongue at first 
may be furred or coated white, 
with red tip and edges, or in 
streaks, and subsequently it 
assumes a raw-beef appearance, 
smooth and glassy; and if the 
blood is affected, dark at the 
root. The matter vomited at 
first is usually serous, or mu- 
cous, or biliary, then becomes 
greenish, latterly like coffee 
grounds, or black, which is 
simply blood changed by the action of the acids of the stomach. 
There is a generally tympanitic condition of the abdomen, and 
patient lies on back with knees drawn up and head and shoulders 
elevated, so as to keep the abdominal muscles from pressing the 
stomach. Temperature is very high ; pulse frequent, small and 
wiry ; respiration frequent and short ; features pinched and 
sharp-pointed ; constipation ; loathing of food and disgust of 
warm drinks; urine scanty, high-colored ; its duration, about a 
week. If not very carefully and energetically managed, death is 
ver\' liable to take place from exhaustion, or suddenly from 
o;ang:rene. The best we can obtain is to run it into chronic 




A vertical section of the walls of the stomach 
in acute gastritis. 



Treatment. — The patient must be kept as- quiet as possible in 
recumbent posture in bed ; weight of bed-clothes kept off by a 
cradle; heat to feet; sponging body thrice daily; mustard 
plaster poultices over stomach, followed by hot poultices of gly- 



BACTERICIDES. 5^^ 

cerine, flaxseed, and opium ; no drink allowed ; patient can take 
water or ice in mouth, but must not swallow much, if any — noth- 
ing to enable the stomach to contract. Small, but oft-repeated 
doses of tincture of green root gelsemium, in alternation with a 
solution of morphia. The two remedies administered on and on 
every half hour till narcotism is induced, which condition should 
be continued for ten or twelve hours, and patient kept on right 
side. If successful with narcotism, then continue same two 
remedies every three or four hours for a few days; give no food, 
a little mucilaginous drink, as gum-arabic water or marshmallow 
tea; nutritive enemata every three hours. The point to be 
aimed at is narcotism, during which inflammatory action ceases. 
If a complication of other diseases, still this point holds good. 
The idiosyncrasy that often exists to the action of opium or 
morphia, is entirely overcome by the gelsemium. If successful, 
be very cautious about beginning diet ; milk and pepsin, beef 
tea and pepsin, white of egg and pepsin, juice of raw beef. 



A low grade of irritation in the vari- 
Inflammation of the ous coats of the stomach. 

Stomach It may follow an acute attack, or 

{^Clivoiiic Gastritis}) may come on from the introduction of 
irritants into the stomach, as arsenic, 
mercury, whiskey, etc. ; swallowing immoderately iced drinks ; 
bolting ice-cream after a hearty meal, thereby suspending diges- 
tion and devitalizing the stomach. In ladies, belts or other arti- 
cles of dress irritating stomach ; in men, from dispensing wiih 
suspenders, wearing belts ; and me^chanical 
occupations, pressing on stomach ; also, 
direct violence and other like causes. 

Symptoms. — The symptoms of chronic 
inflammation of the stomach involve all 
that are present in the various forms of 
dyspepsia, as heartburn, water-brash, eruc- 
tations of gas or liquids, gastrodynia, slow a vertical section of the stom^ 
or imperfect digestion, with headache ; be- ^'^^ '" ''^'■°"'^ s^"^^'^'- 
sides, the tongue is red at the tip and edges, with a w^hite coat 
in the centre ; there are is pain in the stomach, aggravated by 
pressure or the clothes ; disordered bowels ; often a craving for 
food, but only a small portion can be taken without producing 
oppression and vomiting. 

Chronic gastritis is essentially stubborn. It may exist many 
years, even in a mild or aggravated form, but is very apt 
to terminate in thickening or induration of its coats, narrowing 
the pylorus, or ulceration, perhaps going on to perforation. 




638 



DISEASE GERMS. 



Treatment. — In this affection, rest, daily bathing, bowels opened 
by enema of some soup ; flannel clothing. A suppurating sore, 
about four square inches, should be maintained over region of 
stomach, until a few months, after recovery. The diet should 
consist of juice of raw beef, milk, with lime-water or bicarbonate 
of potassa, arrow root, milk toast, boiled fish, chicken, oatmeal 
mush ; three meals per day, pepsin to follow each in a suitable 
dose to digest without without making any demand on stomach 
for digestion ; drinking fluids to be forbidden. 

After attending to those preliminary points, our next and main 
object is to increase the vitalizing tonicity of the stomach. For 
this purpose, compound tincture of cinchona, four ounces ; aro- 
matic sulphuric acid, one ounce ; one teaspoonful every four 
hours in water, or if that does not operate well, use infusion of 
golden seal, from a tablespoonful to three every four hours ; col- 
linsonia, gentian, columbo, or other remedies laid down under the 
head oi dyspepsia. If there is much burning, soreness, or rawness, 
use gelsimium and quinine freely, or gelsemium and chlorate 
of potassa. Once rid of pain, with tenderness on pressure, and 
the red tip and edged tongue, then a general course of vegetable 
alteratives and tonics, with more extended and varied diet. 



Inflammation of the substance of the spinal 
Inflammation cord is extremely rare, usually a segment or 

of the a portion involved, seldom the entire length. 

Spinal Cord. It may be caused by falls, blows, shocks. 

Myelitis.) concussion^, or microbial disease of the 

vertebrae, as the bacillus of tubercle, 
syphilis, etc. 
Symptoms will depend almost entirely upon what part of the 
cord is implicated. If the cranial portion of the cord is affected, 
there is deep-seated headache ; convulsive movements of head 
and face ; inarticulate speech ; trismus ; difficult deglutition ; 
impeded spasmodic breathing ; irregular action of heart ; paralysis. 
If about to prove fatal in the acute stage, great prostration ; 
greater difficulty of breathing ; involuntary excretions. When 
the entire thickness of the cord above the phrenic nerve is affected, 
death takes place rapidly from cessation of respiratory move- 
ments. If the cervical portion suffer inflammation, difficulty in 
swallowing and breathing; impossibility of raising the head, pain 
in back of neck ; sense of pricking and formication in arms and 
hands ; paralysis of upper extremities. If the dorsal, pain over 
the affected part, numbness or pricking sensations in fingers and 
toes; paralysis of arms and lower extremities, with great difficulty 



BACTERICIDES. 



639 



of breathing and palpitation. If the lumbar, marked paralysis of 
lower extremities, at an early period, abdominal pain, and a sensa- 
tion as if there were a cord tight around the body, convulsions with 
retention, followed by incontinence of urine, owing to paralysis 



This plate represents 
the under surface or base 
of the brain, little brain, 
the pons varolii and me- 
dulla oblongata, also the 
anterior surface of the 
spinal cord, to show the 
mode of origin of the 
cranial nerves from the 
base of the brain and 
that of the spinal nerves 
from the spinal cord, a, 

a. Cerebral hemispheres. 

b. Right half of cere- 
bellum. )u. Medulla ob- 
longata. Above this is 
a transverse white mass, 
the pons varolii, c, c. 
The spinal cord, showing 
its cervical and lumbar 
enlargements and its 
pointed termination, e. 
the Cauda equina, i to 
9, the several cranial 
nerves arising from the 
base of the brain and 
sides of the medulla ob- 
longata. Below these, 
on each side are the roots 
or origins of the spinal 
nerves — cervical, dorsal, 
lumbar and sacral. In 
some of these the double 
root can be seen and the 
swelling or ganglion on 
the posterior root, a, .v, 
the a.Killarj' or bronchial 
plexus, formed by the 
lower four cervical and 
first dorsal spinal nerves. 
I. The lumbar plexus, 
s. The sacral plexus, 
formed by the last lum- 
bar nerve and first four 
sacral nerves, t. Shows 
a piece of the sheath of 
the cord cut open and 
within it a portion of the 
ligament which supports 
the cord. 

Plate -^. A transverse 
section through the cord 
to show the form of the 
gray cornua or horns in 
the midst of the white 
substance. B. Shows the 
same parts and also the 
membranes of the cord 
and the anterior and pos- 
terior roots of a pair of 
spinal nerves springing 
from its sides. 




of bladder, involuntary stools followed by paralysis of sphincter 
ani. Pain in whatever part is increased by heat, pressure or 
movement. The loss of power in lov.^er limbs and body below 
the seat of inflammation, and later, of sensation. 



640 



DISEASE GERMS. 




t: 



:^5S- 



In the treatment, the cause should be removed, if possible, 
and the most powerful of all stimulants, the galvanic cautery ap- 
plied, followed with poultices of belladonna. Exalgine should 
be administered in fifteen-grain doses morning and night, more 
frequent if case does not yield ; bowels 
should be freely opened, and the patient 
placed upon bromide and iodide of potassa 
in compound saxifraga. 

The sole aim of treatment is to cairy 
l: ' " the patient through an acute attack and 

run it into a chronic form, which is more 
easily managed. 

Chronic inflaniniatwn may be the sequel 

jt^"^' of an acute attack, but it may arise from 

Acme.nyeht.sofihe.rray ^he samc causcs whlch produccd an acute 

...alter dor.j port.on of attack. Pcrsons in middle life, suftering 

""^'"'^ "^ ' from some chronic disease are apt to suffer 

a form of reflected irritation, which weakens the cord, and gives 

rise to myelitis. It is easily recognized by the pain on pressure 

and movement, on the application of a hot sponge, or the pole 

of a battery, aching in the back and limbs, gradual loss of power 

of the lower extremities. 

Symptoms are much ameliorated after a long rest in the recum- 
bent posture ; the acute form may terminate in effusion of blood ; 
the chronic, in thickening, with atrophic degeneration. 

Very likely to be numbness, coldness, loss of sensation and 
motion in the parts below. If the anterior columns only are 
affected, motor paralysis prevails ; if the posterior columns, sen- 
sibility is either impaired or destroyed. 

If the case has progressed simply to chronic inflammation, an 
effort should be made to get rid of the inflammation by the ap- 
plication of external stimulants, like the irritating plaster kept on 
nearly all the time; by rest in the recumbent posture in bed; by 
keeping the secretions active ; by the administration of bromide 
and iodide of potassa in compound syrup of saxifraga; by 
the administration of such drugs as will diminish the area of 
the circulation in the cord, as ergot, belladonna, calabar bean, 
etc., and a diet rich in phosphates, as oatmeal, wheaten grits, 
cream, eggs. 

Such a plan of treatment is of no avail if white softening has 
set in. 

When white softening of the cord takes place, paralysis of all 
parts below the lesion is inevitable. All symptoms, however, 
admit of palliation ; the case should be carefully watched, espe- 
cially the rectum and bladder. 



BACTERICIDES. 



64: 



Inflammation of the membranes of 
Inflammation of the the cord is very rare, as it is well pro- 
Membranes tected from injuries by the thick, bony 
of the Spinal Cord. casement. 

[Spinal Meningitis.) Nevertheless, the rhe':imatic bacillus 

often excites irritation in its structure. 

The indiscriminate and careless method of prescribing nux 

vomica or its alkaloids exercises a most deleterious action upon 

the membranes of the cord. 

It is, however, to the pathogenic microbe of cerebro-spinal 
meningitis that we owe such grave an.d important changes in the 
cord membranes. 

It usually manifests itself in acute burning, or often sharp lan- 
cinating pains along the spine, extending to the limbs, aggravated 
by pressure and movement. If this irritation is high up, there 
may be some fever and a tendency to opisthotonos, with some 
rigidity of the muscles of the neck and back ; feebleness of the 
limbs ; paralysis and the loss of power increases as the case pro- 
gresses, sense of suffocation, or constriction in neck, back, abdo- 
men; lower down still, constipation, retention of urine, priapism, 
prostration. 

Acute inflammation of the testes 
Inflammation of the may be caused by blows, kicks, falls. 
Testicles. violent exercise; or badly fitting 

{Acute Testitis.) clothing; by a metastasis or exten- 

sion or migration of the gonococcus 
from the urethra, by too quickly sterilizing the urethra by such 
drugs as balsam of copaiba, turpentine, cubebs, kava kava, or 
aggravated by strong irritating injections, or alcohol, or venereal 
excesses. In some cases, only a portion of the testicle is 
affected, such as its body ; or the epididymis and tunica vaginalis 
are attacked, or the entire gland suffers. 

Symptoms. — Pain, and feeling of weight in cord and testicle ; 
great uneasiness in the loin, groin, and upper part of thigh ; fre- 
quent micturition ; diminution or suppression of the urethral 
discharge ; swelling of the epididymis, which embraces and 
hides the testicle ; scrotum firm and tense ; swelling of the cord ; 
great tenderness ; pressure aggravates the pain. There is pain 
in the head, back, calves of legs ; rigors, and a fever ; nausea, 
vomiting, constipation. The inflammation, if violent, powers 
of life feeble, or inefficiently managed or treated, may terminate 
in chronic inflammation, with effusion of lymph, induration 
and enlargement, or abscess; or, if vital force is greatly de- 

41 



64: 



DISEASE GERMS. 



pressed, and system vitiated with mercury and syphilitic germs, 
gangrene. 

Trcatiue)it. — As there is nausea and often vomiting, with a 
depraved condition of the ahmentary canal, an emetic of lobe- 
lia, followed by warm or alcoholic vapor-bath ; then open bowels 
freely with salines ; administer aconite, veratrum and gelsemium, 
freely and frequently, till pulse reaches seventy, then in small 
doses at longer intervals ; opium and Dover's powder, to relieve 
pain ; apply, in the form of packs, several layers of canton flan- 
nel, embracincr the entire scrotum, saturated with the following : 
water, one quart; muriate of ammonia, half a pound ; nitrate of 
potash, quarter of a pound ; common salt, a handful ; tincture of 
iodine, one ounce. Mix. Cover with oiled silk, and moisten 
again and again. If skin of scrotum becomes tender or sore, or 
excoriated, keep it off a few hours, and apply cloths wet with 
^ot water and opium. Bowels to be kept freely opened ; patient 
must be confined to his bed ; diet as for fever. Just as soon as 
the active stage is controlled, place patient upon iodide of potassa 
in a vegetable alterative, followed by tonics. If the inflammation 
of the testis be due to the sudden suppression of a gonorrheal 
discharge, it is unquestionably a good plan to inject the urethra, 
once or twice, with a solution of the sesqui-carbonate of potass, 
so as to cause the gonorrhea to re-appear ; it has the effect of 
removing the inflammation from the testis at once. In bad 
cases, powers of life low, and ignorance of medical attendant 
gross, where the inflammation has been mal-treated, the testicle 
enormously swollen and very painful, it is found to be a good 
plan to puncture the body of the testis, so that by a division of 
the tunica albuginea, the pressure on lobules and convoluted 
tubes maybe removed. The incision allows a quantity of serum, 
lymph, and blood to escape, and affords instant relief in such 
cases. After such, some resort to compression with adhesive 
strips, but this is very painful, and the best plan is to apply the 
hot water and opium. After recovery, patient should wear a 
suspensory bandage for a {^\n months. 



In this we have a low grade of irri- 

Inflammation of the tation, with a large quantity of lymph 

Testicles. effused, which gives rise to very great 

[Clironic Tcstitis.) enlargement and induration, the testis 

becoming, in some cases, enormously 

increased in size. 

Causes. — It may be a sequel of an acute attack when badly 
managed, but more generally it is due to a low grade of irrita- 



BACTERICIDES. 



643 



tion, as horseback exercise, imperfect coition, strains, condums, 
stricture, gleet, or the presence of the syphilitic germ in testis. 

Symptoms. — Testicle hard and swollen ; slightly painful to 
pressure, but very weighty ; the irritation and effusion of lymph 
usually begins in the epididymis, and extends to the body of the 
testicle ; sometimes effusion of serum takes place into the tunica 
vaginalis. The syphilitic form is usually accompanied with indi- 
cations of the presence of that germ elsewhere, as on the tongue, 
throat, skin, bones or iritis. 

In the treatment of enlarged testicle, the patient should be 
placed upon comp. saxifraga and phytolacca internally. Remove 
all causes that can be ascertained, such as a stricture, or mastur- 
bation, or any impediment to sexual congress. Patient must 
wear a suspensory, with as much compression as possible. 
Such local remedies as ointments prepared from iodol ; iodide 
potassa and belladonna ; iodide of cadmium, and the like. Fail- 
ing all, an absorption of the effused lymph may be effected by 
electricity. 

Inflammation of the tonsils is one of 

Inflammation the most common affections of the mouth. 

of the Tonsils. One or both the tonsils may become af- 

(^Aaite Tonsillitis}) fected. 

The predisposing causes are weakness 
of organization, a tubercular diathesis or enervation of the glands 
by mercury, other poisons, etc. The exciting causes are cold, 
damp, exposure, cold drinks when body is heated, seasons of the 
year, as winter, spring, vicissitudes of temperature; common in 
all periods of life. 

Symptoms. — Those consist in the usual languor, lassitude, de- 
bility, rigors, and a fever of a pretty high grade. The tonsils 
and adjacent parts become sore, tender, painful, red, hot, and 
swollen. There is also great pain and difficulty in deglutition ; 
return of liquids through the nostrils in attempting to swallow ; 
there is pain along the eustachian tube and deafness ; glands 
exude considerable mucus, so that the throat is filled, and gives 
rise to some hawking and spitting ; respiration may be affected ; 
the parotid gland at angle of jaw sympathizes ; tonsils can be 
seen often, if double, almost meeting at the root of tongue. 

Its duration is from four to ten days. It may terminate in 
resolution, but apt to return on exposure ; or it may terminate in 
effusion of lymph, with thickening and induration,- or in breaking 
down of lymph, abscess. If indurated or hypertrophied, will 
alter the voice. 

Treatment. — Patient to be kept in bed ; warm room ; the ad- 



644 



DISEASE GERMS. 



ministration of an emetic of lobelia and capsicum is attended with 
good results ; to be followed up with large doses of tincture of 
aconite and belladonna ; mouth and throat washed out eveiy 
hour with chlorate of potassa and tepid water ; heat to feet, and 
general treatment for fever ; locally to the angle of the jaws, 
heat and moisture, poultices with mustard. Patient an adult, 
hypodermic action of pilocarpin might be tried ; it often breaks 
up most severe attacks. Its diaphoretic action is excellent, but 
it has a special action on the tonsils in stimulating them, and 
causing them to disgorge the inflammatory products with which 
they are loaded. If young, better to use the acetate of ammonia 
in alternation with compound tincture of serpentaria. Those two 
remedies act kindly and speedily. Benzoate of sodium is of 
great utility. Benzoate of sodium, half an ounce ; glycerine and 
ehxir of calisaya, of each one ounce. Dose one teaspoonful 
every hour. Salicylate of sodium is nearly as effectual. Just as 
soon as fever abates, begin with doses of iodide of potassa, rang- 
ing from five grains upwards, every three hours. 

If suppuration seems to be inevitable from the presence of 
rigors, pain changed to a throbbing one, and by the appearance 
of a yellow speck on tonsils to the eye, or sense of fluctuation to 
the touch, then let the patient inhale hot vapors of ammonia, 
poultice assiduously, and when ready for evacuation of the pus, 
administer a good, smart emetic of lobelia. In the straining 
efforts at emesis, the contents of the tonsil is freely discharged, 
and a rapid recovery takes place under good diet and such reme- 
dies as compound tincture cinchona and aromatic sulphuric acid. 
If any soreness or induration remains, chlorate potassa for a 
gargle, and iodide internally. 



Once the tonsil has suffered a partial 
Inflammation death, it is very liable to become irri- 

of the Tonsils. tated by very slight causes. This re- 
(Chronic Tonsillitis}) peated, spring and fall, soon tells disas- 
trously on the medulla oblongata, and 
the patient, after suffering a few attacks, becomes tubercular ; 
so that in chronic inflammation we usually find tubercular de- 
posits in the tonsils. In the chronic form there is little soreness 
or heat or pain, but a vast deal of effused lymph or tubercle 
thrown out, and as the gland is very vascular, they often become 
enormously hypertrophied , the enlargement being so great that 
they meet on tongue, causing thickness of speech and obstruction 
to swallowing and even to inspiration. 

In such cases, don't resort to excision, as there is danger ia 



BACTERICIDES. 



64; 



such a proceeding. Place the patient upon saxifraga and Phyto- 
lacca. The one remedy one week, the other the following. An 
effort should be made to hasten 
and stimulate absorption by 
painting the tonsils with equal 
parts of tincture of iodine and 
iodide potass, or jequirity in 
the form of distillation or 
powder ; never irritate ; apply 
about once a week. 

The jequirity causes a shell- 
ing or peeling to take place every time it is applied. 

Soothing mouth washes or gargles of slippery-elm ; benzoate 
of soda ; chlorinated soda, naphthaline. 

A tonic course, change of scene, best of food. 




Perfectly developed cocci found in the mouth 
and throat in aphthori tonsillitis. Magnified 
400 diameters. 



Inflammation 
of the Tongue. 

[Glossitis.) 



The tongue is greatly exposed to the in- 
roads and colonization of disease germs. 

Either acute or chronic inflammation of 
the substance of the tongue is comparative 
rare affection, usually dependent upon some 
or some caustic or irritant poison applied to 



constitutional cause 
the organ. 

In either case there is fever, great nervous depression, and 
debility. The local symptoms are those of pain, heat, redness, 
sweUing. The tongue becomes of a very deep red color, and so 
swollen that it fills and protrudes out of the mouth. It usually 
comes on quickly, and is often attended with urgent symptoms, 
and requires prompt treatment, as active purgatives, followed by 
hypodermic injections of one-third of a grain of pilocarpin, heat 
to feet, poultices of slippery-elm to tongue, and suppositories of 
veratrum viride and gelsemium per rectum. If mercury is the 
cause, iodide of potassa, chlorate of potassa gargles, and sulphu- 
retted potassa baths, or both. 



Acute inflammation of the uterus 
is comparatively rare in unimpreg- 
'nated states, but very common asso- 
ciated with impregnated states. 

Causes. — The causes of this condi- 
tion of partial death are, exposure to cold, damp, and excitement 
when menses are on ; shocks of all kinds, falls, blows ; irritation 
from sponges, rings, and pessaries; abortions ; violence from the 



Inflammation of the 
Uterus. 

{Acute Metritis) 



646 



DISEASE GERMS. 



instrument, of a whalebone, knitting-needle, in performing the 
act, and in the subsequent non-expulsion of all the membranes 
and clots; lingering labor, tedious, and painful violence from 
instruments in delivery ; the use of emmenagogue drugs, as savin, 
tansy, aloes, ergot ; the use of injections. It is doubtful whether 
or not, in very highly civilized women, it may be brought on by 
grief, worry, passion. Poisons, as the imperfectly-washed hand 
of an uneducated physician in removing the placenta, or pieces 
of the placenta ; or in administering ergot erroneously, causing 
the uterus to contract ; or a clot, or coagulum, which excites the 
inflammation ; gonorrhea, the forcible entry of large hands. 
Pathology. — i. Incases of puerperal endometritis, the uterine 




The uterus and its appendages viewed on their anterior aspect. 1, the 
body of the uterus ; 2, its fundus ; 3, its cervix ; 4, the os uteri ; 5, the 
vagina laid open ; 6, the broad ligaments of the uterus on the left side ; 
7, a convexity of the broad ligament caused by the ovary ; 8, 8, the 
round ligaments; 9, 9, the Fallopian tubes; 10, 10, their fimbriated 
extremities; 11, the right ovary; 12, the utero-ovarian ligament; 
13, the Fallopio-ovarian ligament in the peritonaeum of the anterior 
surface. 



and vaginal discharges contain a streptococcus which is present 
in pure, or almost pure, cultivation. 

2. In cases of puerperal pelvic inflammations associated with 
exudation, the discharges contain either the streptococcus with a 
staphylococcus, or the staphylococcus alone. 

3. In such cases where the womb or vagina contain some 
decomposing dead tissues (retained placenta, vesicular mola, etc.), 
the extremely fetid uterine and vaginal discharges prove to teem 
with peculiar rod-shaped microbes, which occur either alone or 
are accompanied by scanty non-pathogenic bacteria of various 
species. 

4. The puerperal streptococciKs is quite identical with the 
streptococcus of erysipelas. There is no difference whatever in 
their morphological properties and biological behavior. Besides, 
the inoculation of the former coccus to rabbits and man gives 
rise to a distinct erysipelatoid attack. 



BACTERICIDES. 



647 



The puerperal baci 



fairly 




[I are rainy thick and ^short (almost 
ovoid). They are, as a rule, arranged in pairs, which form 
irregular small-sized heaps. They grow well both on jelly and 
agar, but somewhat less so (especially in the absence of air) in 
broth. On gelatine they form large circular colonies of a yellow- 
ish-orange color, without liquefying the medium. When culti- 
vated in test-tubes, the microbes develop in from four to six days 
a characteristic offensive putrescent odor, closely resembling that 
of the puerperal discharges from which they have been obtained. 
When inoculated to animals they do not produce any local 
changes, but give rise to fever, the febrile elevation oscillating 

between a few tenths and 
2° C, and lasting from, 
four to eight days, ac- 
cording to the quantity 
injected. 

6. Hence, mild puer- 
peral affections may be 
subdivided into two large 
groups, one of which em- 
braces specific cases caused 
by the penetration into 
the patient's genital tracts 
of certain pathogenic mi- 
crobes (streptococcus or staphylococcus). The other group 
consists of non-specific affections determined by the absorption 
into the patient's circulation of certain ptomaines that are 
elaborated by the putrefaction bacilli described above, in the 
presence of putrescent substances (dead particles of animal 
tissues). 

Symptoms, — Should the shock come on the uterus during the 
menstrual period, or during the lochial discharge, the flow is 
suddenly arrested, and this will' also happen in hemorrhagic 
congestion. Simultaneously there is sharp, lancinating pain in 
the uterus, followed by rigors, and a fever of a high grade. 
Patient lies on back, knees drawn up ; features sharpen and be- 
come anxious; eyes look sunken ; tongue coated, pulse rising; 



Uterus, showin 



the thickening of its 
gestion. 



great tenderness o\'er uterus, a sense of fulness and weight. 
There is throbbing above pubes, in groin, and perinseum ; great 
pain in sacrum, irritable bladder and rectum. Either constipa- 
tion or diarrhea ; if the latter, tenesmus, which is troublesome. 
Usually nausea and vomiting, which is great or persistent if the 
outside covering or peritoneal coat of uterus is involved. The 
OS uteri, to the finger, is hot, congested, patulous, sensitive ; to 
the eye, it looks of a scarlet redness. The secretions of uterus 



648 DISEASE GERMS. 

acid and acrid ; usually after twenty-four hours there is a watery 
discharge, then bloody, or sanguineous, mucous, and serous ; 
pains become acute and bearing-down, intermittent, cutting, but 
at all times the uterus is the seat of pain, which is aggravated by 
pressure of the hand, or bed-clothes. This pain extends to 
perinseum and front part of thighs. If case does not ameliorate, 
symptoms assume a typhoid form. Acute symptoms rarely last 
over seven days. Recovery may take place when the damage is 
not great, and the patient's affections not blasted. 

In unfavorable cases abscesses form in the structure of the 
uterus, or other tissues, as the pelvic, areolar tissue, peritoneal 
membrane; substance of liver and stomach becomes involved, 
and gangrene sets in ; or, in another class of cases, it may leave 
chronic inflammation, or enlargement, or induration of uterus, 
labia, and a muco-purulent diarrhea. 

It may come on at any time if violence is inflicted. After 
parturition, a lady is not quite safe from an attack until after five 
or six weeks. It is exceedingly common and very fatal, and 
with very ordinary care it might be rare. 

Treatment. — Formidable as metritis generally is, still, if seen 
early, much can be done to aid recovery. Suffering is much 
relieved by the recumbent posture and complete repose. Com- 
mence at once with opium and tincture of green root of gelse- 
mium — half a grain of opium every half hour, with a few drops 
of the gelsemium (same as in peritonitis, pushed to narcotism). 
If we delay, or don't come right up to the mark of energetic 
treatment, the patient will die ; don't hesitate ; aconite does well, 
combined with gelsemium; excite an action on the skin with an 
infusion of asclepias, or boneset, or jaborandi ; mustard over 
pubes for an hour, then followed with hot poultices of linseed 
and opium ; keep patient on back, hips elevated ; enemata of 
linseed tea, with tincture of opium, irrespective of diarrhea or 
constipation, twice a day; injection per vagina, of the same, or 
else an infusion of camomile and boroglyceride, thrice daily ; 
dry heat to vulva; hop bags. If there is the debris of a placenta 
in the uterus, then that organ should be washed out with camo- 
mile and resorcin or creolin injection once a day. The great aim 
in the treatment of the case is narcotism ; the opium relaxes 
neck of uterus sufficiently to permit the escape of clots or other 
bodies. If there is much distressing tenesmus, and pain in the 
sacrum, suppositories of belladonna and opium should be used. 

Indeed, whatever the cause, from shocks, fright, lingering- 
labor, or violence, or whatever the symptoms may be, they can 
often be very successfully combated with the opium and gel- 
semium ; under those drugs the inflammation soon subsides, 



BACTERICIDES. 



649 



becomes tractable and manageable. Great care should be exer- 
cised less abscess takes place, and it is well, as the active indica- 
tions subside, to begin with small doses of quinine and antiseptic 
drugs. 

The period of treatment is so short, that if the patient can be 
tided over the seventh day, the condition of death, at least, may 
be obviated. Nourishment must be meagre, and increased 
as recovery progresses ; otherwise, if patient do well, the treat- 
ment of chronic metritis must be followed out. She must be 
careful not to get about too soon, as indiscretion may lead to a 
relapse. 

Chronic inflammation of the uterus con- 
Inflammation of sists in a low grade of irritation, either of 
the Uterus. the neck or entire body of the uterus, with 

\ Chronic Metritis^) effusion of lymph, which produces en- 
largement and induration. 
Causes. — It may follow an acute attack, or be brought about by 
masturbation, tight-lacing, which causes local plethora, or engorge- 
ment, or frequent miscarriages, or abortions ; wearing sponges, 
pessaries ; whalebone, knitting-needles, recklessly used ; gonor- 
rhea, excessive coition, cold, fright and a sudden arrest of 
menses, or suppression; use of irritating injections; emmena- 
gogue drugs. 

Symptoms. — There is a languor, lassitude, debility, pain in the 
head and. back, accompanied by a sense of weight at bottom of 
abdomen ; a bearing-down ; aching in thighs and hips, with 
severe griping pains in uterus, which is very sensitive to external 
pressure ; there are heats and colds, or slight febrile attacks ; loss 
of appetite, constipation, difficulty of breathing; and the head- 
ache is often intolerable. To the finger, neck of uterus is very 
tender, and has more heat than the surrounding parts ; to the 
eye, it is a little redder, but considerably thickened, and there is 
leucorrhoea. The plethora or congestion of the uterus, with aug- 
mentation of bulk, causes it to descend, and produces some ab- 
dominal swelling. This increase in size and weight is due to re- 
laxation of its tissues, and they being filled up with serum, 
lymph, blood, now grave changes take place, owing to the lost 
contractility and engorgement ; its functional activity is entirely 
abolished ; there is inertia, and the organ is predisposed to organic 
changes. The changes are not uniform, they depend often on condi- 
tions, as the transition to puberty, confinement, or forced, celibacy in 
virgins, or mental states; engorgements, indurations, ulcerations, 
are frequent results. These conditions are much aggravated if 
the chronic inflammation occur late in life, for then if the germs 



650 DISEASE GERMS. 

of tubercle, or cancer, or any dyscrasia lurk in the system, it will 
be likely to manifest itself In chronic metritis there is apt to be 
bladder trouble, rarely pain in sacrum, but possibly some pain if 
stools are hard. The entire train of symptoms of hysteria, in 
addition to the above, may be present. It may last a long num- 
ber of years. The menstrual flow is usually excessive or may 
come on several times during the month. 

Chronic inflammation of the uterus is one of the most common 
diseases among modern females, and renders their whole life a 
complete misery ; and even if in mild cases they should marry 
and pregnancy take place, miscarriage at four and a. half months 
will inevitably take place, owing to the stretching of the indurated 
fibres at neck, as the body expands, the irritation being carried 
to the fundus, and thus contractions are induced. 

Treatmoit. — Patients suffering from this very chronic disease 
are usually able to be about, and are often engaged in their ac- 
customed duties, although suffering greatly. If they are unable 
to rest a month or two, it renders the process of cure very diffi- 
cult, because rest in the recumbent posture, in bed, with elevation 
of pelvis, is one of our main stand-bys. The recumbent posture 
is always to be preferred to sitting, and gentle walking to stand- 
ing still. When menstruation is absent, daily bathing, shower 
bath, if possible, with hip-bath thrice daily ; the vagina should 
be syringed out three times a day with demulcents or emollients, 
as linseed tea, infusion of marsh-mallow, slippery-elm, or camo- 
mile flowers ; and as the case improves, alkaline injections, as 
soapsuds, borax-water, chlorate and permanganate of potass ; the 
temperature that is best is slightly tepid ; both bathing and in- 
jections to cease during the catamenial state, and when that is 
over to be resumed. Flannel clothing; bowels to be kept open 
once a day with cascara ; the appetite to be stimulated with 
tonics ; the very best of diet ; beef, mutton, game, poultry, boiled 
white-fish, eggs, milk, coffee. If digestion is faulty follow with 
pepsin. Then place patient upon alteratives and tonics, general 
course, with a class of remedies bearing more especially upon the 
uterus. 

The alteratives should be administered two hours after meals 
and should consist of one of the following for a week; then 
another, selecting the two that does the most good, using 
them alternate weeks : Iodide of potass in compound syrup 
of Phytolacca, compound viburnum, compound stillingia, iodide 
and bromide of potass, macrotys in compound yellow dock. 

Tonics before meals, selecting from the following : Glycerite 
of ozone, glycerite of kephaline, ozone-water, compound tincture 
of cinchona and nitro-muriatic, aromatic sulphuric acid and 
quinine, port wine and Peruvian bark. 



BACTERICIDES. 



651 



Inflammation of the different coats of a 

Inflammation vein with a coagulation of its contents, is 

of Veins. most Hkely to occur from the introduction 

{Phlebitis) into the true skin or cellular tissue of some 

pathogenic microbe, as the micrococci of 

metria, in the lochial discharge ; the virus of chancres ; the 

dressings of wounds, etc. 

Physicians, nurses, and especially washerwomen, are liable to 
have phlebitis, provided they have scratches or abrasions upon 
the hands, through which the germs might find an ingress. 

The germs of puerperal fever, erysipelas, the micro-organisms 
of all forms of pus, venereal germ, are most active and verv viru- 
lent. 

Symptoms, — The moment these micrographic molecules enter 

in the course of the 



radiating 



(^'^ 




the living tissue, there is pam, 
veins ; these vessels become 
thick, cordy, swollen, and a 
streak of redness appears along 
the entire course of the affected 
vessel, first extending to the 
elbow, then up the arm ; very 
prone, if not energetically 
treated, to terminate in suppu- 
ration ; if so, there are rigors 
and flying pains in different 
parts of the body, with great 
constitutional disturbance and 
fever of a nervous or irritative 
type. When suppuration and 
abscess take place the coats of 
the vein ulcerate, and the con- 
tained clot is discharged by means of an abscess. The bacteria 
or germ-poison or microbe does not produce coagulation ; it 
mixes with the blood, rendering that fluid a river of disease- 
germs, affecting the entire body, and giving rise to bacterial de- 
posits in weakened parts, with embolism and abscess in vital 
organs, as the heart, lungs, spleen, liver, kidneys, joints and 
areolar tissue. In some cases a clot is carriea from the \^ein to 
the heart, and causes sudden death. 

Treatment. — The general management of such a case is of 
great importance ; the suction and cauterization of the wound, 
the application of a solution of muriate of ammonia, and poultices 
with yeast and creolin. If the vein has become engorged, thick, 
cordy, the application of a row of leeches along it to empty it of 
its bacterial contents, and hot fomentation of ammonia or per- 



Section of a lymphatic gland in phlebitis, mag- 
nifying power, 700. In and around large 
number of minute bacilli are found at the seat 
of inoculation ; the spleen is large ; in the 
oedematous tissue and iii the blood-vessel-;, 
large and small, numbers of minute bacilli 
are found, chiefly contained in the white 
blood corpuscles, but also free. They are 
very minute, about o 008 to o.coi mm. long, 
to o.oooi to o'ooo2 mm. thick, isolated or in 
couples, or in chains. 



652 



DISEASE GERMS. 



manganate of potassa; or if the clot in vein is so firm that the 
diseased !blood cannot be drawn off, then to paint along the 
course of the entire vein with creosote, and then poultice with 
alkaline antiseptics, as tincture iodine in lime-water, etc. The 
creosote permeates the walls of the vein, kills the bacteria, and 
the blood regains its fluidity. It penetrates better than carbolic 
acid, and is just as effectual in annihilating the micro-organisms. 
Internally, acro-narcotics, as opium and belladonna in alterna- 
tion ; the former to relieve pain, the latter to maintain the fluidity 
of blood. Otherwise the case should be treated with a free use 
of antiseptics, those possessing alkaline properties, as ammonia, 
chlorate or permanganate of potass ; sulphide pf lime should 
have a preference. Suitable doses of quinine should also be 
given. The patient should be well nourished with essence of 
beef, eggs, cream, lime-water and milk, and a total alleviation 
from suffering. 



Influenza. 
Infusorial Catarrh. 



A specific, epidemic, and endemic 
disease, due to the annexed microbe, 
which is pathogenic of it, and cultiires 
from which it can reproduce itself again 
and again. 
Like all microbial diseases, it has a definite period of incuba- 
tion — sprouting and full growth. 

In some respects it is a marvellous 
germ, aerobic, can multiply in the 
air and reproduce itself 

Race and sex are equally attacked 
by the microbe. 

Symptoms . — The symptoms con- 
sist chiefly of a general and definite 
febrile disturbance, and of a special 
affection of the nose and air-passages. 
The disease commences with shiver- 
ing or a feeling of coldness down 
the spine, with a hot, dry skin, quick 
pulse, thirst, and severe headache. 
Sometimes these symptoms come 
on suddenly, sometimes they de- 
velop slowly in two or three days. 
If they come on suddenly, intense 
frontal headache with aching pain 
over the eyes is generally the first symptom. 

This feverish state usually lasts four or five days, and then 
gradually disappears, and its disappearance may be accompanied 




*iii^^ 



The microbe present in influenza or 
infusorial catarrh. 



BACTERICIDES. 



655 



by profuse perspiration or a troublesome diarrhea; in some cases 
the fever may last several days longer, but then some complica- 
tion has probably arisen and given rise to inflammation of the 
lungs or some other organ. The peculiar catarrhal affection 
usually follows the early symptoms of the fever ; it begins with 
swelling and dryness of the lining membrane of the nose, and 
the tissues or* cavities of the forehead, causing great frontal head- 
ache and frequent sneezing; the mucous membrane of the eyes 
or the conjunctiva are generally affected in a less degree, and a 
thin acrid discharge takes place; now and then bleeding occurs 
from the nose ; this condition then occurs all the way down the 
air-passages, even down to the smallest branches of the bronchial 
tubes. This affection may occur in the whole tract of the mem- 
brane at once, or, beginning in the nose, it may spread down- 
wards into the lungs. The inside of the mouth and the tongue and 
pharynx may also become implicated, but in a less degree. The 
discharge from this inflamed surface is at first thin and acrid, 
and at times bloody ; it then becomes thicker, tenacious, and 
purulent. The patient sneezes, has a troublesome and violent 
cough and pains in the side. There is great distress in breath- 
ing, and the pallor of the face and lividity of the lips show how 
great is the obstruction to the circulation in the lungs, for the 
blood becomes in such cases imperfectly aerated, and, owing to 
the accumulation of carbonic acid, flows through the vessels with 
difficulty. - In most cases the catarrh is at its height by the third 
or fourth day, and generally declines from the fifth to the seventh, 
but in severe cases it may last longer. Coincident with the fever 
and catarrh, and perhaps in proportion to the severity of the 
former, is a peculiar state of the nervous system. There is great 
depression and loss of spirits, with aching pains in the muscles 
and neuralgic pains in various parts of the body or extremities. 
The mind is often affected, and the patient may become stupid 
or delirious. The temperature of the body appears to be raised 
in most cases, but no exact observations on this point have yet 
been made. Sweating of the skin often occurs during the defer- 
vesence of the fever, or at the time when a descent of the temper- 
ature takes place, but rarely in the early stages. Crops of 
minute transparent vesicles, or little blisters containing fluid, are 
often seen on the skin. Meningitis, or inflammation of the 
membranes of the brain, and otitis, or inflammation of the ear, 
may come on now and then. Great delirium, as well as intense 
headache, is a dangerous symptom. Neuralgic pains are met 
with in many parts of the body, and there is also a remarkable 
prostration of the muscular strength. The cough comes on in 
paroxysms, and may be so severe as to bring on a rupture, or 



654 



DISEASE GERMS. 



even abortion in pregnant women. There is but slight expec- 
toration at first, and then the phlegm which is expectorated is 
stringy^ and often bloody, then it becomes more consistent, 
opaque, and purulent. Bronchitis, or inflammation of the bron- 
chial tubes, pneumonia, or inflammation of the lungs, and pleurisy, 
or inflammation of the serous covering of the lungs, are present 
in some cases, and add to the danger ; however, the frequency 
of their occurrence varies much in different epidemics ; their 
presence may be detected by a careful physical examination of 
the chest, and by the increase in the distress of breathing. 
Vomiting and nausea often come on at the commencement of an 
attack ; diarrhea, as a rule, occurs later on in the disease, when 
the fever begins to abate. In some cases the skin assumes a 
yellow tint, and bilious vomiting comes on. As in most febrile 
affections, the urine is at first high-colored and scanty, and after- 
wards it often deposits a pink or reddish sand, made up of 
lithates. Occasionally there is complete or partial suppression 
of the urine. Now and then swelling of the glands under the 
chin or in the neck has been observed. Convalescence is often 
retarded by rheumatic-like pains in various parts of the body^ 
and by prolonged debility or unusual nervous depression. 

Treatmejit. — Consists in general principles, warm bath, rest in 
bed in a warm room ; administer exalgine to reduce temperature, 
and comp. serpentaria to excite diaphoresis. 

Select an efficient bactericide, such as sulphide of lime, or 
glucozone, or carbolic acid and tincture of iodine, as in typhoid 
ifever ; hot steam atomizers charged with iodine, or liquor 
chlorinated soda should be kept going on at bedside, and disin- 
fectants exposed in the room in which patient is confined. 
Naphthaline is excellent for this purpose, as it retards the devel- 
opment of the spores. 

Naphthaline finely powdered and well spread, or in solution 
and continually shaken, has its disinfecting power increased. 
In a temperature of 98° the effect of naphthaline is much more 
powerful, which makes it highly probable that it is chiefly in its 
gaseous state that it destroys the germs. Gaseous naphthaline 
in solution has more effect on aerobic than on anaerobic bacilli, 
and more on germs cultivated in a solid medium than on those 
cultivated in liquid. The conditions for the full effect of naph- 
thaline are much more favorable in the intestines than in the test- 
glass. Naphthaline added to feeces decreases their germs by 
about a half, but, administered internally, it first decreases them 
to one-third or even a quarter; after this, however, their number 
rises again almost to its original figure. Against the bacilli of 
infusorial catarrh, naphthaline is considered still more effective, 



BACTERICIDES. 



655 



and decreases the number of the germs even to one-tenth. The 
administration of naphthaUne should be commenced at the very 
beginning of influenza, and continued all through the case. 
Subsequently tonics and nourishing food. 

Epizootic affections in the horse are identical with influenza in 
the human being — in causes, symptoms and treatment, the 
amoeba in animals being of a large or giant micro-organism.. 
But suppose this form peculiar to the horse is communicated to 
man, we not only have an aggravated form of influenza or 
catarrh, but the giant amoeba brings about chronic inflammation 
of liver, spleen, kidneys, giving us ha^maturia, Bright's disease, 
leucocythaemia, dropsy and death ; so that in cases of \\ is kind 
our best modes of nutrition, our most powerful antiseptics and 
tonics, fail either to destroy the germ or maintain vital force. 

/^z';//^ ^^ is simply a modified form of the epizooty or giant 
amoeba, only affecting the mucous membrane of the eye instead 
of the nose. There is a scarlet redness of the eyes, quite con- 
siderable swelling, intolerance of light. General health is usually 
bad from over-work, over-crowding, sameness of diet, or else 
poor food, bad ventilation. 

In all such cases an alterative and tonic treatment should be 
maintained for some months, and the very best of diet that the 
circumstances of the patient can afford. 



These consist in the bruising, laceration, and 
Injuries, division of various tissues, with or without w-ound 
of the skin and other parts. In all injuries from a 
simple contusion or bruise up to the most aggravated lacerated 
wound; from a simple strain up to a perforation of the skin, all 
are changed, altered into a bacterial mass. Even an ecchymosis, 
superficial or deep, all is bacteria. 

When superficial, the ecchymosis of the skin appears speedily 
as a swelling of a reddish color, which speedily becomes black ; 
on third day, violet, with diffused margin or edges; on fifth or 
sixth day, green; on seventh or eighth day, yellow ; and then 
gradually disappears about tenth or twelfth day, sooner or later, 
according to the vital force of the patient, and intensity and 
depth of contusion. If the contusion is deeper-seated, it may 
not appear for twenty-four hours, or several days. Ecchymosis 
may, besides being due to injuries, be a symptom of purpura, 
scurvy, fevers, or of gangrene in inflammation. 

The object of all sound treatment is to overcome the condi- 
tion ot partial death, by checking extravasation of blood, by 
preventing inflammation, by sterilizing and annihilating all mi- 



656 



DISEASE GERMS. 



crobes. For this purpose, the injured part should be placed in 
an elevated position, and a bactericide applied. To an ecchy- 
mosis, a lotion of peroxide of hydrogen should be applied ; to 
an incised wound, a solution of boroglyceride ; to a laceration, a 
wash of chlorate of carbon. 



being a word of negation, is not easy to define. 

Insanity, Doubtless we may speak of it correctly enough as 

any condition which is not that of sound mind, 

but as this soundness of mind cannot be judged absolutely but 

only relatively, in giving such a definition, we are simply tossing 

the ball from one hand to the other. 

Each case, in point of fact, must be considered by itself and as 
a whole. Nay more, one law which after all defines insanity, lays 
down different tests to be applied in different classes of cases. 
Broadly it may be said that the tests of lunacy, which are com- 
monly used in exactly the same sense as insanity, are in each 
case incapacity to manage property or danger to the public, in 
criminal law ; however, it is broadly laid down that the test of sanity 
is the knowledge of right from wrong — a test, as has been well 
said, which, applied to our lunatic asylums, would set at liberty 
three-fourths of their inmates. It would be useless here to enter 
into metaphysical speculations as to the connection between mind 
and brain, or the alterations in brain substance which are most 
commonly associated with the insane condition ; suffice it to say 
that the current belief is, that in the great majority of cases of 
insanity there is a change in the brain substance just as there are 
changes in the lung in diseases of that organ,, or of the heart 
when that part of the body is affected. For just as the function 
of the lung is respiration, and that of the heart circulation, so is 
the function of the brain the manifestation of mind. As we find 
in other parts of the body, however, when the self-balancing 
power is lost or in abeyance, there may be disorder of its func- 
tions without any marked, or, at all events, protracted signs of 
local change, so we may have in the case of the brain temporary 
insanity without any permanent disease of its structure such as 
give rise to the more permanent form of the malady. The causes of 
insanity are generally assumed to be of two kinds, as is usual in 
medicine ; predisposing and exciting, but the so-called predis- 
posing causes mean merely a state in which the individual is 
more likely to become insane than if the same set of circum- 
stances were operating on him in any other state. Accordingly, 
the term predisposing cause may be looked on as synonymous 



BACTERICIDES. 



657 



with tendency, and the origin of these tendencies has here to be 
discussed. 

By far the most potent of these tendencies is derived from here- 
ditary transmission, or, as would sometimes seem, transmission 
from collateral branches of the family. It is of the greatest pos- 
sible importance to fairly understand and to face the tendency of 
insanity to become hereditary, for an individual with such 
an inheritance, if duly guarded, may pass through life fairly 
able to fulfil its duties, whereas if the fact of this inheri- 
tance be ignored and the individual left to face the world 
like men of stronger mental equilibrium, it is more than likely 
that at some crisis the equilibrium will be upset more or 
less permanently. The most difficult question arises, however, 
when marriage comes into play. Too often these things are kept - 
profoundly secret, or even intentionally hidden away, especially 
where property is concerned ; the result in rnany cases is un- 
fortunate, the more so that the consequences of the deception 
frequently fall on the guiltless. We may, however, lay it down 
as a rule that if one has once been insane — be the individual 
male or female, though the rule is more binding on the 
latter than the former — marriage should determinedly be put 
out of the question. Much more difficult is it to decide in 
the case of those who belong to an insane family, but who 
have not themselves shown any signs whatever of the malady. 
There is always a certain risk, and this must be fairly faced, 
but the risk is less the further removed the insanity is from 
the individual concerned. Thus, an insane uncle or aunt 
would be a matter of much less moment than an insane 
father or mother, and an insane father or mother portends 
less risk than does an insane brother or sister. This here- 
dity, however, tends to obliterate itself in course of time 
in two ways. Intermarriage with a healthy stock gradually 
diminishes the tendency to insanity in the survivors, and 
there is besides not only a natural but an artificial tendency 
to put an end to the heredity from the increasing num- 
bers thereof. Thus, a certain number of those tainted will 
probably be incapable of propagating the race, and a certain 
number more being locked up will have no opportunity, and 
so between the two the insane members of the family tend 
to die out, whilst the stronger, having intermarried with a 
more healthy stock, in course of time become like other people. 
Age has something to do with the liability to insanity. It 
is greatest between twenty-five and forty, least in the first ten 
years of life. Then, too, the nature of the insanity varies M'ith 
the age at which the individual is attacked. In the earlier years 
42 



658 



DISEASE GERMS. 



of life there is much more violence connected with insanity than 
there is with the later ; if this rule is reversed, the likelihood of 
recovery is very greatly lessened. Sex, as already hinted, has a 
good deal to do with the liability to insanity, though not in the 
way one might have conceived. When men have grown up they 
are exposed much more to conditions likely to disturb the mental 
equilibrium than are females ; but, on the other hand, if there is 
a tendency to insanity in m.arried females, it is, especially in the 
time of childbearing, etc., likely to have full effect. Next come 
the causes called exciting, which are special to the individual and 
not to any class or group, though practically it is found that the 
same causes do operate in a very considerable number of in- 
stances. Chief among these are the moral causes of insanity, 
which may operate suddenly in the way of mental shock, or they 
may act over a number of years. Doubtless the former are the 
more potent in destroying mental equilibrium, especially ia a 
mind which is badly balanced by heredity or by means of 
the individual's own habits and training. These last, however, 
belong rather to the group of physical exciting causes. The 
most important, according to all accounts, is the inordinate use 
of alcohol. This is especially to be avoided in those of originally 
weak mind. 

The symptoms of insanity differ greatly from the signs of any 
other disease. They consist in great measure of the sayings and 
doings of the insane individual, either acquired by the observer 
from direct inspection or by hearsay. There are certain words 
used in connection with the mistaken beliefs of the insane, which, 
though in ordinary parlance used synonymously, yet, strictly 
speaking, have got totally different significations. These are de- 
liision, lUnsion and hallucination. 

A delusion is a false belief relating to something which has a 
real existence, but to which the insane individual supplies attri- 
butes totally false. Thus he entertains a belief that some one, 
probably the least likely to do so, desires to swindle him ; that 
he himself is a prince possessed of boundless wealth, etc. 

An illusion is a false interpretation of the senses. There is 
something to be and something, to have, but the patient gives 
them a totally false significance. A i<t\N rags are gorgeous robes ; 
pebbles, pearls of great price; a few words spoken in an ordinary 
tone, a command to an army, etc. 

A halluciftation is, on the other hand, a mistake on the part of 
the senses. The eye or the ear itself seems to be at fault; the 
patient hears and sees things where there is nothing to see or 
hear. The word delusion is that commonly used so as to cover 
both the other terms ; but should be limited to the mistaken 



BACTERICIDES. 



659 



imaginings of one whose brain is disordered. These delusions 
are sometimes of a gloomy description. The patient is depressed 
or nervous, and proceeds to account for this feeling in the way 
most congenial to his fancies. A rich man may imagine himself 
a beggar ; a good and worthy man, damned to all eternity. More- 
over, everybody knows it, and treats him accordingly, or he has 
some special tormentor who will never leave him alone. Some 
patients entertain delusions of a totally different character ; these 
delusions are exalted delusions. They fancy themselves rich and 
powerful, and they are happy ; and yet the bodily condition of 
some of these poor patien's is most miserable. They very fre- 
quently indicate a form of brain disease which advances through' 
^vhat to the bystander are exceedingly painful stages to certain 
death. Such delusions are most frequent in the condition known 
as general paralysis of the insane. Again, there are patients 
whose delusions take a different turn ; they live in fear and 
dread, but under which they are not passive ; they are prepared 
to fight, do anything for their life and liberty. Such are amongst 
the most dangerous class of lunatics. But it is not only by 
means of ideas, it is also by means of acts founded or not on 
these, that we judge of man's sanity. 

Amongst the most notable acts of the insane are indecent ex- 
posure, which very often occurs in the early stage of general 
paralysis, and stripping off of clothes, which has a most variable 
signification. Very frequently the removal of clothes is had re- 
course to out of revenge for not being allowed to do as the patient 
pleases. In other cases the patient cannot bear the feeling of 
clothes on the surface, and so tears them off him to get rid of 
them forever. In either case it is troublesome and an expensive 
symptom. In many cases it is hopeless to cope with it. Give the 
patient the strongest materials, fastened on ever so carefully, by- 
and-by they will be torn off and torn to pieces ; blankets are torn 
in the same way. For the former class, that is to say those who 
destroy clothing not knowing what they do, nothing well can be 
done ; but for the others some sort of punishmenthas to be devised ; 
for they know perfectly well what they are about ; and if this fails, 
constant watching, which generally puts a stop to the nuisance. 

Suicidal acts, or acts of self-mutilation, are frequently com- 
mitted by the insane. In the form of insanity called suicidal 
melancholia, where from the depression of mind life has become 
unbearable, it is frequently hardly possible to prevent the patient 
from destroying his life. He will watch his opportunity for years, 
and the first opportunity is sure to be taken advantage of. Very 
frequently in these patients the homicidal is closely associated 
with suicidal impulse. The subject of homicide, however, brings 



56o DISEASE GERMS. 

US to the consideration of those acts which are directed towards 
others rather than to the patient himself. Not unfrequently 
homicide or suicide is the result of over-powering terror. This 
perhaps is the most frequent form assumed in the insanity of 
drunkards. The patients in dread of their lives attempt to escape, 
and are killed in the attempt, or in their desperation and dread of 
attack turn upon the attendants and kill them. A goodly num- 
ber of the murders committed by the insane are from delusions. 
A man thinks his wife and children are going to starve, and so 
thinks it better to kill them at once ; or he fancies he has got 
a command from on high to sacrifice them, and does so. Yet, 
again, it may be done from sheer wantonness, as by an imbecile. 
In all of these cases there is, as a rule, no difficulty in making out 
the insanity ; it is not concealed, and may otherwise be only too 
apparent ; but there is yet another group of cases, which are of 
a much more doubtful category. It is well known that the great 
majority of confirmed epileptics sooner or later become totally 
insane. These constitute the very worst class of insane patients. 
Utterly untruthful, not a single word they say can be depended on. 
Nor is an attendant's life safe with them. Before the onset 
of the epileptic fits, if they have them at intervals, they 
generally go through a state of excitement, in which they 
are exceedingly dangerous. Now the stage is sufficiently well 
marked long before the minds of the patients are so far gone 
as to require them to be sent to an asylum, and during these 
periods they are at any time liable to commit murder, and so it 
may be said of them just after such an attack. It is, however, 
with regard to paroxysmal insanity that there is most discrepancy 
between the opinions of alienists and the public at large. In the 
latter the idea is not pleasant that a man may go on all his life 
quietly and decently; yet suddenly an uncontrollable impulse 
comes on him to murder some individual, after which he returns 
to his normal state. Yet most physicians, who have studied the 
subject, are agreed that this is so ; and it has now apparently 
been admitted by the Bench. 

Homicidal mania, on account of its great importance, is not 
infrequently elevated into a special form of insanity. So too are 
certain others, one which, however, we generally hear ot when 
affecting some of the higher classes of society. These are klep- 
tomania, entomania, and pyromania. 

Entomania can hardly be called a special form of insanity ,- 
inasmuch as the patient almost invariably labors under other 
signs of brain weakness. Nevertheless, in some insane patients^ 
the lucid instincts are the most prominent of these symptoms. 
Such instincts are exceedingly common in many cases of insanity,. 



BACTERICIDES. 66 i 

especially in the early stage of general paralysis. It is, however, 
in women that the form of the malady is most marked, especially 
in young women. 

So Q>i pyromania. Undoubtedly a good many patients have an 
inclination to set things on fire, but such a tendency is hardly to 
be elevated to the rank of a special form of insanity. In many 
insane people the impulse to destroy everything they can lay 
their hands on is very great, and a very convenient way of so 
getting rid of things is to set them on fire. But in all of these 
patients there are other signs of insanity than a tendency to set a 
light to everything they can. Roughly, and in such a way as 
will well suit our purpose, we may divide most cases of insanity 
into two divisions ; those in which there is apparent exaltation, 
and those in which there is depression, and these two we shall 
describe as mania and melancholia ; but both of these tend in the 
long run to end in a condition characterized by absolutely no 
mind — what we term dementia^ though there is a condition not 
inappropriately termed acute dementia. 

Most forms of insanity are preceded by a period during which 
the patient is. not quite himself; he is odd in his ways; there is 
confusion of intellect ; bad sleep at night, and the patient is 
easily excited. The advance of the malady depends a good deal 
on the amount of sleep taken. His delusions, at first mere mo- 
mentary fancies, become fixed and insuperable, and drive the 
patient to acts of insanity. Then most likely the medical prac- 
titioner is called in, and the patient is probably moved to some 
place of refuge. At this time the patient will probably complain 
of headache, very likely with slow pulse and confined bowels ; 
if a woman, the menstrual function is generally impaired, or there 
may be pregnancy, recent parturition, or nursing. All these 
may be removed, and yet the patient does not get well ; we can- 
not restore the mental balance. As a rule, the first thing is to 
remove the patient from home, and surround him with new at- 
tendants who will take him duly in charge in every way, when 
he will be removed from the causes of aggravation, be they what 
they may. With this change of scene and pursuit there should 
be a change of diet to a nutritive one, if it has not been so before, 
and then everything must be done to secure good digestion and 
a due nutrition. The bowels must be properly looked after, and 
sleep must be got. Opium is not good ; in such patients it often 
excites rather than soothes, and increases the headache. Chloral 
is better, and had better be given in good full doses, thirty grains 
or so. It does not confine the bowels. If there is a tendency to 
epileptic fits, bromide of potassium had better be given them too, 
in full doses of twenty or thirty grains, three times a day. 



662 DISEASE GERMS. 

Tonics, especially strychnine, in careful doses, given so that the 
patient can never command enough to do himself harm, should 
be administered. 

All these things require very careful superintendence, and as 
it is quite possible that the patient may get worse instead of bet- 
ter, when constant action may require to be taken, it is always 
better to select a place for change of air and scene where there is 
a good practitioner on whom you can rely, not only for medicine 
but also for what in such cases is more valuable — namely, advice 
how to act. Most probably, if the case assumes a confused 
character, it will also assume the phase either of melancholia or of 
mania. If melancholia, then the utmost depression overpowers 
the unfortunate individual. Everything that happens round him 
seems to be connected with his evil fortune. Very likely he 
thinks he has committed sins too black for him to hope for for- 
giveness. No argument will get him out of these notions ; it is 
useless at this stage to attempt it. The appearance of many 
such patients is very striking. Woe-begone in the extreme he 
may stand for hours in one spot, never moving, or he may be 
restless and trying to wander away, so to speak, from his evil 
fate. Usually such patients suffer a good deal in health ; they be- 
come thinner from want of food and sleep. The pulse is slow 
and weak, and the general condition of the patient indicates im- 
perfect nourishment and bodily change. Suicide is greatly to be 
apprehended in a good many cases, perhaps the majority; and 
this tendency may be so suddenly developed as to defy anything 
save the greatest caution from the commencement. For this 
reason, skilled attendance is of the first necessity, but it does not 
greatly matter whether that be carried out at home or in an 
asylum. Food and sleep are the two great remedies for this 
state, with absolute mental quiet. For sleep, chloral is best ; 
but if this does not suit, morphia may be given under the skin. 
The diet should be carefully selected, so that nourishment in 
abundance may be given. Sometimes these patients refuse their 
food, and when that is so, they must be made to take it, either 
bylthe stomach pump or through the nose. The bowels must be 
moved and kept open. First had better be administered a 
turpentine enema, after which a dose from time to time of castor 
oil, or a small quantity of aqueous extract of aloes, daily at din- 
ner time, will suffice to keep them open. The moral treatment 
of such patients needs to be begun as early as possible. The 
great thing is to draw their attention from themselves, and that 
must be done carefully and judiciously. Once they are brought 
to take an interest in anything outside themselves, they will 
generally do well; this is the first step towards recovery. At 



BACTERICIDES. 663 

this Stage, any sudden event which necessitates, or ought to ne- 
cessitate exertion, will frequently suffice to complete a cure ; but 
if there has been no improvement, it may do harm. Certain of 
the peculiarities above alluded to as characteristic of melan- 
cholia are much better marked in the form of the malady known 
as dcute melancholia. The patient becomes actually frenzied 
from fright. Such patients have very high suicidal tendencies,, 
and require the most careful watching. These, too, are the 
patients who most commonly refuse food, and who require to be 
fed forcibly. They also refuse to lie in bed at night, and espe- 
cially to be covered by bedclothes. This too must be forcibly 
combated. Patients, the subjects of this form of disease, gener- 
ally end badly. They are sure to be badly nourished, and a 
very little superaddition to their troubles in the way of acute 
disease, finishes them. The lungs are especially liable to be 
fatally affected by low forms of inflammation. 

Mania, accompanied by delirium, is perhaps that form of the 
malady which is taken as the type of madness by uneducated 
people. The patient may be suddenly seized wath this form of 
the malady, and may as suddenly become free from it. It is 
most frequently caused by violent passions, disappointed love, 
violent grief and the like, especially if the patient be weak-minded 
or hysterical. The importance of such an attack must depend 
very greatly on the soil in which the bud is cast ; if there be 
much of an hereditary taint, the attack rray be a final and complete 
one, whereas under more favorable circumstances it may speedily 
pass away. As a rule, too, the more marked the symptoms of 
onset, and the longer they have shown themselves before the 
actual malady bursts forth, the more severe it is likely to be. It 
is not always desirable to hurry these patients to an asylum, for, 
as said, they may recover perfectly in a day or two ; but fre- 
quently it becomes absolutely necessary to do so. 

Acutely delirious patients generally behave much in the same 
way. They sing and shout, and will not rest a minute. Com- 
monly they are utterly incoherent, jumbling their words together, 
or they repeat one word or phrase like a parrot ad infiiiituin. 
They show less delusions than do many other insane patients — 
their condition is indicated more by gesture artd behavior than 
word. Sometimes they are full of glee, laughing and shouting ; 
at other times they are angry and outrageous, but not nearly so 
dangerous as some who are quieter in their demeanor. As in 
most similar conditions, the great object here is to get sleep and 
rest, for which chloral is the best medicament. Opium generally 
does harm. Some prefer digitalis to all other remedies, or give 
its active principle, digitalin, under the skin. The wet pack is a 



664 DISEASE GERMS. 

means of treatment greatly commended by some. (See Packing^ 
It is chiefly with regard to these cases, or to the occasional out- 
bursts of chronig lunatics, that the question of restraint or non- 
restraint arises. To some it may seem superfluous to speak of 
there being nowadays a question between the two. Nevertheless, 
no asylum can be carried on without some system of restraint. 
It is itself a system of restraint, and the only question is how 
best to restrain the patient ; if that can best be done by living 
force, let it be applied in the form of the male or female attend- 
ant's hand. If such is likely to do more harm than good, or 
even if it cannot be used with such advantage as can some other 
form of restraint, let the other, even if it be the strait waistcoat, 
be applied. During the. very acute attack there will be some- 
times an entire absence of sleep for days and nights. Women 
•can stand this much better than men ; but both men and women 
require to be well sustained by food during the sleepless period. 
Rest, food, and sleep are the great remedies, and the means of 
procuring the last have once more to be examined. Once more 
chloral stands at the head of the list ; once more opium has only 
to be mentioned to be forbidden. Indeed, before chloral came 
in, treatment by baths was relied upon, so general was the dis- 
trust against opium. No doubt the baths did good by soothing^ 
but they also weakened the patient. The bath, to do any good, 
must be hot, and a stream of cold water or an ice bag should at 
the same time be applied to the head. The best temperature for 
the bath is about 92° or 93° F., and the patient must be kept in 
it for a considerable time — half an hour or so. Shower baths 
are not to be given. If the bowels be confined a good dose of 
calomel may be given ; but this had better not be repeated. 

There is still another form of niaiiia, which may be acute, and 
yet there is no delirium. This insanity may consist of delusions, 
but more frequently manifests itself in actions usually of a vio- 
lent and dirty description. Frequently the patients have their 
wits about them in an almost surprising fashion, quite baffling 
the medical man who endeavors to examine them, so as to sign 
a certificate for their admission to an asylum. Yet, as soon as 
the practitioner is gone, they are dirty and abusive as ever, 
shameless in their conduct, tear up clothes and sheets, break 
windows, chairs, and the like — in short, act like the veriest 
demons. Their incoherence might sometimes be mistaken for 
delirium; but it is totally different. The health of these patients 
is fairly good ; they eat well and sleep well apparently when 
they like. At all events they will have good rest one night, and 
the next they will disturb the whole ward throughout the whole 
night. Sometimes they may go on like this for long periods 



BACTERICIDES. 



665 



together, and, as they are exceedingly troublesome, care must be 
taken to get them quieted. This was the class, and they consti- 
tute a goodly proportion of our asylum folks, who used to be 
dealt with by bodily punishments. The plan did not succeed. 
The plan now adopted, which as a rule, but not invariably, 
answers, is to give to those who are quiet and well-behaved, and 
who do any work, some trifling reward — extra beer for dinner, 
tobacco or snuff, which are always greatly relished ; the privilege 
of excursions and the like. Work in the field or garden is the 
best means of keeping such maniacs out of mischief Very often 
these patients are allowed to run on without care or attention 
until too late, provided they are not especially troublesome, for 
the malady tends to a chronic course if not speedily cured, and 
the only hope of cure rests in seclusion. 

There is a variety of insanity to which the name monomania 
has been given, and of it kleptomania, entomania, pyromania are 
commonly adduced as exam.ples. But it is rare, if indeed such 
a thing ever happens, to find a man mad on one point and not 
on others also. At all events this almost invariably happens — 
one permanent feature of their maladies may for a time be most 
marked, but by-and-by, as time passes, the madness is seen in 
other features of the patient's character, and he probably ends by 
becoming a chronic maniac of the class just described, or a 
melancholia, but without the characters of either division being 
very strongly marked. 

Such are the main divisions of insanity ; but there is one other 
so peculiar that we are fain to give a brief sketch of its history. 
The malady is commonly called general paralysis of the insane. 
It is commonly described as constituting three stages, of which 
the first is such as may give rise to little anxiety on the score of 
insanity, though the individual is often greatly altered from his 
former self The second period is one of acute mania, with ex- 
alted delusions, and the third one of complete dementia, with 
complete prostration of mind and body. In the first stage, a 
general paralytis is usually a prey to exalted notions of his own 
importance and power. If he has money he scatters it broad- 
cast, fancying his supply of it is unlimited. He asserts himself 
as some great dignitary, not unfrequently God Himself; but if 
this position is denied, he will not take the trouble to argue the 
question — he will let the objector go in what seems to him his 
besotted ignorance. As a rule, too, sexual ideas take hold of 
him, he exposes himself in any situation, or assaults women in 
the most unlikely neighborhoods. He is restless, and, above all, 
forgetful. He takes an interest in nothing, or if he do it is laid 
aside in a moment, all about it being forgotten. At this period, 



666 DISEASE GERMS. 

too, in some cases, though not in others, there may be observed 
a tremulousness about the upper hp, and a slowness of speech, 
which are very characteristic. Both these signs, are, however, 
much more marked in the second stage, when the patient becomes 
fairly the subject of delusion. These delusions, as already 
pointed out, are all of an exalted character. He can do wonders in 
every way. All his surroundings, though of the most trumpery 
kind, are interpreted as being of the grandest character ; his 
power is immense, and his bodily strength, though like that of a 
child, he thinks incomparable. As to physical signs, as already 
pointed out, they commonly begin with slowness of speech or 
rather a kind of interval between each syllable, with a kind of 
stutter or drawl something like the utterance of an intoxicated 
man. There is, too, that tremulous motion of the upper lip 
which is so peculiar; but in some there is a kind of stiffness and 
swelling instead of the tremulous condition. The tongue, too, 
trembles when thrust out, and it is thrust out with a jerk, as if 
the patient had not full command of it. 

As the malady advances the delusions of these unfortunately 
get worse. At the same time they are liable to break out in fits 
of violence of a most dangerous character. They are altogether 
unreasoning, and as they are generally men in the prime of life, 
they are not easy to manage when they break out in fits of vio- 
lence. By-and-by they become subject to fits of a peculiar kind, not 
seldom resembling the slighter attacks of epilepsy called/^/// ynaL 
The walk alters, it becomes vacillating about the hips, and the 
legs are not moved as usual, but are rather thrown forward with 
a kind of jerk. The hand-writing, too, becomes imperfect both 
as to mechanism and material. Words or letters are omitted or 
inserted wrongly, the same word is repeated over and again. The 
whole is nonsense. ■ The food is eaten voraciously, sometimes 
bolted, but in other cases, especially as the malady advances, there 
is difficulty in swallowing from paralysis of the fauces. Such- 
patients are very destructive and very dirty, but they tear up 
their bedding without knowing what they are doing, and they 
dirty themselves very frequently for ornament. 

By-and-by the patient gets worse ; he can hardly walk or 
shuffle round the room ; he loses power over the bladder and rec- 
tum if not constantly attended to. His face has lost all expres- 
sion, and yet it seems fat and puffy. He can hardly hold any- 
thing in his hand, and if he is confined to his bed, sores form 
which are hard to heal. Grinding of the teeth is very often 
a marked symptom. His appetite is still good, but he has lost 
the power of swallowing comfortably, so he crams his mouth and 
throat, and there is a risk of suffocation if this is not seen to^ 



BACTERICIDES. 66/ 

At this time all such patients require to be fed. In point of fact 
everything must be done for them. But even in this state they 
may survive a good long time if care be taken of them, and if 
they are protected from cold, to which they are very sensitive^ 
The averag-e duration of the disease, from the onset to the end,, 
does not exceed as a rule two years, whilst it may be much less. 

The causes of the malady are hard to determine. It generally 
occurs in the prime of life, and most frequently in males. In a 
certain number of cases it can be traced to overwork of the brain, 
but as the malady is more common among the laborers than the 
rich, this will not account for nearly all. Another cause assigned 
is sexual excess. This, of course, is no easy to make out, but 
irrregular lives have been noted in a considerable number. As ta 
treatment, that is useless ; we must just do our best to keep the 
patient quiet, clean and orderly. We must try to feed him well, 
and as soon as any difficulty in swallowing appears no food must 
be given in the solid state — the pulpy condition is best. If they 
are confined to bed for a day or two their backs must be care- 
fully watched, and, if necessary, washed with some weak spirit 
with a little corrosive sublimate in it. Stimulants are usually 
necessary, especially in the latter stages — in the maniacal stage, 
they must be given with caution. In these cases during a 
maniacal paroxysm digitalis or digitalin often does good, but only 
for subduing the paroxysm ; nothing does good permanently. 
Meanwhile, as far as we know, the malady invariably ends in 
death. 

Feigned insanity has already been alluded to, but briefly. 
Often as insanity is assumed the fiction rarely succeeds. The 
would-be lunatic, as a rule, overdoes his part ; most likely he has 
never seen a lunatic, and his only conception of one is a raving 
maniac. The means of*detecting feigned insanity are not too nu- 
merous, each case must be dealt with on its own merits; and there 
are some men known to be sane who have for years succeeded in 
keeping up an ostensible insanity. 



Associated with, and dependent on a shal- 
Kleptomania. low state of the typical fissures of the brain, 
among the ordinary phenomena of minds not 
regarded as insane, there is an inordinate tendency to acquire, 
or collect, or hoard. So long as such an impulse does not inter- 
fere with the rights of others, or involve a breach of the law, it 
is readily admitted as an indication of disease, or an absurdity or 
eccentricity which may consign the individual to an asylum, or 
to contempt. But when the amount of the object appropriated. 



568 DISEASE GERMS. 

or the circumsiances under which it is purloined, bring the mat- 
ter into a court ofjustice, the act is treated as a theft and pun- 
ished. In very many cases this is the result of cerebral disease, 
in which the typical fissures of the brain are partially wiped out. 

The inclination to steal is a premonitory indication of many 
forms of mental disease, often a characteristic symptom, where 
violence, delusion, eccentricity, incoherency leave no doubt as to 
the source from which it springs. But there are many other 
cases in which the morbid origin cannot be so clearly demon- 
strated ; where the mind is clear and cogent, the morals pure, 
and where the theft is the only proof of insanity. 

The propensity to steal may be so irresistible that the will is 
impotent, that the appropriation is involuntary and the perpe- 
trator irresponsible. 

The gratification of the impulse is found associated with phy- 
sical changes and conditions which may be regarded as incom- 
patible with the healthy discharge of the nervous system, but the 
connection is not invariable, and the best mode of establishing 
the reality of such a disease, is to consider marked cases, in rela- 
tion to the character, interests, and previous development of the 
individual, to the nature of the articles taken, to the motive 
which determined the action. The incongruities of some point 
to the existence of deep-seated cerebral changes. 

Each case must be tested on its own merits and all its salient 
points and features well considered. The objects stolen, often 
ostentatiously, without any adequate precaution to conceal the 
attempt, or perhaps the article taken may be of no value, even 
useless to the taker, or the taker quite wealthy. The act is soli- 
tary, without motive, and promptly and spontaneously avowed 
and restored. 

This disease is observed in extreme, youth, near puberty in 
both sexes. It often follows falls, blows on the head or spine, 
and looms up as a symptom of perverted sexual abuse, and of 
pregnancy. 

But it is when the uterus undergoes those critical and crucial 
changes at the turn of life, that this affection is most prevalent. 
The interstitial changes in the womb and ovaries is reflected to 
the brain proper, and produces grave changes in the cerebrum 
— changes which the modern jurist and philanthropist should note. 
The incarceration of such cases is a blot on the civilization of the 
age. 

The therapeutics of insanity are of late years becoming more 
extensive. 

Chloral hydrate and bromide of potassa in syrup of orange 
peel, must be given cautiously lest cardiac syncope be induced. 



BACTERICIDES. 



669 



Chloral, bromide potass, conium and hyoscyamus best adapted to 
procure sleep. 

The hydro-bromate of hyoscyamus very valuable in melancholia. 

Amyl nitrate is very useful alternated with morphia. 

Ergot, combined with hypophosphite of soda, excellent when 
paralysis is threatened. 

When insanity is complicated with epilepsy, belladonna, gel- 
semium and cannabis indica afford most salutary results. 

Turpentine of utility when symptoms of an hysterical nature 
manifest themselves. 

Strychnine, avena sativa, electricity, calabar bean, used with 
variable success. 

For procuring sleep, amylene nitrate, sulphonal, paraldelyde, 
hydrochlorate hyoscyamus. 



Insomnia is often an early and premonitory 
Insomnia. symptom of a partial death of the brain. 

(Sleeplessness) It may be caused by passion, mental anx- 
iety ; dyspepsia ; imperfect action of the liver ; 
constipation ; disease of the heart, pregnancy. 

It is often an aggravated and persistent symptom of chronic 
inflammation of the brain, insanity, mania, chronic alcoholism. 

Besides, it is often present in neurasthenia, poverty of nerve 
force, cerebral softening, paralysis and other states, which are the 
sequel of exhausted nerve force, whether by mental work or 
sexual excess ; it brings about the state of an organ tissue- 
starved. Following this, granular deposits on the arachnoid, 
adhesion of the membranes to the surface of the convolutions, 
crystalline granulations in the lining membranes of the ventricles, 
with an unusual amount of fluid in the sac of the arachnoid and 
in the lateral ventricles are found in the brain of those who de- 
vitalize that organ. A tissue-starved brain gives rise to inflam- 
mation of the cortical part of the brain, ending in its degenera- 
tion of the nerve cells of the hemispheres, structural change in 
the convolutions, the cells of which lose their integrity and look 
like an irregular heap of particles ready to fall asunder. 

The brain of man owes its healthy existence to the quantity of 
phosphorus it contains ; if this is enconomized, independent of its 
scantiness in modern food, it might sustain him probably as long^ 
as life lasts and health holds out; but let the brain starve, health 
fails, nature can supply no more ; then, unless the patient can 
obtain phosphated food, or ozonized tincture of oats, or the 
animal phosphorus of kephaline, degenerative changes will take 
place in the gray substance of the cerebrum ; the cells of that 



6/0 



DISEASE GERMS. 



part will become granular and deposits of granules scattered 
through its substance, and these changes take place in all parts 
of the brain and spinal cord, when the phosphorus in the brain 
is exhausted. Brain workers, merchants, professional men, 
know this ; they feel it in their languor, tired brain ; those are 
the victims of excessive brain exhaustion. How far this granu- 
lar change in the nerve cell is compatible with healthy mental 
action, we cannot yet say. 

In the treatment^ the removal of the cause, whether it be men- 
tal or physical ; the regulation of the secretions ; daily baths, 
with massage ; good digestible food ; moderate exercise ; 
abundance of fresh air ; an avoidance of all stimulants, as tea, 
coffee, tobacco, are all important. 

One essential element in the management of all cases of insom- 
nia is to crowd in more elements containing more phosphorus. 

In order to accomplish this, without disturbing the organism 
too much, it is always best to administer a tonic, either wine of 
cinchona or ozonized coca wine ; the latter being essentially the 
most active, it stimulates the absorption of vitalized phosphatic 
compounds. The tincture of oats and the glycerite of kephaline 
are the two best remedies for brain nutrition ; and we can pro- 
cure their absorption by means of the coca. These remedies 
when thus administered, penetrate the brain, nourish and invigo- 
rate it. These are our two best brain foods, a nerve-vital essence ; 
they entirely supersede comp. hypophosphorus as a recon- 
structor of shattered nerve force ; invaluable in all forms of loss 
of brain power, as loss of memory, paralysis, white softening ; 
very refreshing to the nerves when tired by worry, when in neu- 
ralgia they cry for richer food, purer blood. 

These are the only true remedies, they cause sleep by promot- 
ing cerebral nutrition. 

In order that this point be correctly gained, sulphonal can be 
administered in doses sufficient to procure sleep, until the remedy 
has time to act. 

Sulphonal is the best of all drugs for that purpose, as it does 
not interfere with the secretions. 

It is a capital remedy in cases of sleeplessness in brain-starved 
subjects. 

Other drugs of value are boldo ; glucine ; methylal ; hydrate 
of amylene ; somniferin ; antipyrine ; hyoscyamus, etc. 

All remedies failing, then the case should be placed upon 
precisely the same treatment as that employed for neurasthenia, 
namely, vitalized massage, electricity, seclusion, rest, and gener- 
ous brain diet. This is never-failing, although expensive. 



BACTERICIDES. 



671 



Invagination or intussusception is the most 

Invagination frequent of all kinds of interstitial obstruc- 
of tion. In the case of children, it is the charac- 

The Bowels, teristic form of obstruction, and any other kind 
is a rarity. In adults, the affection is far less 
-common, and differs in its locality and in its clinical course. 
The disease is far more frequent in children than in adults, and 
in infants at the breast than in older children; it is more 
common in boys than in girls; in adults, the distribution be- 
tween the two sexes is more nearly equal, or even. 

The invagination may take place at any portion of the bowel, 
but most common at or near the ileo-caecal. In the so-called 
enteric form, the lesion is in the small intestines ; next the colic 
variety, in which the large intestines is affected, and the valvular 
or iieo-colic variety, in which the ileum passes through the valve. 
Intussusception of the rectum is so rare that it is a pathological 
curiosity, and still more exceptional is it for the duodenum to be 
involved. 

judging from statistics, the common types are more common, 
and the rarer forms more rare than is generally supposed. 

The course of this affection is essentially acute, from a few 
hours to a few days from the first symptom to the termination in 
recovery or in death. 

Synnptovis are remarkably constant and even; pain always per- 
sistently present, severe, and sudden in its accession ; then remit- 
ting, returning again and again. It is of a colicky character. 

Vomiting is usually an early and very constant symptom. It 
is a reflex effect. In chronic cases it subsides, or may even be 
absent at first, and appears in the later stage, when mechanical 
obstruction has become complete. 

Tenesmus, which is often mentioned as a characteristic symp- 
tom of invagination, only appears when the intussuception has 
reached the rectum. It would seem to be always absent when 
the small intestine is the seat of the disorder, and is naturally 
more obvious in adults and older children than in the case of 
infants. 

The bowels are, in some of the most acute cases, confined 
from the first, in others diarrhea appears for a time, and in the 
more chronic there is often a period of irregular looseness of the 
bowels, ending in complete obstruction. 

A more characteristic symptom is the passage of blood, or of 
blood and mucus, unmixed with fecal matter, containing no pus, 
and varying from frequent and abundant hemorrhage to the 
presence of a little blood-stained mucus on the examining finger. 
We never see the black, tarry stools ■ of mela^na, for the blood has 



^,7 DISEASE GERMS. 

r.ot undergone acid digestion in the stomach. Hemorrhage from 
the bowel is almost invariably present. 

The characteristic sign of a tumor felt through the abdominal 
wall was present in sixteen cases out of twenty-four. The 
only other movable tumors likely to be present in a case of 
obstruction are a scybalous mass in the colon, a gallstone im- 
pacted in the small intestine, or a cancerous nodule in the omen- 
tum. The two latter possibilities would be excluded in the great 
majority of cases of invagination by the age of the patient. No 
other tumor moves gradually from the right iliac fossa across the 
abdomen, and no other contracts under the hand as an invagina- 
tion sometimes does. If the reflex centre is in any way weak- 
ened, tetanic symptoms slight or aggravated according to the 
weakness existing. 

Abdominal distension is occasionally an early symptom, but 
more often only appears in the latter stage of chronic cases. It 
was most marked in a case which lasted three months, and was 
associated with visible peristalsis, an appearance commonly in- 
dicative of chronic obstruction in the larger intestine; but in this 
case the invagination affected the ilium. 

Infants very early show signs of collapse, with cold extremi- 
ties, feeble pulse, and sighing respiration. The temperature is 
often subnormal, but in one case of mine, in a child six months 
old, it rose to above 103° F., although the autopsy showed neither 
peritonitis nor any other morbid condition, but a reduced ileo- 
caecal invagination. 

Diagnosis. — When there is no tumor to be felt either in the 
rectum or through the abdominal walls, the diagnosis of the case 
depends on the combination of symptoms of acute abdominal 
disturbance, pain, vomiting, and early or late obstruction, with 
the passage of blood and mucus. When these occur in a child 
almost the only condition likely to be confounded with invagina- 
tion is ulcerative colitis, so-called infantile dysentery. In adults 
the diagnosis is more difficult. Cancer of the upper part of the 
rectum may closely simulate the effects of invagination, particu- 
larly when it leaves diarrhea, instead of, or in addition to. 
constipation. 

Prognosis and Treatment. — Invagination is always a grave con- 
dition. There is little doubt that the bowel occasionally extri- 
cates itself by a reversed movement, as may be seen in the case 
of animals dying from asphyxia. This natural reduction hap- 
pened in three out of twenty-four cases, in one of them under 
the influence of chloroform. 

Far more frequently cases left to themselves go from bad to 
worse ; the invagination extends farther and farther, and the 



BACTERICIDES. 



673 



patient dies quickly of abdominal shock, or more slowly from 
exhaustion or from peritonitis. If the invaginated gut slough? 
off speedy death often follows by perforation or by hemorrhage. 
Probably this event was more frequent formerly than now, when 
our power of diagnosis and of treatment is better. It has rarely 
been recorded in the case of children, and is an accident of 
chronic rather than of acute cases. The part involved is more 
often the small than the large intestine. 

The best treatment seems to be to administer chloroform at 
once, and then to inject air. When the abdominal walls are re- 
laxed, a tumor before undetected may be readily felt, and the 
condition is more favorable for inflation. If for any reason, how- 
ever, it is undesirable to administer chloloroform, or if inflation 
has to be repeated, there is no need for an anesthetic, since the 
operation is painless. The hand should be kept upon the ab- 
dominal tumor while air is being forced into the bowel ; the 
inflation of the colon is then felt, and the tumor disappears from 
the touch with a characteristic sensation. Moreover, one can 
thus better appreciate and regulate the force used, which must 
be gradually and cautiously increased. If with justifiable pres- 
sure reduction is not effected, the best plan is to desist for two or 
three hours, put the patient under opium, and try again either by 
inflation or by an enema. Not infrequently the invagination 
returns after reduction, but it may be again reduced by a second 
or even a third inflation. When the invaginated gut has reached 
the anus, or protrudes therefrom, it must first be replaced by a 
large, well-oiled bougie, until there is sufficient space in the rec- 
tum for the nozzle of the inflation-pipe to enter two or three 
inches. An ordinary pair of bellows is as convenient and efficient 
as any other means of inflation, and has the great advantage over 
specially devised apparatus of being always at hand. 

Some good authors prefer the administration of forcible and 
copious enematato inflation as a means of reduction. The water 
should be warm, plain or medicated with lobelia ; and the requi- 
site power obtained by raising the receptacle from which it flows. 
Advantage is moreover gained by raising the patient's pelvis, or 
by more complete inversion of the body, so as to open out the 
sigmoid flexure and increase the space between the *' plug '^ and 
the anus. On the whole, the injection of air appears to be the 
safest and most efficient treatment. 

Neither method, however, is uniformly successful. Indeed, 
when the invagination has long existed, adhesions have taken 
place, so that no safely exerted pressure can reduce it ; and if 
this were effected it is likely that a rupture of the softened Oj. 
sloughing gut would take place. In one case that lasted only ^ 

43 



6/4 



DISEASE GERMS. 



single day it was found impossible, even after death, to effect re- 
duction by injection of water into the rectum. 

In these cases we must, after two or three careful and patient 
attempts, either keep the patient under opium and hope for a 
natural cure by the plug sloughing off safely, or else open the 
abdomen and deal manually with the invagination. 

In this case we have the great advantage of a diagnosis, so 
that the surgeon knows what he has to deal with. The seat as 
well as the nature of the obstruction can usually be ascertained, 
and there is scarcely ever already existing peritonitis. These 
are all favorable circumstances, but on the other hand we have 
the early age of most of the patients, and the fact that they are 
already exhausted by want of food for hours or days, as well as 
by pain and vomiting. In the more chronic cases the patient is 
usually older and stronger, and more nourishment has been 
taken ; but it is likely that adhesions and other local changes 
may have rendered reduction impossible or dangerous. 

The results of treatment are not, therefore, very favorable. Of 
a very large number of cases treated, a very large percentage 
died. The most recoveries take place under the administration 
of large doses of opium, hyoscyamus and belladonna, internally ; 
with copious warm lobelia injections into the rectum. 

In nearly all cases of abdominal section, death follows, not 
from the operation and peritonitis, but from the damaged state 
of the invaginated intestine, or from the shock and collapse. 



This is the name given to a disease of the skin in 
Keloid, which there is hardening or thickening of that tissue, 
so that the part very much resembles that seen after 
a burn. It occurs on the back and upper extremities chiefly, and 
seems to be an incurable disorder. The word ** keloid " or 
**kelis" is derived from a Greek word signifying a crab's claw. 
There seems to be two kinds or varieties of this disease. The 
one appears as hard, shining tubercles or small nodules of a 
dusky or deep-red color, and generally attended wtth itching, 
pricking, shooting, or dragging pain in the part. These tuber- 
cular elevations gradually increase in size until they are as large 
as a horse-bean or even an almond, and about one-tenth or one- 
sixth of an inch above the general level of the skin. They are 
hard, firm, and elastic, but after a while they become broader and 
more irregular. Some delicate whitish, glistening lines appear 
on the surface, and from each there is a claw-like process from a 
quarter of an inch to an inch in length, which appear to cause a 
puckering of the skin. Growth may go on for months and even 



BACTERICIDES. 



675 



years, but they only cause local inconvenience and do not impair 
the general health. The other form of keloid does not begin 
with tubercular elevations, but as white, roundish patches of 
skin, very slightly raised and surrounded by a zone of redness. 
At first there is no pain nor uneasiness ; afterwards there is itch- 
ing and pain with a feeling of tightness in the part ; at length 
the part becomes hide-bound, and the skin is hard and rigid, so 
that the movement of the part is impaired. The fingers are very 
liable to be affected in this way. After a time the skin shrinks, 
becomes red or yellowish, and may go on to ulceration. If the 
affected part be extirpated it often returns, and no treatment 
seems to be of any avail, but a prolonged use of the Chian turpen- 
tine mistura. 

Skin diseases in our country have neither the 

Leprosy, virulence nor malignity of other parts of the world. 
This is due to our highly oxygenized atmosphere, 
to the extreme abundance of healthy food, and cleanliness of our 
people. 

We look with holy horror at the emigration to our north- 
western States of nearly all the lepers of Scandinavian Europe 
and Asia. It is well known to our profession in those States 
that certain localities are literally packed with individuals having 
this malignant disease. The time is opportune and no false 
notions of philanthropy or religion should deter us from insist- 
ing upon the segregation and isolation of all lepers, and upon 
forbidding all such entering our country in the general tide of 
immigration. 

Lepra is an infectious parasite disease of an exceedingly 
chronic character, the microbe or parasite in its embryonic state 
breeding in the blood, when more matured invading every organ 
and tissue of the body ; chiefly characterized by cutaneous pig- 
ment changes, disordered or abolished sensation — making its 
chief ravages upon the skin, in either tubercles, bulbae, cicatrices, 
atrophies, or destruction. The germ creates a cachexia which 
terminates fatally. 

There are several varieties as lepra tuberose, maculae, anaesthe- 
sia, etc. 

Leprosy is a contagious and infectious parasite disease, produced 
by the bacillus lepra. Common to both sexes, all ages. After 
the microbe is once hatched, breeding freely, it produces organic 
or degenerative changes in the nerves, which explains the 
anaesthesia, or hyperaesthesia, and possibly th-e pigment altera- 
tions, so characteristic of the malady. 

The peculiar inaptitude of the nervous tissue to undergo retro- 



676 



DISEASE GERMS 



gressive metamorphosis ; the slow growth of the germ, its ten- 
dency to invade the skin with no involvement of the internal 
viscera, explain the slow growth of the disease. 

The bacillus lepra is discernible in no other disease affecting 
man, although in leprosy, in tuberculus, in syphilis the aggrega- 
tion of germs often tend to cutaneous and subcutaneous growths 
or nodes ; nodules in the cornea, cartilage, testicle, spleen, liver, 
bone. 

In a drop of blood placed under the microscope the germ is 
visible in lymph spaces, or in any new formation. The microbe 
consists of fine, slender delicate rods with tapering extremities, 
some rather long and pointed, some clearly mobile and others 
not. In the secretions they are recognized sprinkled through 
the mass, have a beaded appearance. 

The germ bears artificial culture in blood, serum, and alkaline 











The microbe of leprosy in its embryonic state, 
magnified 1000 diameters. 



.•^^ 



The full-fledged bacillus of leprosy, mag- 
nified 1500 diameters. 



meat extracts. Inoculation on animals nearly allied to man pro- 
duces the disease. 

The germ is most prolific in the tubercular form of leprosy ; 
here their growth is prodigious, and as a result they are found 
in enormous numbers in the mouth, palate, larynx, liver, spleen, 
kidneys, testes, lymph glands, and in the interstitial tissue of the 
nerves in anaesthesia form. 

The recognition of leprosy is very easy ; the eruption, its ap- 
pearance, odor, chronicity, its large, brownish-yellow, glazed 
bulbous lesions; its leathery, mica-tinted cicatrices are rare in 
any other contagious disease. 

As regards treatment we have a most remarkable and exceed- 
ingly tenacious microbe to deal with. No remedies known to 
science have thus far had any direct curative effect ; that is, we 
have not yet found the potent germicide. Even the Chian tur- 



BACTERICIDES. 



677 



pentine with the ethereal peroxide of hydrogen, with resorcin 
and thallin, which so effectually annihilates the cancer germ, fails 
in half the number of cases in which it has been used to destroy 
the lepra bacillus. Other remedies, as the comp. saxifraga; 
half-drop doses of creosote ; oil cf cashew nut, gurgun balsam, 
ichthyol, chaulmoogra oil, alvelos milk, siegesbeckie, internally 
and locally have all been employed with varying success ; they 
mitigate greatly, but fail to exercise a controlling influence over 
the disease ; that is, they do not kill the germ. 

The most recent and extensively used remedies to kill the mi- 
crobe in the connective tissue between the nerves, are chaul- 
moogra oil and gynocardic acid with glycerine. Both oils 
are administered internally in increasing doses to one drachm a 
day. Chaulmoogra oil in emulsion. 

■The adoption of a highly nutritious diet, the exhibition of our 
best tonics, as iron, cinchona, avena, kephaline, wine and malt 
liquors are always of good service. 

Baths are of great advantage in all cases. Those of the high- 
est potency in germicidal properties, as ozone, sulphur and 
iodine, should have the preference. Such remedies would be of 
utility in syphilis and cancer. 

Every secreting ulcer and open surface in a leper should be 
attended to by the application of resorcin and ozone ointment, so 
as to destroy the bacilli that are contained in it. The prominent 
indications in each case should be met. If the patient happen to 
reside in a district where the disease prevails, an immediate 
change of residence and climate is necessary. 



An essential symptom of all diseases of 

Leucorrhcea. vagina, uterus, ovaries. 

It is therefore present in debility of the va- 
ginal walls ; in acute and chronic inflammation of the uterus ; 
uterine catarrh, and ulceration ; in all forms of displacement; in 
all forms of ovarian irritation, etc. 

If the original morbid condition can be got rid of, there is 
little trouble in getting rid of leucorrhcea. 

General internal treatment consists in the use of tonics and 
alteratives; pulsatilla and caulophyllum, in alternation with the 
aleteris cordial and compound tincture cinchona. 

As the discharge in all cases is loaded with disease-germs the 
remedies used must be bactericides ; as extract hydrastis, dioxide 
of hydrogen in tepid water ; hemlock bark, dioxide of hydrogen 
in tepid water; acetic acid, solutions of boroglycerides ; packing 
the vagina with boroglyceride ; lime-water and tincture of iodine. 



6/8 



DISEASE GERMS. 



Infantile leucorrhcEa, as seen in children of three or four years 
of age, differs altogether from the leucorrhoea of adolescence or 
maturity. Its location is the vulva ; discharge, sero- or muco- 
purulent. The subjects of this disease are tubercular, and the 
victims of hereditary syphilis. Exceptional cases are due to the 
germs of the eruptive fevers and ascarides. There should be an 
improvement of the general health by all possible means, fresh 
air, abundance of nutritious food, cleanliness and the affected 
parts bathed three times daily with a warm solution of borogly- 
ceride. Internally, compound tincture of matricaria in five- 
drop doses, in water, is most effectual in overcoming the patho- 
logical condition of germ evolution which is dependent on 
debility. 

A disease in which the number of white 
Leucocythaeniia. corpuscles in the blood is greatly in- 
creased, with a simultaneous diminution 
of the red. This state is brought about by chronic, exhausting 
diseases, exposure to cold, wet, privation, and insanitary condi- 
tions, and often a sequelae 
of malaria, typhus, typhoid, 
puerperal fevers and pneu- 
monia; affections of the 
lymphatic glands or of the 
spleen, and is attended 
with a decided train of 
symptoms. 

Great weakness and de- 
bility, anaemic pallor, with 
all the other symptoms of 
anaemia ; disordered re- 
spiration, loss of appetite, 
mental depression, abdomi- 
nal swelling, with enlarge- 
ment and induration of the 
spleen ; sometimes diar- 
rhea, at others, constipa- 
tion, nausea, jaundice ; 
often hemorrhage from 
nose, lungs, stomach ; jaundice, anasarca, ascites, prostration, 
ending in death. Very chronic, lasting usually quite a number 
of years. 

The morbid condition is characterized by an excess of white 
corpuscles in the blood, with great enlargement, induration of 
the spleen, often as large as a child's head, its proper structure 




Destruction of the red corpuscles of the blood in the 
spleen by the microbe of malaria, which gives rise 
to the white-cell disease of the blood. 



BACTERICIDES. 679 

obliterated, filled with coagulated blood, soft and friable, and a 
mass of bacteria. Oftentimes we have a peculiar inflammation 
of the retina. 

All methods of treatment and our best remedies fail us in this 
disease. 



An eruption consisting of small pimples or papules, 

Lichen, arranged together separately, or in clusters, and oc- 
curring anywhere on the surface of the body. The 
term is restricted to inflammatory papules, which undergo no 
metamorphosis. 

In the treatment there are three indications, the improvement 
of the general health, especially as regards the nervous exhaus- 
tion ; the relief of the itching by local means, which will go far 
towards the removal of the eruption. 

The patient should not scratch the heads off the pimples, as 
he may produce an irritable sore which may become eczematous. 
The papules arenot large, but are hard, dry and red in color. 
They tingle or itch and disappear by scaling off. Numerous 
varieties are described, according to the cause which gives rise 
to it ; none of them dangerous, but as a rule troublesome or 
intractable. 

The employment of general alteratives and tonics, among the 
latter, avena, mineral acids, nux vomica. 

Local remedies of most utility are thymol, naphthaline, respr- 
cin, creolin, rubbed up in lard or vaseline ; in the form of lotions, 
try oil of cade cut with alcohol ; or chrysarobin five to ten per 
cent, solution ; baths of sulphuret potassium. 

The case must be pushed; nerve tonics, it is essentially chronic, 
and if untreated may last for years, spreading and leading to 
grave complications. 

Various lesions may be occasioned by the local application of 
many substances ; chiefly irritants ; but eruptions also some- 
times follow the internal administration of certain drugs. 
Amongst the more common thus caused are the following : 

A scarlatiniform eruption (from belladonna), erythematous 
patches (from quinine or chloral), a rubeoloid eruption (from 
copaiba), a vesicular rash (from arsenic), pigmentation (from the 
prolonged administration of arsenic or silver-salts), an acneiform 
eruption (from iodides or bromides), and a purpuric rash (from 
iodide of potassium). 

By leaving off the drug, those various eruptions will each and 
all disappear in forty-eight or seventy-two hours, without any 
treatment whatever. 



68o DISEASE GERMS. 

A hybrid micro-organism produced by the pre- 

Lupus. sence of the microbe of syphilis and the bacillus 
tuberculosis. It usually attacks the face and mani- 
fests itself in a variety of forms. 

L. erythematosus. — The least severe form. Most common in 
the female sex and usually attacks face. It is mostly symmetri- 
cal and makes its appearance as an erythematous patch on either 
cheek. These generally become joined across the nose, the ar- 
rangement then somewhat resembling a butterfly with its wings 
spread out. Sooner or later scabs form which adhere closely to 
the skin. When removed by the nail, they are seen to extend 
into the orifices of the sebaceous glands by numerous fine pro- 
cesses from their under surface. The scabs, in fact, consist of 
dried sebaceous matter. The disease has, therefore, been con- 
sidered by some as an affection of the sebaceous glands. Its 
affinities, however, are more marked with the other affections de- 
scribed as lupus, and like them it leaves permanent cicatrices. It 
is a chronic affection and may last for years. 

L. vulgaris. — The more severe form often causing great de- 
struction of tissue. Begins mostly in early life — usually before 
puberty, often in quite young children. May go on for years 
even if vigorously treated. More common in the female sex. 
Sometimes hereditary. Said to be frequently associated with 
struma, but many cases of scrofuloderma were doubtless formerly 
erroneously regarded as instances of lupus. Any part of the body 
may be attacked but, as with the erythematous form, the face 
is the favorite locality. It also attacks the mucous membranes. 
The characteristic appearance of lupus is that of rninute yellowish- 
brown translucent (" apple jelly") nodules in the substance of the 
skin. They average a line or two in diameter, are not raised 
above the surface, and are covered with epidermis. The tuber- 
cles may occur singly or in groups. The former arrangement is 
rare and has been termed acne lupus from its superficial resem- 
blance to the follicular prominences seen in acne. More generally 
the nodules occur in groups which gradully tend to get larger 
owing to fresh portions of the skin getting attacked. The older 
nodules get paler in color. Microscopic examination shows the 
growth to begin by an aggregation of small round cells in the 
corium mainly in the coats of the vessels. The growth extends 
along the vessels until it involves the whole thickness of the 
corium. It occupies the interspaces of a fine fibrous network in 
which a few capillaries may be seen. Later, there is marked over- 
growth of the epidermis, and the cells of the rete malpighii are 
infiltrated with leucocytes. 

The two principal varieties of L. vulgaris are L. exedens (or 



BACTERICIDES. 68 1 

exulcerans) and L, non-exedens, so named according as ulceration 
does or does not occur. L. tuberculatus is a form in which the 
new growth forms prominent tubercles, and pustular lupus is a 
variety having a superficial resemblance to impetigo. 

In L. non-exede7is the new growth does not extend deeply but 
is limited to the skin itself, a considerable tract of which may 
become ultimately involved by irregular gradual extension of 
the disease. As the growth advances in a fresh direction cica- 
trization takes place in the parts first attacked and grayish-white 
glistening scars are left. The hair-follicles are destroyed in the 
process and the hair is therefore not reproduced on the areas 
attacked. Compared to the next form this is a comparatively 
benign affection, though deformities may result from the con- 
traction of the cicatrices. 

L. exedensls that form in which the process goes on to ulceration. 
Most common on the face, especially on the nose and cheeks. 
As a rule the ulceration has more tendency to advance superfi- 
cially than deeply. When the process has lasted a certain time 
a fresh patch is attacked, and on the older patches a scab forms, 
beneath which gradual destruction of the tissues may still go on. 
More or less cicatrization may ultimately result and disfigure- 
ment or deformity may ensue. On the face the lower eyelids may 
be drawn down and everted, the mouth drawn out of place, and 
incurable nasal deformity be caused. On the limbs the con- 
traction may limit the movements of the joints. In those 
rarer cases in which ulceration tends to extend deeply extensive 
destruction may be caused. Almost the whole of the face may 
thus be destroyed and even the bones may be attacked. 

Pustular lupus is an eruption consisting of isolated tubercles 
{occasionally confluent) which may reach two lines in diameter. 

They become pustular at their 
summits, and soon small dark 
scabs form and adhere firmly. 
If removed fresh ones form. 
The tubercles finally disappear, 
leaving temporary discolora- 
tions and permanent scars. 

In lupus we have a hybrid 
germ ; a microcosm, which ex- 
ercises a fierce, unrelenting 
struggle for existence. 

The hybrid microbe lupus in nests interspersed T„ ;j.^ f^^t^^t-l^^^ i^ra. "U'^rro. o 

with sweat ducts and sebaceous follicles. -■■" iLS lOrmailOn WC naVC a 

disappearance of both the bacilli 
of tubercle and that of syphiUs ; no doubt these two bacilli, when 
together, generate a diastase which kills themselves. 




682 



DISEASE GERMS. 



The hybrid microbe, the factor of lupoid infiltration and ulcera- 
tion in all its varied forms, is the direct offspring of the micro- 
organism of syphilis and tubercle in the blood. The presence 
of both germs in the lupus nest in the skin, actively proliferating, 
places the origin of the disease beyond all doubt, as well as the 
fact that both disease germs can be isolated and cultivated. 

Simultaneous with the evolution and growth of both mother- 
germs, the hybrid lupus follows. 

Both the internal, as well as the external, treatment, must ne- 
cessarily be, in the highest degree, germicidal. 

The internal treatment should be constructive and alterative, 
the best of diet, bathing, clothing and a mode of life calculated 
to build up vital force, embracing the very same remedies which 
are of utility in syphilis and tuberculosis, as the iodide of starch, 
saxifraga, glycerite of ozone, sulphur water, hydrogen, peroxide, 
Phytolacca, have a marked effect in sterilizing the organisms, 
dwarfing their micrococci and their multinucleated masses of 
protoplasm. Constitutional remedies do great good ; they 
sterilize the blood and the lupus-nests fail in their organization. 

The favorable results obtained 
by some of the following local 
remedies have again and again 
been verified. The favorite are 
either iodized oil, thymol, ich- 
thymol, naphthol, chrysarobin, 
iodol, sozoiodol, creosote, per- 
oxide of hydrogen, salicylate 
soda, chromic acid, sulphurous, 
pyrogallol in ointment form. 
Equal parts by weight of ozone 
ointment and resorcin most 
efficacious ; lactic acid. 

Erosion, scraping by the der- 
mal curette or spoon*, followed 
by the application of iodoform, 
has met with fair results. Be- 
fore any remedy, either in 
ointment, lotion or in gutta- 
percha and chloroform be ap- 
plied, the crusts should be softened by boroglyceride oil and 
slippery-elm. If a caustic be deemed indispensable, electrolysis, 
or nitric acid in which the chloride of gold et soda is dissolved, 
should have the preference. A mixture of thallin and papoid. 
made into a paste, of immense value ; sprays of C. P. peroxide of 
hydrogen, very effectual. 




Lupus microbes removed with ozone ointment 
and resorcin. 



BACTERICIDES. 



683 



Several most interesting cases of facial lupus have been speedily 
and permanently cured byjthe local use of one ounce of ozone 





Lupus ceedens before treatment. 



Lupus exedens after treatment with 
ozone ointment and resorcin. 



ointment and one ounce of resorcin. Mix thoroughly and ap- 
ply over night, during the day sprinkling the part with iodol. 



This is a term applied to a most pernicious 
Masturbation, and disastrous habit — the stimulating the 
or penis with the hand, in order to excite the 

Self-Abuse. pleasurable sensation of coition and a dis- 
charge of semen; an act revolting to 
humanity, destructive to vigorous manhood, and one which 
depreciates vital stamina, entails degeneration, disease, insanity 
and death upon all who practice the vice. 

The causes which give rise to this habit are the defects and 
vices of modern civilization ; a poverty of nerve force ; isolation, 
monotony, solitary confinement which wipe out and obliterate 
the typical fissures of the brain ; isolation of the sexes ; the 
developing the nervous system at the expense of the physical ; 
the moral tone of society is blunted. 

The symptoms incidental to this habit are insidious languor, 
lassitude and debility ; a want of energy and ambition ; a depres- 
sion of spirits ; a disinclination to society ; a pallor of the face ; 
weakness of the back and knees ; hands and feet are cold and 



684 



DISEASE GERMS. 



clammy ; noises in the ears ; specks and spots before the eyes ; 
the circles around the eyes are depressed and darkened ; a gen- 
eral want of nutrition, emaciation ; he cannot bear the cold, as he 
is morbidly sensitive ; morbid thoughts annoy him ; his old pur- 
suits and amusements have no attraction for him, neither do 
new ones have any charm for him ; his memory becomes imper- 
fect, so does vision and hearing; the freshness and vigor of 
health disappear ; a general destructive metamorphosis sets in ; 
the skin becomes rough, often of a leaden hue ; the eyes lose 
their brilliancy, and by languor express that of the whole body ; 
the lips lose their vermilion tint ; the teeth their whiteness ; the 
hair becomes dry and falls out, and sometimes even the whole 
body is bent and distorted ; his face is shrunken, haggard, pale, 
unmeaning, soulless, inexpressive ; eyes become dull and lack 
lustre, in other words, the masturbator is a physical, moral and 
mental wreck. 

This vice is not confined to the male sex, it is equally com- 
mon among women. Young and apparently modest ladies are 
dying by thousands from tuberculosis, uterine complaints, spinal 
and nervous disease, general debility, prostration caused by this 
habit. The symptoms and effect? are similar to the male. The 
practice causes a glary, white discharge to pass away, which is 
very weakening ; besides, it gives rise to leucorrhoea, ovarian and 
uterine irritation, mental aberration, suppression of the menses, 
and general disorganization and bankruptcy. 

The effects of masturbation are invariably disastrous, it always 
gives rise to irritation of the prostate gland and ejaculatory 
ducts ; damages the testes, the veins of which with those of the 
spermatic cord, become weak, varicose ; atrophy or wasting set 
in, or if the practice has begun in early life, they do not attain 
their full size, lose their power of secreting semen, and the entire 
body is dwarfed and suffers vital deterioration. 

As a rule the generative organs suffer first, the penis and tes- 
ticles resemble those of a boy, they take on interstitial absorp- 
tion, lose their elasticity and firmness — their proper structure is 
anaemic — the spermatic cord atrophies, its nerves degenerate and 
the cremaster muscle disappears. The thin, watery semen that 
is formed under such a state is entirely destitute of spermatic 
granules and spermatozoa ; its fertilizing power is gone ; impo- 
tency supervenes. 

When the testicles waste away, as the result of masturbation, 
the wasting is equal, dwindling to nothingness ; whereas if they 
waste as the result of the localizing of the syphilitic germ, they 
alter in shape, become uneven, or irregular, or elongated as well 
as small. 



BACTERICIDES. 



685 



In some cases, enlargement of the testes takes place, puff up, 
insidiously increase in bulk, but diminish in firmness, consistency 
and elasticity ; in others, they become spongy. Whether it be 
enlargement or atrophy, it is the precursor of degeneration. 

The reflex effect of the act upon the spinal cord and brain is most 
disastrous in setting up an irritation, in draining off the nervo- 
vital fluid, in changing the whole aspect of the cerebral areas. 

The time when most males and females become addicted to 
this vice, is usually about puberty, the most critical period of life. 
The generative propensity, called forth perhaps prematurely and 
viciously gratified, steps in amidst the natural efforts of growth, 
with its unnatural train of nervous shocks, and physical pollu- 
tions, causing our boys and girls to have the appearance of old 
age, being feeble, pale, effeminate, with perverted tastes, drained 
out brains, mere wrecks of humanity, victims of nervous 
disease. 

It is thus the delicate, the impressible nervous system of the 
young of both sexes, that most vividly experiences the depress- 
ing effects, the soul-wrecking ravages of self-abuse. Such a 
habit strikes at the root of society ; the origin of species ; dwarfs 
humanity in its very bud, deforms its features, stunts its growth. 
Its direct reflex effect on the nerve centres creates an intense 
tubercular diathesis, and this peculiar nervous defect aids in the 
creation of this abnormal desire. 

Fathers, but especially mothers, must not shut their eyes to 
the fact that their children often, at an early period of life, resort 
to tickling their sexual organs. Later on, just at the time when 
all the energies of the system are needed for growth and develop- 
ment, the practice is most devitalizing, but when puberty sets in 
with its rapid grov/th of the organs, the increased power and 
frequency of erection, the dawn of a new life, the practice is most 
demoralizing, and its effects more permanent. 

Man, with his instinctive and moral nature, is often a slave of 
habit, and if the act of masturbation be but a few times indulged 
in, this habit is created. 

The blighting effects of masturbation are not confined or lim- 
ited to the sexual organs, to wasting or atrophy of the spermatic 
cord, testicles, spinal cord, but re-acts upon the brain, impover-. 
ishing the nerve centres ; so that the semen secreted becomes 
thin and watery, of a sickly odor, with no living spermatozoa in 
it, consequently not fertilizing. 

The effects produced by masturbation may be embraced un- 
der three heads : 

I. A condition of genital debility, in which the seminal ducts 
will not retain the semen, but it oozes away by day or night or 



^^^ DISEASE GERMS. 

both, with or without seminal incontinence ; or a chronic prosta- 
titis may be the result, with emissions often and persistent. 

2. Chronic irritation of the lumbar portion of the spinal cord. 

3. Exhaustion and irritation of the brain. 

The leading or characteristic symptoms of these three stages 
are as follows : A general feeling of languor, lassitude, debility ; 
there is vertigo or swimming in the head ; specks or spots be- 
fore the eyes ; noises in the ears ; skin becomes white ; pupils 
are dilated ; breath fetid ; digestion is feeble ; bowels constipated ; 
the faeces harden in the rectum, and produce irritation of the 
seminal ducts in their vicinity ; the circulation is languid ; the 
extremities cold and clammy ; the muscles soft and flabby ; by- 
and-by, the forehead may be dotted over with pimples ; the 
corners of the mouth are lengthened ; the nose and features be- 
come sharp ; eyes sunken and deprived of their brilliancy ; there 
are bluish circles around them ; no look of gaiety or animation ; 
he cannot look you in the face ; becomes 
morbidly sensitive ; loses all his vivacity or 
grit. 

The case progresses onwards ; there is 
weakness about loins and knees ; a crack- 
hng in the joints; memory fails; percep- 
tions become dim ; desires blunted ; dis- 
traction or absence of mind, which ren- 
ders him unfit for business ; imagination 
gives birth to the wildest fancies and most 
":S?rLrmTn'°X^Tver groundlcss fcars ; an allusion to the habit, 
turbation"^ ^^^ ^""^ °^ "'^" ^^ ^^^ prcscnce, causing a twitching, a 
flush of shame, or even despair. The 
affected one shuns the face of man, and dreads the observation 
of women ; then, after a while, there are fainting fits, wandering 
pains, chorea or convulsions, trembling, epilepsy, and partial 
paralysis. 

The debility of masturbation is both local and general, never 
partial. Persons so affected, in attempting sexual intercourse, 
may be unable to get an erection ; or, if the act is accomplished, 
an emission takes place too quickly, and is followed by exhaus- 
tion ; besides, there are daily as well as nocturnal losses ; the 
^ semen regurgitates, and finds its way into the bladder, and is 
passed in the urine ; or it may be passed during an evacuation of 
the bowels ; the patient becomes keenly alive to his weakness ; 
is timid, fearful, careless of everything; his mind becomes ab- 
sorbed in the consideration of his malady, until the presence, re- 
currence and persistence of the same train of thought, with the 
ever-leaking seminal ducts, creates a monomania or premature 




BACTERICIDES. 



687 



old age. There is not a gland or function or movement of the 
body natural, nor a faculty or organ, nor sense or perception of 
the brain clear or healthy ; all is out of gear ; nothing but dis- 
integration and disease ; incessantly, by night and day, the 
seminal fluid or brain juice oozing, dribbling away without 
sensation, erections, or any show of natural ejaculation. This 
persistent drain of the most vital fluid in the body varies in 
quantity, according to the state of weakness. 

Onanism wipes out the deity of manhood. The victim of the 
solitary vice is repulsive to his fellowman ; his very skin emits an 
odor resembling the smell of the ailanthus blossom in a decaying 
state, or that of a dog-kennel ; his brain softens, insanity super- 
venes. 

First Stage. — The main, if not the only trouble, is in involun- 
tary emissions. The patient, after having practiced masturba- 
tion, has generally discovered its pernicious nature and aban- 
doned it, hoping by temperance and frugality to outgrow its evil 
effects. But the injury once having been done to the delicate 
sexual apparatus, he is sooner or later surprised and alarmed by 
the occurrence of involuntary discharges of semen. These, in 
the first stage, occur at night, sometimes at considerable inter- 
vals, at others several times a week, usually accompanied by a 
dream of an obscene nature. These seminal losses are a terrible 
drain upon the system ; they impoverish the blood, and rob the 
body of the precious elements of manhood. For some time no 
other serious effect is observed, the general health being good, 
and the sexual powers vigorous. When these symptoms are 
present, treatment should be resorted to at once, for if the evil is 
not remedied it soon passes into the second stage. 

Second Stage. — The emissions now occur not only at night 
with dreams, but sometimes without them, the patient knowing 
nothing of it until he observes the stains on his linen the next 
day. He also soon learns to know, by a wretched feeling of 
malaise and depression the next day, that he has suffered a loss 
of the vital principle. In this stage the weakness of the organs 
increase so that emissions take place in the daytime, the semen 
escaping with the urine, or while straining at stool. The sufferer 
now begins to experience a gradual failure of his usual strength 
and powers of endurance ; in some cases there is loss of flesh, 
and various abnormal symptoms, headache, dyspepsia, low spirits 
and melancholy, weak back, gloomy forebodings, etc. And, 
although from not being married he may not observe it, there is 
perceptible weakening of the sexual powers. The power of erec- 
tion may remain comparatively perfect, but the sexual powers 
are easily exhausted. In such cases, on attempting intercourse, 



588 DISEASE GERMS. 

the emission takes place too soon, thus defeating the end of 
marriage, and bringing disappointment instead of mutual happi- 
ness. In an advanced degree of this stage urethral complica- 
tions set in. The urethra becomes relaxed and weakened, the 
semen is not ejected with force, and is sometimes thin and 
watery, producing feeble, unhealthy children. There is a low 
degree of chronic irritation, which produces uneasy sensations 
in the passage at times, a burning sensation on passing water,, 
and a driobling of urine afterwards Sometimes there is a kind 
of oozing of a clear, whitish fluid, like the white of an Gggy 
which may be either mucus, prostatic fluid, or these discharges 
mixed with semen. These are always bad symptoms, as they 
denote an advanced stage of the disease, and debilitate the genera- 
tive organs and impair the health. This is followed by nervous 
irritation, restlessness, lack of energy and ambition, loss of 
memory and want of self-confidence. If, from neglect or im- 
proper treatment the disease has been allowed to reach this stage, 
appropriate treatment should be adopted at once ; as, if not 
remedied, it gradually passes into the third stage, making a con- 
siderably longer course of the remedy necessary. 

Third Stage or impotence and sterility, '' Loss of Manhood," 
as it is termed, the sexual powers continue to gradually fail ; the 
emissions are now less frequent, because but little semen is 
secreted. The nervous energies, however, suffer the same. 
Inclination for the opposite sex is irregular and feeble, the secre- 
tions are slow, weak and imperfect, and no longer under the con- 
trol of the will, intercourse is often wholly impracticable, owing 
to absence of erection, or premature discharge ; when the semen 
escapes it is often accompanied by a burning sensation, owing to 
the unhealthy state of the urethra. In time all sexual power is 
wholly lost ; occasional erections of mornings may be observed, 
but they are due to a distended bladder rather than the presence 
of semen. If married, the patient discovers himself incapable of 
consummating it, and many under such circumstances have com- 
mitted suicide in despair. The general health is often still more 
impaired, although on the gradual extinction of the sexual func- 
tions, a person will sometimes become fleshier, and to outward 
appearance look well, the same as eunuchs and castrated animals. 
No one knows better than himself, however, what a fraud he is to 
womankind. He is impotent; or if capable of occasional inter- 
course, his semen is imperfect, containing no spermatozoa, and 
he is sterile and incapable of transmitting life to posterity. 
Towards the latter part of the second stage, and during any part 
of the third stage, the mind is liable to become diseased as well 
as the body; then comes mania, insanity — a grave consultation 



BACTERICIDES. 



689 



of friends and physicians — a hurried removal to the confinement 
of an asylum — and he is entombed alive — a few months, or at 
most years, of mad delusion follow — and all is over ! This is the 
sad end of many a once ambitious and promising life, recklessly 
sacrificed by vice and ignorance. 



This is a function performed by women 
Menstruation, between the age of puberty and middle life; 
this forms the child-bearing period, and 
usually lasts about thirty years. Various names have been 
given to this function ; it is spoken of as the menses, the period, 
the catamenia, etc. When not performed at all the patient is 
said to have amenorrhoea, when the function is performed with 
difficulty or pain it is called dysmenorrhoea, and when the dis- 
charge is very profuse the individual is suffering from menor- 
rhagia. The appearance of menstruation is generally accom- 
panied by more or less pain in the back, headache, and lassitude ; 
often, also, the patient loses color, and has a dark ring round the 
eyes. From thirteen to fifteen years of age is the average time 
when menstruation commences, but it may come on a year or 
two earlier in some cases, or it may be much delayed in others. 
The periods are frequently irregular at first, and some months 
may elapse before the function is carried on with regularity. 
When well established, an interval of about four weeks elapses 
between each period, but sometimes only three weeks intervene. 
The blood that flows differs from ordinary blood in being acid 
instead of alkaline, and in not clotting unless poured out in 
large quantities. This function is always suspended during 
pregnancy, and is, in fact, the chief symptom from which a woman 
dates the expected time of her confinement. Many things will 
tend to cause irregularity in the performance of this function 
during the child-bearing period of life — exposure to cold or wet, 
mental emotion or worry, acute diseases, consumption, cancer, 
and many other diseases may either cause menstruation to stop 
altogether, or be diminished in quantity, or to occur at irregular 
intervals. The period of life when menstruation ends is known 
as the climacteric period, and the cessation of the function is 
often accompanied by more or less distress ; the patient becomes 
nervous and is easily worried, suffers from lowness of spirits, 
pain in the back and between the shoulders, pain also frequently 
in the left side, and headache ; the temper may be irritable and 
the appetite capricious. These symptoms arise in a great 
measure from a disturbance in the nervous system, giving rise to 
various neuralgic pains ; such symptoms, however, though often 

44 



690 



DISEASE GERMS. 



troublesome, are not attended by danger, and subside when the 
function of menstruation has quite ceased. The flow generally 
ceases gradually, and becomes more and more scanty ; sometimes 
it is for a short time much increased in quantity. 

Menstritation has a nerve origin ; not a sliedding of imicoiis 
membrane. Recent authority points out that this monthly phe- 
nomenon is the result of changes in the condition of the nerve 
supply, manifested by symptoms of a general character. With 
the approach and appearance of the monthly flow the whole 
frame, as one would naturally expect, participates more or less 
in the change, and the amount of disturbance experienced as 
well as manifested is commensurate with the power the organism 
possesses of adaptation. The true nature of the catamenial dis- 
charge is still conjectural and theoretical, yet its elimination 
from the body renders it highly probable that having already 
served some special end, its detention in the blood may exert 
some deleterious influence upon the animal economy. Ovula- 
tion and menstruation are coincident. It is alleged as an estab- 
lished theorem that from the period of puberty to the climacteric 
age there is, besides a gradual death of the mucous membrane 
lining the whole uterine cavity — which must ever recur, to be 
compatible with life — a more or less regularly-recurring and 
complete death of this coat. In the whole animal kingdom we 
search in vain for a physiological change truly analogous with 
this. To maintain the integrity and activity of the menstrual 
function almost indefinitely, we have two most remarkable rem- 
edies, namely: avena sativa and ozonized distillation of apiol ; 
the former acts on the origin of the sexual appetite in the brain ; 
the latter upon the uterus. 



The mesentery is a double fold ot 
Mesenterica, peritonaeum which retains the small in- 

Tabes Mesenterica. testines in their place in the abdominal 
{Marasmns) cavity; it is fan-shaped in form, and 

attached to the front of the spine at its 
narrow end. Around its longer margin the bowels are arranged, 
so that perfect freedom of movement upon each other is allowed, 
while yet each portion keeps in its proper place. Between these 
two folds run some vessels which take blood to and from the in- 
testines ; these are called the mesenteric vessels, and consist of 
arteries and veins ; they are also accompanied by various nerves. 
There are besides a great many glands in the mesentery, called the 
mesenteric glands, and these are often liable to disease. Through 
these glands passes an alkaline, opalescent fluid called the chyle ; 



BACTERICIDES. 



691 



this chyle is collected in the intestinal walls by a vast number of 
small v^essels called lactcals, which are very analogous to the 
lymphatic vessels in other parts of the body : these lacteals join 
toi^ether and form larger branches, until, having- passed through 
the mesenteric glands, they convey the chyle, altered by that 
process, to the receptacuiinn cliyli — a dilated tube lying in front of 
the spine and servmg as a kind of reservoir fjr that fluid, which 
afterwards passing up the thoracic duct, enters the blood at the 
lefc side of the root of the neck. 

The lymphatics of the mesentery belong to the same class of 
glands as the suprarenal capsules, spleen, pink marrow of bones, 
lymphatics, active blood raisers. 

Any irritation in the bowels, as 
diarrhea, cholera infantum, worms, 
irritates and weakens the mesentery 
and renders it a congenial place for 
the localization of germs, so that the 
bacillus of typhoid, tubercle and other 
germs, lodges in its meshes or network; 
grows with great rapidity, fills up its 
tissue, destroys the function of the 
gland ; their growth obstructs the 
passage of chyle through the convo- 
luted lacteals which traverse the mes- 
entery in all directions ; besides there 
is a complete failure on the part of the 
gland in elevating the white discs of 
the blood, consequently all the tissues of the body starve and 
waste. 

The symptoms of tabes mesenterica are very plain, usually 
some intestinal disturbance, as diarrhea or cholera infantum ; 
when the abdomen becomes hot, tender, swells with less or more 
pain in the bowels ; in some cases pain severe, griping, causing 
the legs to be drawn up towards abdomen ; deep red color of 
lips ; angles of the mouth covered with small ulcers, in which the 
oidium albicans abound ; the passages from the bowels resemble 
chopped spinach, and sour smelling ; are very irritating ; abdo- 
men continues to swell or bloat; becomes tense and greatly en- 
larged ; at the same time the emaciation is fearful ; the patient 
gets down to skin and bone ; even the marrow in bones wastes ; 
skin white and wrinkled ; intense debility, \\\\h rapid, increasing 
weakness. The abdomen, although intensely swollen, soon be- 
comes irregular to the feel, lumpy in masses like large eggs at 
first ; when tubercle is active and growing, soft ; then a cheesy 
feel, and latterly calcareous ; there may be a tubercular condition 




[nflammation of the omentum; the 
tubercular bacilli filling up its 
interstitial structure. 



69: 



DISEASE GERMS. 



of lungs, bronchi, or membranes of brain. Its duration is un- 
certain, depending on the condition of vital force and season of 
the year. If it appear early in June, the little sufferer, unless 
taken to the seashore or country, stands a poor chance of recovery 
before September ; whereas, if it appear in August, there is 
usually little difficulty in tiding the patient into the cool weather. 
It may occur at any season, but much more common when the 
vital forces of the child are depressed by solar heat and city life 
— season when cholera infantum is prevalent. 

True, the mesentery may be the abode of numerous germs, but 
none seem to have the power of holding their position, breeding 
and going through its different stages of growth, like the tuber- 
cular bacilli. 

The treatment of tabes mesenterica requires the nicest tact and 
good judgment. Bathing twice daily, with massage; diet chiefly 
essence of beef 

The whole aim of treatment is to keep up vital force and kill 
the microbe ; a good plan to begin on is to keep the intestinal 
tract aseptic. 

Several remedies have lately been proposed as intestinal disin- 
fectants. Naphthaline, which has been recommended by Ross- 
bach, is very sparingly soluble, so much so that it passes to a great 
extent unchanged through the whole of the intestinal canal. It 
certainly destroys the disagreeable odor of the motions in infan- 
tile diarrhea, but it does not appear satisfactorily to check the 
disease. Salol is the phenyl ether of salicylic acid. It passes 
through the stomach unchanged, but in the duodenum it is split 
up by the pancreatic juice into salicylic and carbolic acid. 
Although the carbolic acid is set free at the point where its action is 
wished, yet there is still the disadvantage of its being poisonous, 
and so betol has been recommended. The constitution of this 
substance is similar to that of salol, but it splits up into salicylic 
acid and beta-naphthol, which is more sparingly soluble, and 
which is less poisonous than carbolic acid, while it is much more 
powerfully antiseptic. Resorcin, thymol and benzoate of soda are 
among the antiseptic remedies which sometimes are used here with 
success. 

A disease of the skin, characterized by 
MoUuscum. round elevations of the skin, varying in size 
from a hemp-seed to a hazel-nut, and marked 
on the summit by a dark point and a depression in the centre. 
The color of the skin over them is sometimes translucent, or of 
a pinkish color. Some of the growths have no black mark and 
no depression. These little tumors may increase slowly in size 



BACTERICIDES. 



693 



without undergoing any change, or they may ulcerate and dis- 
charge their contents. There seem to be two kinds : (i) Mol- 
luscum fibrosum, which consists in an increased formation of the 
fibrous tissues round the hair follicles ; and (2) Molluscum con- 
tagiosum, which is due to an increase in the sebaceous follicles, 
so that the contents of each tumor have a cheesy appearance. 
The usual seats of molluscum are the back or front of the trunk, 
the neck, face, and scrotum. Its presence is not attended with 





Microbe of molluscum. 



Section of molluscum (microscopic). 



any constitutional disturbance ; it may exist at any age, but is 
most frequent in children. There are generally several of these 
small tumors present at the same time. The treatment is purely 
local ; the tumor should be laid open, the contents squeezed out, 
and the inside touched with caustic ; if attached by a thin stem 
to the skin, the growth may be snipped off with a pair of scis- 
sors, and the cut end touched with caustic. 

Some cases are benefited by a course of general alteratives 
and tonics, as saxifraga, phytolacca, in alternation with glycerite 
of kephaline, tincture of oats ; with a local treatment of either 
resorcin, ichthyol, or creolin in a solution of gutta-percha. 



The nails may be absent or imperfectly developed 
Nails. {onycliatropJiid). Either of these conditions is usually 
congenital and associated with absence or imperfect 
development of hair. Hypertrophy of the nail {onychauxis) may 
occur and be either lateral, causing ingrowing toe-nails, or be 
limited to the extremity of the nail. A special form of hyper- 
trophy, limited to the centre portion of the nail, is termed ony- 
cliogry pilosis. Either of these forms of hypertrophy may be 
treated by scraping away the nail with knife or scissors. In- 
growing toe-nail may be treated by scraping the nail with a piece 
of glass until it is very thin, or softening it with liquor of potassae. 



694 



DISEASE GERMS, 



Inflammation of the nail (onychia) may occur in a Hmited form 
from ingrowing toe-nail, or more extensively as the result of 
injury. Pus forms under the nail and the latter becomes loose. 

Certain diseases of the skin involve also ^the nails in some 
cases. The most important in this connection are eczema, psori- 
asis, lichen ruber, ringworm and favus. These may not be easy 
to distinguish one from the other by having regard only to the 
condition of the nails, but the accompanying eruption will gen- 
erally guide to a correct diagnosis. Ringworm or favus may, 
however, attack only the nails, usually by direct contagion in 
persons who have to attend on patients suffering from these dis- 
eases. They may be diagnosed by scraping the nails and exam- 
ining the scrapings under. a microscope after soaking them in 
liquor potassae. The nails become brittle and split when in- 
volved in eczema, lichen ruber, or psoriasis. The former affec- 
tion of the nails begins with pitting, the pits gradually extending 
until the nail splits longitudinally. 

After febrile diseases shedding of the nails may accompany 
the desquamation of the skin which goes on; the nails may also 
be shed in acute eczema and pityriasis rubra. 

During a severe illness transverse lines form on the nails ; one 
at the root of each nail. As the nail grows they are carried for- 
ward until they reach the free edge and are cut away. It is 
hence possible, on seeing a patient several weeks after a severe 
illness, to calculate the date of his illness by observing the situa- 
tion of the lines and taking into consideration the known rate of 
growth of the nails. 

Violent paroxysmal pain either in the trunk or 

Neuralgia, branch of a nerve, due either to a want of nutri- 
tion in the nerve or to the presence of disease 
germs or their ptomaines, toxically acting on the same. 

The causes, then, of neuralgia, are disease, germ-laden blood, 
anaemia, debility, overwork, struggle, worry, defective nutrition. 

It divides itself in numerous varieties, according to the special 
nerve affected, and the cause producing it. 

The primary indication in all cases is to afford immediate relief 
of the pain, and subsequently remove the cause. 

The various antithermic drugs, exalgine, phenacetine, solol, are 
used with success in all neuralgic affection, whatever their loca- 
tion may be ; the best results are obtained from small doses, fre- 
quently repeated. 

Croton Chloral Hydrate. — This contains two more atoms of 
hydrogen than the chloral, and is, properly speaking, butyl 
chloral, which has the property of diminishing sensibility before 



BACTERICIDES. 



695 



producing narcosis. It gives instant relief in facial neuralgia in 
doses of fifteen grains, repeated, if necessary, after meals or 
largely diluted with water. The syrup of croton chloral is an 
elegant and efficacious preparation. It gives immediate relief. 
To combine the croton chloral with quinine we have still a more 
effective remedy. 

Citrate of caffeine is a valuable drug in facial neuralgia, the 
dose to be such as will give relief of pain. It operates better 
than guarana — not so rapid and effectual as the croton chloral. 

Bromo-hydric acid, with or without quinine, of which it is a 
solvent, operates very beneficially, if the neuralgia is due to reflex 
causes, in doses of half a drachm upward. 

Tincture of green root gels eniiiim, being non-poisonous, only in 
very large doses, is best adapted to malarial cases, in doses of 
a half drachm upward. 

Salicylate of quinine, in rheumatic and gouty cases, is so speedy 
in its action that it is unnecessary to precede it with any of the 
above remedies, for in six-grain doses it is usually efficacious 
within a {^\n minutes. 

While pursuing this course of treatment in relieving pain, the 
cause must, if possible, be ascertained and removed. In looking 
over the list of causes, we must scan them carefully as to anaemia, 
mercury, malaria, gout, rheumatism, syphilis ; and to reflex 
causes, as teething, worms, liver, kidney, or other forms of chronic 
disease. The treatment should in all cases be adapted to each, 
and if no cause can be ascertained, the patient should be put 
upon an alterative and tonic course ; all through relieving the in- 
tolerable pains. In these cases the condition of the stomach, 
bowels, skin, kidneys, should be seen to. 

Local remedies for the relief of pain are of little utility, but if 
used should, in all cases, be combined with chloroform, to carry 
the remedy down to deep-seated parts. Aconite and belladonna 
are especially valuable in neuralgia of facial nerves ; cinchona, 
iodine and gelsemium, if of a malarial type ; coffee, if due to 
nervous anaemia; phosphate of quinine, if due to gout; and 
general treatment as to cause. Improvement of the general 
health in all cases. Diet very nourishing, raw eggs, animal food, 
milk. Clothing warm, flannel next the skin. Warm tepid or 
cold salt-water baths. Friction to skin ; change. Indeed, every- 
thing to improve the nervous system, and give the patient richer 
and purer blood, pure air night and day, great cleanliness, and 
avoidance of all causes. The true aim of treatment is to fertilize 
the brain by the persistent administration of avena sativa and 
glycerite of kephaline— thorough reconstruction. 



696 DISEASE GERMS. 

The free anastomosing of the uterine 

Neuralgia of the nerves with those of the mammae, their 
Breast. blending or junction with the sympathetic 

{Mastodynia}) in the breast of all highly civilized ladies, 

renders the nerves of the mammae ex- 
tremely susceptible of irritation and weakness. 
j^They are very liable to suffer from the presence of microbes 
in the blood, from reflex irritation from the uterus or ovaries ; 
from certain other causes, as occupations ; corsets ; sitting at 
benches. 

Neuralgia exists without any structural lesion. 

Symptoms. — Pain in the breast of a sharp, lancinating charac- 
ter, or it may be an aching, .wearying kind, but usually like neu- 
ralgia elsewhere, acute and liable to exacerbations. There may 
or may not exist a slight pufifiness, or swelling, or even an in- 
crease of temperature of the affected gland ; and even the lobules 
may feel rather firmer than natural. But it is more generally 
the case that the gland feels healthy to the touch. When due 
to uterine or ovarian trouble anaemia is generally prominent. 
In some women the breasts enlarge and become irritable ; suffer 
from neuralgic pains at and during menstruation. In all cases 
there is some impairment of general health ; nervous dyscrasia ; 
loss of appetite; constipation; leucorrhcea; restless nights; 
anxiety. 

In the treatment, immediate relief must be afforded from the 
distressing pain. 

For this purpose a combination of the sulphate of morphia 
and atropia is most effectual ; or cocaine subcutaneously ; iodide 
and bromide of potassa ; belladonna plaster over the entire breast 
followed with dry heat. 

As soon as pain is relieved, the cure of the disorder upon 
which the pain depends ; search carefully for malaria, mercury, 
syphilis, gout, rheumatism, anaemia, chlorosis ; but above all for 
ovarian and uterine irritation, and the greatest attention to diet 
of the best; proper outdoor exercise; daily bathing; flannel 
clothing, and regulated bowels. 

Alteratives and tonics, embracing ozonized phytolacca, or saxi- 
fraga, iodide potass, iodide of lime, glycerite of ozone, and keph- 
aline, sulphate of quinia, cinchona. 

No application to breasts equal to the belladonna; if the 
plaster does not produce the necessary anesthesia, put on the 
chloroform, aconite, and belladonna liniment; the chloroform 
will carry the belladonna down to the deepest nerve. There 
should be proper support, but no pressure. The uterine trouble 
should be seen to, and removed, according to its cause. 



BACTERICIDES. 



697 



Young infants, boys, and girls about puberty, are liable to 
slight neuralgia of the breasts. In some cases there are enlarge- 
ment, tenderness, and secretion of milk. There must be no irri- 
tating applications applied, no friction, nor any stimulating ap-. 
plication, the belladonna plaster being usually sufficient. 



Neuralgia of the auditory nerve is 
Neuralgia of simply the cry of a nerve for better 

the Auditory Nerve, and purer blood. It may be brought 
{Otalgia^ about by cold, damp, rheumatism, 

gout, tubercle, syphilis. 

When an attendant upon some acute disease there may be 
fever, but more generally it is unaccompanied by any febrile dis- 
turbance. The intimate connection of the auditory nerve with 
the various nerves of the face, especially those supplying the 
upper and lower jaws, the stomach, liver, uterus, render ear-neu- 
ralgia common where those organs are out of gear. Ear-ache is 
thus common, as its causes are numerous and varied. 

It is easily recognized by the sharp, lancinating pain in the ear, 
very severe ; frequently also shooting through the nervous fila- 
ments distributed over the side of the head and face, causing 
much suffering and great restlessness. 

Treatment. — If it is traced to imperfect performance of stom- 
ach or liver, an emetic of lobelia, and saline purge ; a carious 
tooth, extraction ; or to any special diseased germ, treat for its 
destruction ; drop one or two drops of mullein oil in the ear. 
In all cases, and at once, relieve pain by resting the head on very 
hot pillows of hops, or camomile flowers, or bran, or salt ; or 
the roasted bulbs of onions ; or, better still, garlic. In addition, 
if very severe, the aconite, belladonna and chloroform liniment 
should be applied to the side of the face ; cotton-wool, saturated 
with glycerine, tincture of opium and belladonna in ear. Dur- 
ing the day, aconite and belladonna, in alternation with quinine, 
are true stimulants to this nerve, and it is well to give pretty 
large doses; at night either chloral or morphia, to procure a 
good night's rest. In the mean time, treat the case according to 
the cause, with alteratives and tonics ; and bear in mind that in 
this painful nerve-cry, that brain-food, or nerve-forming diet, is 
an essential and important element in the cure. Animal food, 
eggs, milk, boiled white-fish, oatmeal porridge, cream, and those 
admirable drugs, glycerite of ozone and kephaline. Nutrition is 
an important indication in the treatment, so as to prevent a re- 
. currence, especially among the little ones. 



698 



DISEASE GERMS. 



Pain, tenderness about coccyx; often 

Neuralgia of the sharp, tearing, lancinating ; is a most un- 
Coccyx. pleasant form of neuralgia. Most com- 

{Coccyody?ua.) mon in women, on account of their great 
development of coccyx, and above all, in 
women of high civilization, who have as an index of that condi- 
tion a sacrum at an angle well verging on to 45°, and a coccyx 
most perfect. In women of low civilization the sacrum is 
nearly straight, and the coccyx almost as rudimentary as it is in 
man. 

Causes. — Hurried labor, or insufficient support to the peri- 
naeum, whereby the nerves of the coccyx receive a shock; blows, 
falls, fractures, and horseback exercise, etc. 

Symptoms. — Pain in sitting down or in rising, or in v/alking, 
or in defecating. Pain is even more than neuralgic, more than 
sharp and lancinating ; there is a general soreness. In many 
cases patient can only sit on one hip. Any movement or pres- 
sure on the surrounding parts give rise to pain. It is aggra- 
vated by menstruation, or sexual intercourse. It may be reflex, 
as in chronic inflammation of uterus or ovaries. It is very 
chronic in its nature. 

Treatment. — Remove all sources of irritation about uterus, 
ovaries, rectum. Place patient upon a general alterative and 
tonic course of treatment, with the best of food. Keep bowels 
open with cascara ; suppositories of cocaine, belladonna and 
opium at bedtime, or hypodermic injections. 

To raise the standard of vitality in the nerves of the coccyx, 
warm hip baths, quinine, iron, pulsatilla, glycerite of kephaline, 
and other nervines, such as musk, valerian. 

Painful Sitting. — In coccyodynia, as a result of fracture of the 
hinge-joint, after ossification, in having a child after thirty-five 
years of age, there is apt to be a laceration of the nerves, and 
neuralgia established, which gives rise to painful sitting. 

This is also present in deep-seated inflammation of the genital 
organs, especially in the uterus and ovaries, so very slight, how- 
ever, that the patient does not experience uneasiness, only in the 
sitting posture. 

Relaxation of the great joints of the pelvis towards the end of 
pregnancy is very natural ; they become loose and juicy, and a 
considerable increase of motion is observed in them. If the 
labor is long, the presentation not a good one, or the head of the 
child large, or instrumental delivery, made with force or violence, 
there may be a low grade of irritation set up in them. So that 
there is a morbid loosening, which not only gives rise to pain in 
sitting, but hopeless lameness. Rest, general alterative and 
tonic treatment will, in time, effect a cure. 



BACTERICIDES. 



699 



Facial neuralgia or irritation of the nerves 

Neuralgia of the face may be due to any of the mi- 

of the Nerves crobes which infest the human body ; to 

of the Face. cold, damp, exposure ; to the irritation of the 

microbe of dental caries. 

In the treatment of all forms the cause must be removed, and 

the microbe annihilated ; if due to the rheumatic germ, manaca ; 

salicylate soda in acetate of ammonia ; colchicum and quinine ; 

if due to the microbe of syphilis, chloride of gold et soda, saxi- 

fraga ; if due to cancer genu, Chian turpentine; if due to the 

malarial germ, com. tincture of kurchicine, etc. 

To procure anesthesia of facial nerves, aconite, belladonna, 
ammonia, phosphate of quinine, as a local remedy in all cases, 
concentrated ozone with chloroform. 



Often due to gravel, or disease-germs, 
Neuralgia of the like malaria ; to drugs ; to suppression of 
Kidneys. an eruption ; in the left kidney to poisons 

(Nepliralgia}) of rheumatism ; gout, cold, wet. 

It is attended with most excruciating 
suffering ; sharp lancinating pains, coming on suddenly, violent 
in intensity, relieved by pressure, never ap-gravated by it. If due 
to gravel, it may be continuous, beginning at the time it com- 
menced to pass into the ureters, and continuing till it reached 
the bladder. The pain is paroxysmal in its character, not only 
experienced in the loins, but extends to the groin, thigh, or 
abdomen, causing retraction of the testicle in the male, and irri- 
tation of ovary in the female. If the paroxysms are severe, 
they may be accompanied with nausea and vomiting; a small, wiry^ 
feeble pulse ; profuse perspiration ; prostration, with a desire to pass 
urine, and an inability to do so. When concretion, if due to 
that, reaches the bladder, pain suddenly ceases ; if due to other 
causes, it may continue till the cause is removed. Its location 
(relieved by pressure), character of pain being paroxysmal, with 
other symptoms of kidney irritation, are always important land- 
marks. 

In the treatment, alcoholic vapor-bath ; external warmth over 
kidneys; if stomach is so irritable as to cause everything to be 
rejected, apply mustard over it, and 'give a large dose of tincture 
of green root of gelsemium ; if vomiting still persists, hypo- 
dermic injection of morphia, preceded by the inhalation of a 
few drops of chloroform. Then apply belladonna plaster over 
kidneys, and depend on quinine and gelsemium internally. In 
some cases aconite and belladonna answer well, with dry cups 



yQQ DISEASE GERMS. 

and lobelia fomentations. If due to the retrocession of an erup- 
tion, compound tincture serpentaria or jaborandi ; if due to rheu- 
matism, alkalies, as nitrate of potassa and cream of tartar, fol- 
lowed with nitro-glycerine ; and acetate of ammonia and salicy- 
late soda. Each case manag^ed as to its cause. 



Neuralgia of the nerves of the pleura 

Neuralgia of and of the intercostal are generally 

Intercostal Nerves, due to the bacillus amylobacta, more 

{Pleurodynia) rarely caused by the microbe of 

syphilis. 

Associated with the presence of one or both microbes, we find 

all that class of patients suffering from great impairment of the 

general health, with mental and physical prostration — phosphates 

and chlorides in the urine. 

The recognition of the pain being non-inflammatory coming 
on, leaving suddenly but intensely sharp and lancinating, fatigue 
is often an exciting cause. 

In the treatment, apply either dry cup, or irritating plaster at 
once — dry heat ; then follow with either salol or manaca, or 
salicylic soda in acetate of ammonia ; these three remedies are 
most efficacious. 

Follow up with comp. saxifraga and phytolacca, tincture of 
oats, glycerite of kephaline. 



Stiffness, soreness, cramp, or pain in the vol- 
Neuralgia of untary muscles of the body, may be due to 
Muscles. various causes : for example, in young persons 
(^Myalgia) of rapid growth, persons in whom the bones 
grow faster than the muscles, the muscles and 
tendons become stretched, and the individual suffers from what 
is termed groiviiig pains. These are often quite severe, and in- 
volve both the fleshy part of the muscles as well as its tendons, 
either the centre, or where it is inserted into the bone, or both. 
It is often due to a strain, lift, over-exertion, and involves the 
muscles of back, chest, abdomen, arms, or legs. It is also a 
symptom of a shock from cold, great nervous prostration, and is 
thus prominent in certain diseases, as fevers, inflammation, partu- 
rition, rheumatism, scurvy, tuberculosis, cancer, chlorosis, leuco- 
cytha^mia, dysentery, diarrhea, prolonged lactation, exhausting 
maladies generally, and spermatorrhoea. 

Symptoms. — Pain is the chief s)'mptom ; and this in its degree 
and intensity bears a direct ratio to the amount of debility that 



BACTERICIDES. 



;oi 



is present. Where it depends on too rapid growth of bone in 
young persons, they seldom complain of it in the morning after 
a good night's rest, but comes on after exertion, and gradually 
increases till night. In the case of the masturbator, or those 
suffering from seminal losses, pains in the morning, and rather 
wear off during the day ; whereas in case of disease, mostly an 
aching all the time. The pain in all cases, however, is aggra- 
vated by movement. General health in all cases is poor; skin 
cool, pulse natural or depressed ; appetite good, clean tongue. 
In bad cases there may be night-sweats, loss of appetite, im- 
paired digestion, constipation, no vigor or energy, inability for 
work, severe mental depression. 

Treatment, — The principles of treatment will be modified by 
the cause, but all cases require good nourishing diet, as animal 
food, boiled fish, oatmeal porridge, cream, raw eggs, fruit, vegeta- 
bles in abundance ; tonics, as cinchona and mineral acids ; sul- 
phate quinine and aromatic sulphuric acid , quinine, iron, hy- 
drastin, nux pill. Rest for the affected muscles, by splints or 
otherwise. Massag;e to be performed twice daily; begin with 
half-an-hour treatment, and increase length to two hours, if pa- 
tient has means to carry out treatment. In the massage treat- 
ment, bathe a limb with soap and water ; dry ; use dry hand 
until there is a glow of warmth ; then shampoo, rub, knead, and 
otherwise manipulate with warm olive oil ; then another limb in 
same manner until the entire body is massaged. Electricity can 
follow if case is bad, or in a hurry to get well. 



An intense form of neuralgia, character- 
Neuralgia ized by acute pain following the course of the 
of the great sciatic nerve extending from the sciatic 

Sciatic Nerve, notch down the posterior surface of the 
{Sciatica^ thigh to the popliteal space, and often along 

the nerves of the leg to the foot. 
The causes are a depression of the sheath of the nerve, by 
cold, damp, sprains, etc., and blood charged with the bacillus 
amylobacta circulating through the weakened tissue, giving rise 
to thickening and compression of the nerve. 

Sciatica, properly speaking, is not an affection of the nerve, 
but its sheath, which, under the irritation, becomes thickened and 
contracted, compressing the nerve, and thus causing the excru- 
ciating pain in movement, or numbness in the leg by compression. 
Sciatica, then, is not, at least at first, neuralgia of the nerve, but 
inflammation and thickening of its sheath, and this thickening 
produces a mechanical condition which presses the nerve, and 
thus gives rise to the neuralgia. 



yQ2 DISEASE GERMS. 

In the treatment we must pursue a course of treatment very 
similar to rheumatism. 

SaHcylate soda and acetate of ammonia, salol, manaca, cascara 
sagrada lozenges, etc. One of those remedies should be admin- 
istered ; if it fail to give relief, then try a mixture composed of 
equal parts of tinctures of aconite root, colchicum seed, bella- 
donna and actia racemosa. Mix. Six drops every few hours 
till relief is felt, or use a hypodermic injection of morphia and 
atropia. 

Locally, along the course of the nerve, paint on and confine 
concentrated ozone — its action is prompt, much superior to men- 
thol, acupuncturater, or dry cups. 

Exalgine has been very highly recommended. 

If case resists ordinary treatment remedies then it should be 
placed upon iodide potass in the compound saxifraga. 



'A temporary irritation of a special 
Neuralgia of nerve or nerves often gives rise to a 

Special Nerves, spasmodic and involuntary contraction 
(^Q'amps) of one or more muscles, attended with 

rigidity and great pain ; most common in 
the muscles of the lower extremities, as the large, muscle of the 
calf of the leg ; but it is very apt to affect the muscular fibres 
of internal organs, as the stomach, intestines, bladder, uterus, 
pharynx. 

The true cause is a weakness in the nerves that supply special 
muscles, and those weakened nerves crying for pure or better 
blood ; so that disease-germs in blood, poverty of blood, gout, 
rheumatism, metals in blood, the bacteria of dyspepsia, the 
cholera germ, etc., besides pressure on nerves not infrequently 
causes it, as the head in labor, etc. Swimmers often attacked, 
and common cause of drowning. 

Symptoms. — The nerves of a muscle, weakened, irritated, cause 
the contraction, which gathers the muscle into a knot, apprecia- 
ble to the touch and often to vision, when external. Pain is not 
only severe, but agonizing. The cramp, or contraction, or spasm, 
may last a few seconds, minutes, hours, and leave the part tender 
and patient prostrated. The same nerves of a muscle may be 
affected over and over again, if its vital integrity is not restored ; 
or if due to*a poison, it may affect different muscles, as in cholera, 
where all the muscles of the body are in a cramp. 

Treatment. — To relieve the cramp immediately, administer 
either chloroform or the antispasmodic tincture, in twenty or 
thirty-drop doses, in warm boneset tea, every few minutes till re- 



BACTERICIDES. 



703 



lieved. Then search for causes, as debility, anaemia, indigestion, 
constipation, lead, tin, zinc, gout, rheumatism and other blood 
diseases, and remove them with alteratives and tonics. Best of 
food ; pure air. To raise the tone of nerves, quinine, glycerite 
of kephaline, aconite, belladonna, friction, shampoo, massage, 
stimulatincr liniments, baths. 



When the nerves of the testes are irri- 
Neuralgia of the tated by the microbes of syphilis, rheu- 
Testes. matism, etc.; or weakened, exhausted, or 

drained out by venereal excesses; or when 
the ejaculatory ducts become clogged, or stopped up, affording 
no outlet for for semen secreted, and the testes suffer compres- 
sion ; or there may be a shock from mechanical irritation — 
in which condition the nerves suffer a partial death, neuralgia 
supervenes. 

If due to rheumatism, acetate of ammonia and salicylic acid; 
manaca; colchicum and quinine; tincture black cohosh, etc.; 
locally, dry heat with camomile flowers or bran. If due to 
syphilis, iodide and bromide of potassa ; saxifraga, phytolacca ; 
chloride of gold et soda. 



A poverty of nerve force. May be general, 
Neurasthenia, involving the whole body, or it may be local, 

affecting an organ. 
The present work aims to increase our knowledge of the origin 
and phenomena of disease-germs ; how normal living matter, 
concerned in the nutrition of the body, can be changed, altered, 
or degraded by conditions adverse to life, into diseased or malig- 
nant living matter, of a special kind, genera and species, each 
capable, in a proper medium or fertilizing fluid, of reproduction 
and independent existence, the powers of growth being prodi- 
gious ; Jiow such diseased living matter is contagious and infec- 
tious ; that living, breeding, organized germs are no phantom but 
a living enemy ; hozv such conditions can be averted by maintain- 
ing a high standard of health, of vital force and rigid enforcement 
of the laws of sanitary science ; and how all can be obliterated 
by an antiseptic treatment. 

In nettrasthenia or nervousness, there is a degradation of the 
primary molecules of nutrition of brain and nerve tissue into the 
disease germ; in all deviations from health, or mental vigor; 
in all states of ph^enal incapacity ; in all nerv'ous affections, even 
in nervous headache ; in trance, natural or artificial ; in all grades 



^Q, DISEASE GERMS. 

or degrees of insanity, mental aberration ; in epilepsy, inebriety, 
cholera, etc. ; evolution and dissolution, or a change of living 
elements, preside over all the phenomena of nature. 

For all practical purposes, the definition of neurasthenia may 
be thus given : It is a condition of nervous debility or nervous- 
ness ; a chronic morbid condition of the nervous system ; a prac- 
tical death of that tissue, the basis of which is an impoverish- 
ment of nerve force; a starved phrenal state, in consequence 
of which there is a liability to quick exhaustion and an impera- 
tive necessity for frequent supplies of force ; there is beside in this 
state a lack of inhibitory or controlling power, both physical and 

mental ; a feebleness, an instability 
:i-4:0}.'''VPi f'^'^' of nerve action, with excessive 

. .-• • I r^^ \ S\^ rc^^i ^ sensitiveness and general and local 

r^^r -'■^^ physical and mental con- 

stitution of man gives us the high- 
est type of evolution, of organic 
life, of phrenal development; and 
3)/3'- no acquaintance with the laws of 
physics and natural science is re- 
quired to rightly understand, that 
if the human brain is placed in an 
Microbe orneurasthenia. abnormal condition by worry or 

strain or overwork ; or by over- 
stimulation by climate, alcohol, tobacco, opium, chloral — a con- 
dition analogous to a hot-house, that its evolving cells will be 
weakened, degraded, or take on excessive development; hence, 
debility, weakness, exhaustion, etc. 

A partial death of the nervous system, or as it is termed nerve 
exhaustion ; a most common condition, one incidental to all nerve- 
ous diseases ; one that is dove-tailed into them, blended and 
enumerated under different heads ; in an infinite variety of forms, 
in all affections that are common to men and women who have 
exhausted their vital force ; affections that are generally looked 
upon by the profession as modified forms of idiosyncrasies, 
crankiness, hysteria, morbid thoughts, increased sensibility, de- 
praved appetite, perversion of special nerves or senses, or parts 
of the nervous organism ; giving rise to neurosis of mucous 
membrane, glands, skin, organs; special modifications impress the 
nerves that supply the organs of circulation, giving rise to nerv- 
ous headache, nervous palpitation of the heart ; abdominal pul- 
sation, due solely to nervous influences, which has too often been 
mistaken for abdominal aneurism ; besides we have nervous 
cough, asthma, a .spasmodic contraction of the bronchial tubes ; 




BACTERICIDES. ^05 

aphonia, weakness of the laryngeal nerves ; musca volitantes, 
tinnitus aurium, and many other marvellous nerve disorders. 
In this condition of nervousness, there is very apt to exist 
restlessness, mobility, with or without undue excitability of 
nerves. 

The brain presides over nutrition, secretion, excretion, diges- 
tion and assimilation. If the integrity of that organ is impaired 
the whole body is out of gear and a degradation of the primary 
elements concerned in its nutrition takes place. 

Causes. — The causes that give rise tP general nervous debility 
in individuals and nations are very numerous, as the increased 
necessities and activities of civilization — a condition very wear- 
ing to the brain, unless muscular work be in excess. The con- 
dition of early precocity in children, fostered and nursed by a 
perniciously too early education ; by children's magazines, 
rushing the immature brain of childhood into excessive develop- 
ment by over-culture. To this hot-bed of civilization, we add 
care, worry, overwork, struggle, intense tension, the brain being 
overtaxed at the expense of the physical. There are causes in 
our country, in our highly oxygenized and ozonized atmosphere. 

There is no climate, no portion of the earth, so productive of 
neurasthenia as North America. There is every essential in it to 
produce increased brain activity, active cell development, and no 
one living under its influence can escape becoming neurasthenic ; 
its exhausting faculty added to great mental efforts, together 
with the almost universal use of tobacco, alcohol, excesses, 
effect the result. 

The mighty momentum of all that is great in science, in arts, 
in practical utility, sways the ever active brain of the American 
who, if left to himself, will soon become the prototype of the 
noble Roman. 

While glancing at these and other causes, we must ever bear 
in mind that the human body is but a reservoir of nerve force, 
which is constantly escaping, while at the same time it is con- 
stantly renewed from the centre of all force. A healthy man be- 
tween twenty-five and fifty-five years of age has a large amount 
of nerve force in reserve, and is not much if any way exhausted 
by the ordinary tear, and wear of the body. He has, so to speak, 
always a margin left behind and beyond that required for his ordi- 
nary avocation, on which in powerful emergencies he can draw with 
no other efft^ct but shght fatigue, which disappears under rest, 
sleep and food ; whereas an individual suffering from neurasthenia 
have a very meagre amount of nerve force in reserve ; the slight- 
est exertion, mental or physical, will drain it off. 

Symptoms. — In appreciating the condition of nervous debility 

45 



7o6 



DISEASE GERMS. 



we must look closely at the nerve centres. True the entire ner- 
vous system is a unit, a whole, but for the sake of description or 
a perfect elucidation of symptoms, we map it out into three great 
centres, the brain proper, spinal cord, and great sympathetic, — 
they form a trinity, a three in one — one emanation of Deity. 
This microcosm, in a highly civilized and sensitive man is a per- 
fect centre of reflex action, and it is this that in some measure ac- 
counts for the variety and intensity of the symptoms. 

An individual or race suffering from general nervous debility 
usually manifests itself in a strong nervous temperament, with a 
white skin, sharp cut features. They suffer from languor, lassi- 
tude, debility, being easily exhausted on the slightest exertion ; 
they have no reserve of vital force, no margin upon which they 
can draw, the fountain-head is empty or drained off. They may 
do more work, exert more nerve force in a short time than a 
strong man, but they are more easily exhausted than the vital ; 
may eat and digest with little expenditure of vital force, but they 
cannot bear labor nor fatigue, nor privation, nor loss of sleep. 
It may not shorten life, nor destroy its usefulness, but the indi- 
vidual or race has not the tone, or vigor, or vivacity of the vital ; 
they have lost the stamina for essential work. 

Neurasthenia may exist in an individual or race for many 
years, and the affected party be unconscious of its existence. 
The leaves, blossoms, twigs, branches may begin to fade, while 
the tree remains sound and strong ; and the true condition is not 
realized until the disease, in its progress downwards, attacks some 
of the main branches or trunk, or until some vital organ is smit- 
ten ; until pneumonia, cardiac and kidney disease, nervous dys- 
pepsia insomnia, physical and mental prostration, attract the 
individual's attention. The fatigue, pain, worry, want of rest, 
the wreck produced by mental toil is marvellous. 

The symptoms of neurasthenia are very varied, being often 
central in the brain proper, but the largest number are reflex, 
taking place through the motor and sensory nerves ; the sympa- 
thetic and vaso-motor, the irritation being transmitted to weak- 
ened parts in the cord and bulb. When the mental wreckage is 
great, fear is a predominant symptom, fear of society, fear of soli- 
tude, of place, of disease, of morbid impulses ; suicide, mental 
depression, wakefulness, headache, impaired memory, deficient 
mental control, palpitation, aneurosis, neuralgic pains, dysentery, 
spinal irritation, cardiac insufficiency, etc. — neurosis somewhere. 

Effects. — The grand predominating effect of neurasthenia is 
general vital deterioration. The intellectual torpor of a semi- 
civilized state is more favorable for brain vitality, national growth 
and vigor, than one highly civilized. We have an excellent illus- 



BACTERICIDES. 707 

tration of this in an Irish woman, she keeps all her vital force in 
reserve, she will do any amount of hard work, even drudgery, 
unblessed, uncared for by exhausting sentimentalism, without 
being able to read or write, or calculate past, present or future. 
In her daily toil, she seldom brings out all her available vital 
force; whereas, the sensitive, highly civilized American woman, 
with a small amount of inherited vital force, living an in-door 
life; her mind highly active, subsisting upon pernicious litera- 
ture ; real or imaginary stories, the effeminating journals of the 
day, attending theatres, receptions, balls, subject to worry, care ; 
she has no reserve of vital force, it is exhausted as generated ; 
whereas the Irish woman has a large amount of vital force, a full 
reservoir, an excess — a battery of potential vitality, with great 
power of resistance ; while the neurasthetic is endowed with 
the most meagre supply. 

All highly evolved nervous organizations have a smaller 
amount of vital force, have very little resistance to disease, or to 
the entrance of disease germs into their bodies, or to molecular 
change, much less than those whose organizations are low. The 
highly evolved nervous organizations are more complete, they 
are stronger reflex agents ; the mechanism of their nervous sys- 
tems is more elaborate, has a finer grain, contains more cineri- 
tious matter, it has deeper fissures of thought, but it is less re- 
sisting, less vital than the lowly organized. 

Individuals free from neurasthenia are vital, all organs are 
strong and normal, and resist disease. 

Among nations, the modern American is the most nervous ; 
they are ever in a state of tension, or strain ; they are incessant 
at work, from the cradle to the grave, and do an immense 
amount of work, though not of the highest. 

All forms of nervous exhaustion prepare the way for disease ; 
they prepare and fecundate habits of inebriety, in tobacco, opium, 
and alcohol. 

This inherent state of deteriorated nerve power comes from 
weakness and degeneration ; all the victims have oxaluria, lithae- 
mia, phosphuria ; all have degradation of blood elements, and 
suffer from disease germs in every structure of the body ; all 
have the stamp of effaced vitality. Children affected with n^eu- 
rasthenia exhibit well marked symptoms. The child is restless, 
fidgety, suffers from insomnia, headache, indigestion, manifest 
weakness and irritability in the cerebral nerve mechanism. The 
higher grade of brain life, phrenal activity, is illustrated in rapid 
development, or evolution, early precocity, weakness of organi- 
zation with attendant symptoms. 

Pathology. — Neurasthenia, poverty of nerve force, cerebral 



^708 DISEASE GERMS. 

softening, paralysis and other states, are the sequel of exhausted 
nerve force, whether by mental work or sexual excess; it brings 
about the state of an organ tissue-starved. Following this, 
granular deposits on the arachnoid, adhesion of the membranes 
to the surface of the convolutions, crystalHne granulations in the 
lining membranes of the ventricles, with an unusual amount of 
fluid in the sac of the arachnoid and in the lateral ventricles are 
found in the brain of those who devitalize that organ. A tissue- 
starved brain gives rise to inflammation of the cortical part of the 
brain, ending in its degeneration of the nerve cells of the hemi- 
spheres, structural change in the convolutions, the cells of which 
lose their integrity and look like an irregular heap of particles 
ready to fall asunder. 

The brain of man owes its healthy existence to the quantity ot 
phosphorus it contains, if this is economized, independent of its 
scantiness in modern food, it might sustain him probably as long 
as life lasts and health holds out ; but let the brain starve, health 
fails, nature can supply no more ; then, unless the patient can ob- 
tain phosphated food, as ozonized tincture of oats, or the animal 
phosphorus of kephaline, degenerative changes will take place 
in the gray substance of the cerebrum ; the cells of that part will 
become granular and deposits of granules scattered through its 
substance ; these changes take place in all parts of the brain 
and spinal cord, when the phosphorus in the brain is exhausted. 
Brain workers, merchants, professional men, know this ; they 
feel it in their languor, tired brain ; those are the victims of ex- 
cessive brain exhaustion. How far this granular change in the 
nerve cell is compatible with healthy mental action, we cannot 
yet say. But we do say, and nothing can invalidate it, that 
unless our brain-workers obtain more phosphorus, white 
softening, paralysis and insanity will become more common. 

General Remarks. — Man, the embodiment of the Great I Am, 
in whom he lives and moves and has his being, his body, with 
his instinctive, moral and intellectual nature — embraced in the 
sympathetic with its numerous ganglia or little brains, the gen- 
erators of nerve force, constitutes a bundle of nerves, reflex in 
their character, that rebound upon each other, reflecting irrita- 
tion, to the medulla oblongata, which force thence is reflected to 
weakened parts, so that any irritation set up in one part is liable 
to produce an irritation in another. There are certain organs, 
which, on account of their importance, complexity of their 
nerves, and from the fact that they are indispensable to the func- 
tions of life, are pre-eminently the seat or centre of reflex 
action ; the cord, the heart and blood vessels, through their abun- 
dant, complex and sensitive nerve supply, keenly feel any irrita- 



BACTERICIDES. ^09 

tion from any source. The circulation is kept unbalanced, waves 
of irritation, under a myriad of causes, explain the fugitive char- 
acter of the symptoms. There is a power within the human 
body, partly physical, partly mental, of working off or tolerating 
disease. A vigorous man physically and intellectually, with a 
certain mental organization, will bear pain, suffer shocks well 
— states which would make a weak man a chronic sufferer, a life- 
long invalid, rendering his existence a cipher. Strong, vital con- 
stitutions will bear suffering, ward off disease, and by the inherent 
element within them will prevent degradation under which others 
would succumb. 

Neurasthenia is as jealous as a woman, it allows no rival. Let 
there be malaria, syphilis, gout, any form of blood poisoning, the 
nerve debility intrenched in the constitution of the individual 
will hold its own and ever be on the top, in spite of all diseases, 
but being paramount, it modifies every affection known to the 
human race. 

Varieties of NeurastJienia. — Nervous debility is a devitalized 
state, a disease, which has its cause, its symptoms, its effects, its 
antidote, and when thoroughly intrenched in any individual will 
hold its own position, often in spite of every effort. It is true it 
may be aggravated, complicated, modified by every known dis- 
ease, and its presence in the individual makes other diseases 
more difficult to eradicate or overcome. 

The action of the mind upon the body in health and disease, is 
a problem that has caused much perplexity to all medical men, 
and still more the enormous capacity of those affected with neu- 
rasthenia for mental exercise and work. 

Neurasthenia, like insanity and other mental states, is divisible 
into a vast number of varieties, such as hypochondriasis, or 
crankiness, a demonstrable form of cerebral disease ; certain 
idiosyncrasies, which are purely mental wrecks ; the infinite num- 
ber of forms of neurosis of every organ, gland and structure of 
the body. The most marked or noted of all forms of neurosis is 
the sexual — pruritus is very common ; painful connection is most 
distressing ; continence or incontinence of urine annoying. 

Nymphomania, a species of madness, in which the excitation 
is so great, that spasms are excited by the sight of a man ; or the 
irresistible desire to masturbate or hold abnormal rfiethods of in- 
tercourse of the sexes, is often accompanied with peculiarities of 
voice (squeaky) or by obscene language or conduct, fits or at- 
tempts at suicide, states in which the mind is peculiarly affected 
— termed Erotomania, a mental state, exclusiv^ely occupied by 
illusions, hallucinations, etc. 

Nymphomania is physical ; erotomania, mental, ps)xhical ; 



710 



DISEASE GERMS. 



satyriasis is peculiar to the male sex, and is to man what nym- 
phomania is to women. Its symptoms are hallucinations, fits of 
sexual furor at the sight of women, repeated ejaculations, obscene 
conduct and words, a tendency to suicide. 

Strange, undefinable sensations amounting to numbness or 
even pain ; inharmonious states, incompatibility, loathing, dis- 
gust, complete perversion of the sexual appetite, which gives 
rise to callousness, imaginary impotency ; or farther, where the 
neurasthenia has progressed to a wiping out of the typical fissures 
of the brain. 

A poverty of vital force, a want 

Neurasthenia of Brain, of nutrition is often applied to tis- 

Spinal Cord and sues or organs when tjfieir vitality 

Great Sympathetic. is impaired, irrespective of any 

disease of the blood, such as 
anaemia of a nerve in neuralgia, a starved heart in rheumatism 
and gout ; atrophy of a muscle, owing to an insufficient blood 
supply ; anaemia of the uterus, etc. In cerebral anaemia the 
quantity of blood in the brain is reduced below the natural 
standard, or the quality of the circulating fluid is impoverished. 
In either case the nutrition of the organ is interfered with. In 
the one case there may be a loss of blood, or the blood cannot 
permeate the nerve-centres, or there may be a lack of blood 
formation. Insufficient nutrition is the cause of anaemia of the 
brain, spinal cord and sympathetic, and this may be brought 
about by worry or struggle for existence, or it may be due to 
insomnia, to sameness, monotony, isolation, or to irritation 
reflected, to diseases within the body, or to disorders of diges- 
tion or assimilation interfering with nutrition. It is well known 
that under a condition of worry, sorrow, grief or other depressing 
passion, the blood becomes poor in quantity and quality from 
deficient nerve supply, and is unfit to nourish the brain, and the 
great centres suffer from the shock incidental thereto as well as 
from poor blood, and with it the whole body suffers. 

In cerebral anaemia from impoverished nutrition, there is not 
only a decrease in the red corpuscles of the blood, but the power 
of the heart and blood-vessels is lowered; there is a deficiency 
of the functional energy of all organs, due to a want of blood 
and innervation; strength of will, vigor of intellect and the vital 
capacity of execution and determination are impaired, and the 
individual is capable of no effort. The mental inertia or depres- 
sion is generally accompanied with lassitude and a feeling of 
utter incapacity for muscular and mental exertion of any kind. 
The causes of anaemia of the nerve-centres are very varied, 



BACTERICIDES. 



7ir 



and embrace to a certain extent a long list of diseases, such as 
concussions, the action of the sun, chronic inflammation, soften- 
ing ; the action of whiskey, opium, chloral, tobacco ; mania, 
monomania, dementia, melancholia, nervous dyspepsia, hysteria, 
epilepsy, catalepsy, ecstasy, somnambulism, paralysis, convul- 
sions, -headaches, etc., in addition to worry, tire, exhaustion, 
study, mental strain incessant; masturbation, sexual excesses, 
deteriorating influences of civilization, over-stimulating the 
nerve power ; defective assimilation of brain elements, improper 
reading, deleterious trades ; solitariness or sameness, which wipe 
out the typical fissures of the brain and thus lower its quality ; 
too early an education, which causes a defective power of assimi- 
lation in the brain, protracted inhalation of air deficient in 
oxygen, whereby the centres are not vitalized. Nerve tire ; to 
which may be added civilization, refinement, culture, which 
create new and abnormal responsibilities, new anxieties, every 
one of which brings on additional mental strain. The mind of 
highly civilized man is ever on the alert. The brain has no 
rest ; nutrition of other tissues is diverted to repair the waste of 
nerve-tissue, and sooner or later inevitably comes the anaemia 
or exhaustion. It is undeniable that anaemia of nerve-centres 
increases with civilization, and that diseases of the brain, spinal 
cord and ganglionic nerves are alarmingly on the increase. 

Among the most prominent of these causes is worry, struggle, 
real or imaginary ; this gives rise to a grave loss of nervous 
energy and anaemia of nerve-centres. By it the united brain, 
in tone, strength, capacity is seriously impaired ; by its wearying, 
gnawing, exhausting influence, the organ is devitalized and irre- 
trievably suffers ; by it the whole machinery is thrown out of 
gear, and exercise, recreation and amusement become painful and 
destructive. The victim of worry is on a precipice ; if he escapes, 
it is something providential. Worry is disorder, and nature 
abhors it. The energy employed in any pursuit under a state 
of worry gives a small result and speedily becomes exhausted. 
Under it the faculty of recuperation is arrested ; the failure of the 
appetite soon takes place and the effort to work is laborious ; 
the task of fixing the attention grows increasingly more difficult; 
thoughts wander ; memory fails ; reason becomes feeble ; preju- 
dice takes the place of judgment; brain disturbance very apt to 
supervene and a crash is likely to follow, with mental disquietude 
and distraction. 

Next to worry we have mental strain, incessant attention for 
hours in bank officers, railroad employes, merchants, etc. No 
one who has any practical acquaintance with the human brain 
can fail to recognize the fatuity of a policy which entrusts the 



71 



DISEASE GERMS. 



safety of their lives and fortunes to the integrity and precision of 
the mental function performed by one brain, continuously engaged 
for several hours in succession ; the keeping o( the brain on the 
stretch for long intervals; the sustained attention of onerous 
duties weakens its integrity and it becomes anaemuc. In the na- 
ture of things, physical memory fails ; mind wanders ; and if it 
were not for habit, the task probably could not be performed. 
The higher cerebral centres are relieved by the strain put upon 
them by delegating their power to the lower automatic centres ; 
but if with this relief the tension is excessive, and the Avay in 
which the ease is purchased by habit, is in itself a source of peril. 
Acts that do not call the reasoning power into operation and 
form a judgment ; acts that are merely routine or habitual, are 
dangerous. It is critical for man's brain to work automatically 
or by habit ; it leads to anaemia. 

In anaemia of the nerve-centres, produced by over-study, there 
is usually irritability and excitability of manner and an utter im- 
possibility of concentration. When intellectual exertion, if 
monotonous, is carried on beyond a certain point, the brain be- 
comes fatigued and anaemic, and the nutrition in the ganglionic 
cells of the cortex become impaired, diseased, altered from health; 
then headache becomes not an inR-equent concomitant of the 
case, and indicates a still more advanced condition of an irritable 
and exhausted brain. Headache is indicative of cerebral debility, 
whichever of its two great factors be present, anaemia or conges- 
tion. A great deal of the present amount of anaemia of the 
nerve-centres is due to brain starvation, as well as overwork, 
worry and strain. It is simply preposterous for a nation of brain- 
workers to live on vegetables and starch. Our present diet is 
poor in phosphates. A brain-worker should eat freely of corn- 
bread, oatmeal in some form, and boiled white-fish, which are 
true brain and nerve food. If no deleterious compound is intro- 
duced into them they give or afford pabulum for lost nervous 
energy ; they relieve lassitude, refresh the nerves when tired by 
any drain, strengthen the failing memory and give renewed vigor 
in nerve-tire. 

Cerebral starvation is also brought about by adulteration of 
food, as the use of baking powders, which destroy the phosphates 
in flour, corn, buckwheat, and the introduction of diabolical, dis- 
ease-generating food, as pork, oleomargarine, glucose, which 
shouid certainly be prohibited by rigid laws. This insufficiency 
of brain elements in food tells dreadfully upon the offspring in 
the production of infantile brain anaemia, and it is doubtful 
whether it is not of more importance in whittling down the 
nervous system to the very lowest ebb than over-stimulating 



BACTERICIDES. 



713 



diet, tobacco, literature and other assigned causes. Under the 
absurd name of hysteria we find a large percentage of anaemia 
of nerve-centres in ladies. This is due to a variety of causes, 
such as their extreme susceptibility to impressions, to their in- 
door life, monotony or sameness, sedentary habits, which neces- 
sarily gives rise to a deficient aeration of blood, a deviation from 
a natural type, and causes a marked characteristic, which condi- 
tion is aggravated by literature and surroundings. All morbid 
states of the body directly or indirectly tend to produce brain 
anaemia. This is explained by reflex action. .Masturbation is a 
dual cause, a direct drain and irritation superadded. 

Symptoms. — To lay down a train of symptoms is impossible ; 
there might be forgetfulness, loss of memory, nervous debility, 
indifference to the world, white face, dilated pupil, nerve-tire or 
irrepressible languor, sleeplessness, irritability, heats and colds, 
burning in the hands and feet, vertigo, noises in the ears, specks 
and spots before the eyes, phosphates and chlorides in the urine, 
abnormal sensation in the skin, seminal weakness and loss of 
power of the generative organs, or, in other words, no definite 
symptoms can be laid down, depending a great deal on the so- 
called disease present, or that develops itself. Hypochondriacs, 
cranks, nervous dyspeptics, confirmed invalids of all sorts, widely 
scattered over the entire countn.', paralytics, monomaniacs, hys- 
terical subjects, bed-ridden, sleepless, helpless victims, the result 
of abuse and erroneous treatment, worn and wasted, a burden to 
themselves and their families ; subjects who may or may not 
suffer from some local disorder, if none, the exhaustion, prostra- 
tion, difficulty of progression, and general nervous disturbance 
incident to the anaemia will be paramount. As a general rule, 
whatever the phase in which it presents itself, there is wasting of 
the fatty and muscular tissues combined with the anaemia ; the 
patient having lost all healthy appetite and power of digestion 
and assimilation, there being scarcely enough eaten to keep vi- 
tality alive. Patients suffering from cerebral anaemia, whether it 
be the monomaniac, hypochondriac, hysteric or dyspeptic type, 
have their sympathetic system highly excited and are highly 
emotional, constantly craving pity, sympathy, which they usually 
obtain to a degree prejudicial to their welfare, and monopolize it 
until the entire household and neighbors become victims to their 
morbid selfishness. One doctor is tried and another, one cure, 
water-cure or spring, and even different sections of the country 
are utilized with no good. 

Treatment. — In cerebral anaemia our usual medical treatment 
is almost useless, and this very fact necessitates a complete 
change of procedure, a change that involves not only great ex- 



714 



DISEASE GERMS. 



pense but considerable inconvenience, as it involves the removal 
of the patients from the unwholesome moral atmosphere in which 
they have been living, away from sympathizing friends and neigh- 
bors ; by a renewal of the patient's vitality by baths, brain food, 
and other nutrition, and causing its assimilation by positive mus- 
cular exercise ; by resorting to peripheral stimulation, thus 
stimulating the reflex centres, causing an increased cutaneous 
circulation, and thus improving nutrition. The treatment is 
physiological, and up to the latest discoveries in medicine, and 
involves the following heads : 

I. Seclusion and Rest. — This is absolutely indispensable to 
carry out the entire treatment in its most minute detail ; the en- 
tire seclusion of the patients under a competent nurse, and their 
removal from old scenes, associates, and the morbid atmosphere 
of invalid habits which encircles them. Unless the patient is en- 
tirely removed from the injudicious sympathy and constant wait- 
ing on of friends, it is impossible to obtain the necessary control 
over them which is requisite for a cure. This point is to be 
made absolute ; sever the connection between th^m even if it 
seems harsh and strange ; no compromise on this point can be 
made, and if it is impossible to secure the removal, the isolation 
and perfect seclusion of the patient, better to have nothing to do 
with the case and its peculiar treatment, for even if they are iso- 
lated in a separate room in the same house under a competent 
nurse and visited by no one but the medical attendant, the case 
does not do so well as when apart. 

There should then be a perfect separation from all moral and 
physical surroundings ; the change is beneficial, and aids im- 
mensely in the cure. Following this is rest in bed, absolute re- 
pose, no reading, talking, looking at pictures, no sewing or knit- 
ting, not even allowed to feed themselves for at least six or eight 
weeks. Under this condition of rest the whole system becomes 
regenerated, and new tissues begin to form ; it acts like a brain 
or nerve food ; it restores lost energy, refreshes the nerves tired 
by worry, excitement or strain, and gives renewed vigor to the 
whole body. After this condition of absolute repose has existed 
for six or eight weeks, it may be broke or lessened, and then the 
patient be permitted to sit up several hours daily, and gradually 
this is to be extended. The old diseased habits are to be dis- 
carded and a new life to be inaugurated while the above is being 
faithfully carried out ; the essential part of the treatment is also 
being fulfilled in the form of — 

Massage. — Simultaneously with the condition of seclusion 
and rest being commenced, this, the really indispensable part of 
the treatment, should also be inaugurated : the entire surface of 



BACTERICIDES. 



715 



the body of the patient morning and evening to be thoroughly 
sponged off with castile soap and water, and well dried by the 
nurse, and thus made ready for the massage. This is to be per- 
formed by a young, healthy, vigorous person, full of vital force,, 
intelligent, and well posted in his or her work. Massage should 
be commenced the first day, half an hour in the morning, and 
same length of time in the afternoon, the duration of time in- 
creased daily, until two and a half hours are thus occupied 
morning and evening, making five hours altogether daily, and 
after its performance each time, one-half or three-quarters of an 
hour of electrical manipulation to follow. This massage is to 
consist in taking a leg and thigh, beginning at the toes, foot, leg 
up to groin, first rubbing from the extremity up ; then grasping 
the parts between both hands, from foot up, moving each joint 
as you go along ; then a careful, pains-taking kneading from the 
sole of the foot up, manipulating the joints well ; this is to be 
followed by beating or patting with the fingers of both hands 
coming down on the part at the same time, and the whole to be 
followed by a rubbing with the points of the fingers, always 
moving the joints. Aftef one limb has been well done, then the 
other ; then one arm, then the other ; the back, and laterally the 
abdomen, spending upon each a little over half an hour. If 
there is great sensitiveness, it is often best not to spend the en- 
tire time on one member at once, but to go from one to the 
other, going over each several times. The intensity of massage 
will depend altogether on the sensibility of the patient. In no 
case is there any violence or roughness to be used ; neither is 
the skin to be irritated nor much redness induced. During this 
manipulation, the patient is to remain perfectly passive — not to 
make a single effort ; all to be done by the operator. This sys- 
tematic shampooing, grasping, kneading, patting, beating and 
exercise of all the muscles and nerves of the body, extremities 
and trunk, has a magical effect. Its advantages are, the peri- 
pheral nerve stimulation carried to brain, cord and other centres, 
raising the standard of central vitality, the vital force or stamina 
of the operator is planted into the nervous system of the patient 
by reflex emanation ; all his reserve vitality accumulated are 
thus given to the devitalized. Nerve action in all cases is vibra- 
tile ; in anaemia of brain an abnormal series of nerve vibrations 
are set up. This is at once changed by massage, which restores 
the healthy, mechanical vibrations to the nerve ; carrying the 
same state of vitality to the centres, it thus relieves wandering, 
erratic pains and neuralgia, strengthens the nerve centres, and 
gives renewed vigor in all diseases of nervous exhaustion or 
debility ; it stimulates the cutaneous circulation, the muscles are 



7i6 



DISEASE GERMS. 



exercised without the expenditure ot nerve force; the reflex 
stimulus carried to the medulla oblongata gives greatly improved 
vitality, and the psychological condition of the manipulator, as 
well as his vitality, is implanted in' the patient. To do it effect- 
ually, requires a well-educated person, of fine mind, strong will, 
solid determination, sound vigor, and of high vitality. The party 
who does the massage should have nothing else to do but walk 
around, eat well, and acquire all the vitality possible, so as to 
communicate it to the patient. The regular nurse, tired and 
wearied with his peculiar avocation, should never be permitted 
to perform the massage. There is to be no oleaginous body 
used by the operator, as that destroys or breaks the vivifying 
current. 

After the first application the patient v/ill feel sore and stiff, 
but this will soon wear off in a few days. Although we incul- 
cate gentleness, still it must be efficient ; this feeling of soreness 
will soon pass off, when the patient will enjoy the manipulation 
amazingly, and after it is performed will have a pleasant sense of 
exhaustion followed by refreshing sleep. 

Electricity. — This should follow the fnassage, and is to be used 
simply as a means of exercising the muscles. The interrupted 
current should be employed twice daily, from half an hour to 
three-quarters of an hour. The poles armed with wet sponges 
squeezed out of salt water, so as to to carry the electricity away 
down into deep parts, are to be placed on the muscles to be 
operated on in turn, beginning at the leg and going up, taking 
each muscle in turn. The sponges with the poles should be 
placed four inches apart and moved slowly up and down the 
muscle until it contracts fully and freely. This is somewhat pain- 
ful and annoying, but is of unquestioned utility in long-standing 
cases of cerebral anaemia, espec'ally where there is wasting or 
muscular paralysis. It is not to be used about the neck or head, 
and it should never be rubbed about indiscriminately, but simply 
applied to the muscles. 

Regimen and Diet. — These form an important and essential 
part of the cure. All this class of patients are but living skele- 
tons, skin and bone ; white, anaemic, wasted, emaciated, neither 
able to sleep nor walk ; suffering a living death, mocked at by 
ignorant physicians who are too superficial to understand their 
case. And it is perfectly astonishing to see how the treatment 
tends to recuperate and rejuvenate them. Once the patient 
is secluded, it is well to cleanse out the bowels and begin with a 
milk diet exclusively for a few days. This should be given every 
two hours in sufficient quantities, which they are able to consume 
and perfectly assimilate, usually from three to four ounces. After 



BACTERICIDES. 



717 



two days of the massage, the amount can be increased to eight 
or ten ounces, so that within the twenty-four hours from two to 
three quarts of milk will be consumed. There is no difficulty in 
getting rid of that quantity even if there are dyspeptic symptoms, 
for they disappear like magic, and flesh, strength and increased 
weight are visible to the eye from day to day. As soon as the 
manipulator reaches five hours of massage and an hour and a 
half electricity daily, one-half in the morning and the other half 
in the afternoon, then the diet is to be increased by the following 
additions, which are greedily taken, thoroughly digested and as- 
similated into brain, muscle and other tissues. The following 
schedule will give an imperfect idea of the diet list or something 
near it : 

Every evening during the treatment there should be made beef 
tea, say a pound and a halt of fine lean meat, chopped fine, and water 
sufficient to obtain ten ounces ; this should stand over night, so 
as to be ready for use at five a. m., when, after the patient is 
sponged off, a portion of it should be taken with a soda- cracker. 
This meat extract should be seasoned to suit the taste, and parsley, 
if in season, added to it. 

At five a. m., beef extract with cracker, to be followed with 
two and a half hours massage and half an hour electricity ; to 
be followed with a bowl of oatmeal porridge and cream. 

A nine o'clock a. m., breakfast, consisting of toast and butter, 
soft-boiled eggs, corn bread, boiled beefsteak and coffee. 
At eleven a. m., milk. 

At one p. m., dinner, consisting of boiled white-fish, chicken, 
mutton chop, broiled beefsteak, vegetables, fruit and cream. 

At three p. m., milk, to be followed with massage and elec- 
tricity for three hours ; to be followed with beef extract, fish, 
biscuit or milk. 

In other words, a system of feeding consisting of brain ele- 
ments, and that to excess. 

In this treatment, which is so successful, the massage is the 
dominant agent, and the question is — How does it work? The 
vital stimulus of the rubbing, patting, kneading, shampooing, is 
imparted to the superficial nerves. This passes along the nerve 
tubes by means of the pulp to the gray matter of the spinal cord, 
where, by the influence of the ganglion through which it runs, 
the supply of blood to the nerve cell is regulated. In the cell of 
the gray matter of the cord a vital electrical condition is estab- 
lished which travels along the spinal cord to the brain, which is 
toned up and receives more blood. Every rub, every vibratory 
thrill gives a myriad of tonic phenomena, and causes the 
anaemic capillaries to become filled with blood rich with brain 



7i8 



DISEASE GERMS. 



elements, and a renewal of life in the weakened tissue promoted. 
This treatment, simple as it looks, needs the supervision of a 
medical attendant of great skill. The time necessary to accom- 
plish a cure is usually about twelve weeks, unless in old cases of 
paralysis, which may require a longer period. 

Is this treatment reliable ? Assuredly it is. Not only reliable, 
but endorsed by the highest medical authorities, and thousands 
of hopeless cases of disease have been cured by it. It is no ex- 
periment. The nervous system is the controlling agency by 
which development is perfected, and the animal magnetism of 
the operator is the mysterious force that rouses it into action. 
No drug, no remedy whatever can quicken the benumbed and 
paralyzed limb or faculty like the invigorating stimulus of intel- 
lectual animal magnetism. There is an affinity in all cases of 
debility to absorb or draw from the strpnger around, to imbibe 
their nerve vigor and thus rouse their own dormant activities. 
The system of cure as laid down above comes right in among a 
class of diseases in which all remedies fail. For there is no 
drug or mechanical contrivance that can induce a healthy 
vibratory action of the nerves with living, thinking matter, and 
bring a new power to the deadened nerve forces but this. • 

The disorders of the sympathetic or of the great sympathetic 
ganglionic system, which in the white man is so profusely re- 
flected to the face, lungs, heart, spleen, liver, and genito-urinary 
organs of both sexes, in which the moral nature of man, emo- 
tions, desires, affections and passions reside, or what some term 
his visceral brain or soul, have not as yet been elucidated, and 
therefore not classified. The immense amount of rich gray 
matter in the sympathetic ganglia and its connection with the 
organs of animal life, with the united process of nutrition, blood 
formation and reproduction, exercise an immense influence on 
the circulation through the medium of the sympathetic, by 
which the neuric manipulations are produced, and any deviation 
from health in any of the organs of chest and abdomen leads to 
anaemia of cord and brain, especially so i( the complex^ genera- 
tive system is affected. It may be called reflex irritation, or irri- 
tation carried along the sentient gray matter to the cells of the 
cord, which in time wears them out and the influence of repeated 
or abnormal vibrations exhausts completely the central cells and 
the non-vital condition is established, with the weakening and 
disturbance of the electrical condition of the cord and brain. 
The superiority of the gray cell of the sympathetic, its intrinsic 
sentient matter is apparent, its growth and development in man 
being coeval with his moral responsibility ; and when any organ 
it freely covers is affected, as the uterus, the penis, the left kid- 



BACTERICIDES. yig 

ney, spleen, mesentery, heart and lungs, then rapid changes do 
occur on the supervention of the irritation. In such cases we 
see the rosy hue of the cheeks becoming pale ; the graceful 
gambols of the child giving way to the distortions of chorea ; we 
hear the sad gurgling of the epileptic, or the fierce ravings of 
mania, or the meanings of melancholia. Once the affections of 
the sympathetic are classified, we will be better able to treat 
the diseased manifestations of those organs under ganglionic 
control. * 

It is not our purpose to speak of evolu- 

Neurasthenia. tion, or of the opposite state, dissolution. 
{Sexual.) Suffice it to say here, that the order in which 

the principle organs of the body are evolved, 
are as follows : Heart, brain, eye, ear, mouth, nose, digestive 
organs, organs of special sense, moral qualities, reason and 
higher faculties, and lastly the reproductive organs, and the fac- 
ulty of abstract thought. 

It is a principle of evolution that functions, when not disturbed 
by disease, decline, wither, decay, atrophy, and disappear in the 
reverse order in which they are developed. 

The functions of the hum.an body, that are last in the order of 
development, are the reproductive, or procreative, the power to 
reproduce the species, and the power of abstract thought. 

Puberty in the Caucasian is not reached till fifteen years of age, 
but even then the male is not mature till he is twenty-five, and 
the female till she is twenty-one, and few persons attain the 
power of reasoning earlier. Before that period the human pro- 
geny are simply imitators. 

It is a fundamental rule in physiology, that it is the sexual 
organs that make the man — that it is upon them manhood is 
built up. 

The nervous system of man is intrinsically the most valuable 
substance in nature, and when thoroughly matured in either sex, 
between twenty-five and forty-five, it is the most difficult to de- 
vitalize, but when impaired it is the most tardy in recuperation ; 

*The most brilliant results have been obtained in the treatment and cure of chronic 
and hitherto deemed incurable, nervous disease, by the use of vitalized massage, elec- 
tricity, seclusion, rest, over-feeding, glycerite of kephaline, avena sativa. Sanitariums 
are best adapted for carrying out the treatment in all its details, and affording a com- 
plete rejuvenation of the patient. In the United States we have a few which excel, in 
magnificence in the profound ability of its attending physicians, and in their thera- 
peutic appliances, anything in the world. In the East, The Flower Medical Hotel, 
41 7 Columbus xA.venue, Boston, Mass. ; in New York State,the Sanitarium of Dr. Gleason, 
of Elmira ; and Dr. Dewey, CUfton Springs ; in the West, Prof, Skelton's Sanitarium, 
at Bloomfield, Iowa, and Prof. W. T. Burks, M. D., Napa City, California. 



^20 DISEASE GERMS. 

the great nervous ganglia with the reproductive organs are late 
in maturing ; and when there is any wreckage or disease, the 
genital organs and intellect suffer first. 

This law holds good, subject to some variations of tempera- 
ments, idiosyncrasies, hereditary conditions, or perversion of the 
intellectual faculties. 

The genital organs are the first to suffer in all cases of nervous 
debility ; they arc the first to feel the slightest disturbance of the 
nervous system ; the first to feel the shock ; and this sexual im- 
pairment is soon followed by heats and colds, by feebleness of 
memory, more or less general depression. Nerve shock, nerve 
tire — worry, struggle for existence, operate actively, keenly upon 
the reproductive organs, giving rise to such conditions, as sper- 
matorrhoea, the flowing away of semen in the urine or otherwise ; 
different grades of impotence, even to a want of power of intro- 
missions ; irritable prostate, with dribbling of urine, or frequent 
micturitions ; oxaluria, phosphuria, lithsemia, often existing 
months or years without the knowledge of the individual ; but 
sooner or later, other functions will suffer, as digestion, power of 
mental concentration, irritability of the spinal cord, torpidity of 
liver, Bright's disease. 

Disease of the brain, cord, great sympathetic, makes the indi- 
vidual sick all over. No one can have any form of nervous dis- 
ease and be well, and absolute impotence may exist and the 
individual be to all intents and purposes well. 

The explanation is, that the function of generation being the 
last to be developed, is the first to give way, or decay — it has 
nothing depending on it — it is simply a twig, a branch, not a 
main trunk like the brain ; it is a periodic function, capable of 
long intervals of inactivity, not of short intervals like the diges- 
tive organs, or constantly active like the heart or lungs. 

A man may enjoy excellent health, and his sexual apparatus 
dormant, without being capable of reproducing ; without exer- 
cising the function of abstract thought; without general activity. 
These functions are of late development. 

There is a border line of local sexual debility that cannot be 
passed without bringing suffering to the entire body ; so sexual 
neurasthenia leads to nervous dyspepsia, constipation, liver, kid- 
ney and heart disease, and numerous other morbid conditions. 

True, in the sensitive, in those of high mental culture, in the 
highly developed, this border line is speedily reached as they 
have little power of resistance ; little, much less reserve of vital 
force than those of a more rugged constitution. 

The muscular man is stronger, more vital, offers more resist- 
ance, has greater vital tenacity, is in other words impregnable to 
ingress of disease, to depressing influences. 



BACTERICIDES. ^^21 

If the neurasthenia is induced by masturbation, the individual 
so devitalized loses his manhood, and all the attributes of virility 
long before old age; his beard and hair fall off; his genital 
organs atrophy ; his sexual appetite and desires disappear ; his 
voice becomes feeble and altered ; his body loses its force, vigor, 
energy — he becomes effeminate, he acquires the habits and attri- 
butes of a woman. 

But there is in modern society other elements aside from mas- 
turbation existing, operating, devitalizing, which might be termed 
sexual perversion, which exhibits itself, in unnatural forms of 
coitus, even worse than self-abuse. These we need not enumerate, 
suffice it to say that the wearing of condums and the common 
practice of both single and married men resorting to premature 
withdrawal in the act, is the worst, the most blighting; the prac- 
tice gives rise to irreparable damage to the prostate, perverts the 
sexual appetite, causes early impotency and nervous disease. 
Certain trades, occupations, as photograpers, riding on horse- 
back, reading dime novels, give rise to seminal losses or leakages, 
general genital excitation, prostatic disease ; under which the 
generative organs atrophy, grow smaller, feeble ; the desire, 
power of intromission by and by ceases ; courage and man- 
hood disappear. 

Sexual neurasthenia, in all cases, leads to feeble-mindedness, 
or imbecility, epilepsy, inebriety, insanity. The practice of mas- 
turbation or perverted sexual appetite, however gratified, gives 
rise to ph renal incapacity, which leads to insanity, preceded by 
melancholy, a state which leads its votaries to lunatic asylums. 
Genital losses depreciate, destroy, the intellectual and moral 
nature, they demoralize, wreck, throw out of gear the entire in- 
tellectual fabric. 

An unmarried man in apparent good health may occasionally 
have emissions ; they are evidence of weakness, debility ; they 
are exhausting, have a debilitating effect on the body and always 
bring on nervous disease, and if they are combined with any 
form of sexual perversion induce anaemia of the brain and cord. 
Masturbation and all forms of sexual perversion are ruinous, the 
involuntary oozing or loss of the seminal fluid is disastrous in 
the extreme. 

True spermatorrhoea, or the flowing away of semen, either 
nocturnal or diurnal, or its loss at stool or in the urine, indicates 
debility of the parts, and of the sexual appetite or sense at the 
base of the brain, and is a frequent and persistent symptom of 
neurasthenia. Such states are very common among the highly 
civilized American. The urhie^ aside from the general feeling of 
languor, is a barometer test of the true state of the system, and 

46 



^22 DISEASE GERMS. 

the amount of urates, oxalates, phosphates, etc., present, indi- 
cates the degree and intensity of neurasthenia. 

Our habits, our literature, our highly oxygenized atmosphere, 
mould us into sexual neurasthenia, and when induced, there is 
genital debility, less or more impotence, spermatorrhoea prostra- 
tion, irritable prostate, structural nervous disease. 

Numerous complications or deviations arise in all cases, no two 
being alike; in some there is the loss with stinging pain; in 
others the testes atrophy, penis is cold, erections slight ; in 
others erectile power is increased abnormally, prostatic secretion 
or seminal fluid scanty, priapism and aspermatism may exist, 
owing to excitation of the cord. 

The desire for sexual intercourse is the most powerful passion 
of human nature, indispensable for the perpetuation of the species, 
yet how few understand the importance of that function. 

Normal sexual intercourse is a sedative tonic, promotes sleep, 
removes the cobwebs on brain, calms, strengthens the nervous 
system ; if in excess it exhausts, wrecks the whole body, but if 
the sexual act is perverted by unnatural methods, whatever they 
may be, whether they be prolonged, or a dalliance, or a with- 
drawal in the act of ejaculation, or in the use of condums, or 
other methods, too diabolical and soul-perverting to enumerate, 
it shatters the vital elements of being, of existence. In order to 
have a healthy race of children, a man should never have mastur- 
bated, nor resorted to unnatural methods to gratify his sexual 
appetite ; all are bad, but I cannot too emphatically condemn the 
practice of married men, withdrawing in the act of ejaculation, 
also the very common practice of dalliance or prolonged coitus, 
which is much more injurious than when frequently repeated ; 
all such and too many other obnoxious methods are fearfully 
hurtful to the offspring. 

The diagnosis of neurasthenia is not difficult, the presence of 
general nervous debility at all periods, year in and year out, with 
no special disease, if any. The brain is chiefly affected, usually 
phrenal disturbances manifested in a thousand ways ; if the sym- 
pathetic ganglia are implicated there will be emotional disturb- 
ance, religious hallucinations, hysterical conditions ; if the cord 
is affected loss of power will be predominant. 

But it may penetrate further and deeper, special neurosis of 
nutrition central, with a collateral loss of power in the lymph 
canals, and pink marrow where the degradation of living matter 
takes place with the disease germ tubercle ; further and deeper, 
this nervous debility may be so great that the primary elementary 
molecules may be degraded into the diseased germ vibrios in 
which typhoid fever appears ; besides, there is always likely to 
occur a spinal neurosis of weakened parts or organs. 



BAClEklClbfc:^. j2't 

In the diagnosis of sexual neurasthenia, every appHance known 
to science should be brought to bear upon the case, the ordinary 
physical signs as to spermatorrhoea or leakages must never be 
neglected; the examination of the urine, that great barometer, 
should never be overlooked. Determine the sensitiveness of the 
prostate by introducing the index finger of the right hand into 
the rectum, press firmly against the prostate, if it is healthy the 
pressure causes very little pain, but if the individual suffers from 
sexual neurasthenia there is pain, tenderness of an acute char- 
acter, often excruciating pain ; sensitiveness may exist without 
enlargement, irritable bladder or rectum, frequent micturition, 
aching testicle, pains in the lumber region, etc. The more 
highly developed the nervous system the more serious the 
effects. 

A very high grade of neurasthenia may exist without tuber- 
culosis — there is a border line to be reached before a degrada- 
tion of bioplasm takes place into the disease germ tubercle. 

In making the diagnosis we must bear in mind that life begins 
in a homogeneous fluid ; from this is developed the varied forms 
of living beings. There is a life force inherited from a pre- 
existing life which builds up matter into living tissues and holds 
it together for a time, and the tenacity with which this force holds 
organized matter together does not depend on size or strength 
or muscular development, but on an even balance of the several 
parts, on an entirety of vital force. 

Neurasthenia is not incompatible with intellectual greatness, 
for the greatest men in science, art,^ literature have been so 
afflicted. Our aim should be to leave the body better than we 
found it, and to transmit improved vital force to posterity, which 
true evolution will do, making death the beginning of life. 

Treatment. — General principles must guide us, the predomi- 
nating idea being to improve vital force. True a general altera- 
tive and tonic treatment is always of utility, and frequent changes 
of treatment are indispensable. Besides a well-grounded faith in 
the action of drugs that they will aid vital force, we shall briefly 
enumerated the essential points of treatment by which neuras- 
thenia can be wiped out in individuals and nations. 

Clothing for those affected with general nervous debility from 
the cradle to the grave should consist of flannel next the skin. 
It should be fine, not to irritate, and sufficiently thick to be com- 
fortable, free from all drugs, which simply render it most delete- 
rious and toxical. The use ot such an agent over the entire sur- 
face is to stimulate vitality, its reflex action is superb ; it 
generates vital electricity which is reflected to the nerve centres ; 
it, directly over the abdomen, keeps up continuous ganglionic 



^24 DISEASE GERMS. 

action from the million of little brains located there ; a barom- 
eter of force, besides it protects the keenly sensitive neurasthenia 
from the vicissitudes of change of temperature. 

We not only insist upon flannel over the entire body during 
all seasons of the year, but durmg night in bed asleep, when the 
nerve centres are drawing or draining living vital force from the 
centre of all force. The affected individual should sleep between 
blankets, which are highly vitalizing ; if the climate does not 
permit of such, silk is most excellent. 

Diet. — Obviously man was made to eat a mixed diet, including 
both animal and vegetable food. The grade of civilization, 
country, climate, development, peculiarity of individuals, eccen- 
tricities, determine the kind, quality, supply and demand. 

The theory of evolution aids us in providing our drugs and 
also our food, because food is medicine, it supplies material which 
the vital forces can organize into living matter, to aid and nour- 
ish nature in the cure of disease. 

The earth itself feeds on grasses ; fruits and cereals feed on the 
the earth ; the lower animals feed on fruits, cereals and other 
animals ; man, according to this gradation should feed on the 
lower animals, with a small proportion of fruits and cereals. 
In proportion as man becomes civilized or diseased, he, through 
those conditions becomes sensitive or nervous, he should diminish 
the quantity of fruits and cereals, which are far below him in the 
scale of evolution, and increase the quantity of animal food 
which is nearly related to him in the scale of being, as these are 
more easily assimilated. The best food for all suffering from 
nervous debility is beef, mutton, lamb, game, poultry, milk, eggs, 
boiled white-fish, oysters, butter, etc. Lean, tender meat is in all 
cases to be perferred to fat, because fat is a non-vital element 
and is of very low organization, — all fats except butter. Beef 
animals are nearer to him in the scale of evolution, and an ex- 
cess of it, mixed with other articles, contains more brain ele- 
ments, is the best food for brain and muscle workers, and is in 
most perfect harmony with the theory of evolution. 

Just as civilization advances, as the human constitution in- 
creases in development, the diet should be still closer, nearer to 
man in the scale of development. Flesh meat of some kind 
should be the main staple or factor of diet, and on this alone is it 
possible to maintain the highest working capacity for brain and 
muscle. 

As a rule the nervous debilitated are unable through sheer lack 
of force to digest food, at least enough to maintain the wear and 
tear of the body, hence it is of the utmost utility to either 
administer some reliable preparation of malt or pepsine after 
every meal. 



BACTERICIDES. 725 

Thorough mastication, an active liver and a normal evacuation 
of the bowels once every twenty-four hours are indispensable. 

The rule is food of the best, even over- feeding is justifiable. 
Poor food or poverty of food is productive of debility. It is true, 
the human constitution possesses great elasticity and will toler- 
ate poor or bad for a long time, but lessened vitality inevitably 
follows ill nourishment, and the heart is an organ that suffers 
vastly with irregular action under poor food. One thing is posi- 
tively certain, that modern diet is insufficient to maintain the 
activity of brain work, and we need a thorough reform ; our 
dietetics should be prepared for nutrition of the brain, for that 
organ becomes more complex, its cells gain greater power, as 
civilization progresses. 

The first essential of life is good food. The majority of people 
are underfed and a large proportion are improperly fed. Lessened 
vitality inevitably follows impoverished blood and ill-nourished 
tissue. 

Massage is of the greatest efficacy. It should be performed 
for at least one to two hours daily. It is valuable in stimulating 
the nutrition of the entire body, but especially by its reflex action 
in promoting activity of the brain. Under massage the brain 
cells become more active, they grow and gain greater power, a 
higher evolution or development of the nervous system takes 
place, the assimilative process becom_es more active, patient gains 
flesh and strength. 

In all cases of under nutrition of the brain, the cerebral areas 
are much enlarged by massage. It should, in all cases, be per- 
formed systematically and regularly, and by highly vitalized 
manipulators, and is always beneficial in correcting irritability of 
the nervous system, in overcoming defective nutrition. Massage, 
when properly performed, is a never-failing remedy in causing an 
improvement of tissue, by w^hich all is strengthened and degra- 
dation of tissue prevented. 

It is a means in itself, if the directions are closely followed as 
laid down in the domestic practice, that will cure many forms of 
nerve disease and effectually overcome nerv^ousness and prolong 
life to an indefinite period. 

Electricity is a powerful constitutional tonic, a local stimu- 
lant of no mean value, an excitor of nerve force, valuable in ex- 
haustion of the brain, spinal and great sympathetic ; and in cases 
of genital debility. It is a remedy that should be applied with 
great care. 

The faradization of the superficial muscles ot the entire body 
is attended with the most happy results. It enables the vital 
forces of the body to draw renewed life from the centre of all 
force. 



726 



DISEASE GERMS. 



It should follow the massage. 

While using this excitor of nerve force the bed or table on 
which the patient is placed should be thoroughly insulated by 
glass castors, the head placed to the north, in order to conform 
with the magnetic law of the earth, and thus prevent the escape 
of the vital electricity of the body. 

It should be used under the auspices of an experienced 
physician. 

Bathing the entire body, at least once daily, is always at- 
tended with the most happy results. It is efficacious under all 
possible conditions, cold or tepid baths, and, if near the shore, 
salt-water bathing. 

After the bath the individual should be well dried, and either 
well rubbed with the dry hand or massage performed ; the latter 
being the best. 

If the patient is a child, bathing twice a day will be beneficial. 

Location has much to do in the production or cure of neuras- 
thenia. Inhabitants of cities all manifest a typical type of de- 
generation, whereas denizens of the country are highly vigorous. 
The sea, or in close proximity jto it; as well as mountain tops, 
imparts great life, strength to its people, chiefly from the atmos- 
phere of ozone which surrounds them. 

Next in value to mountain air is well-directed sea bathing 
during the summer months, associated with abundant exposure 
to the sun and the open air of the seaside. Sea bathing is best 
with repeated plunges ; or the dashing of the surf over the body 
is the best natural douche. 

No condition or location that favors isolation, monotony, 
sameness, should be selected, as those states directly induce 
vital deterioration by wiping out the typical fissures of thought 
in the brain. 

Exercise, moderate in kind and never exhausting, should be 
inculcated. Walking, riding, rowing, fishing ; there should be 
incorporated an aim, an idea, and in no case persevered with till 
fatigue ensues. * 



* Although we would insist upon moderate exercise, never to the slightest fatigue, 
still it must ever be remembered that sedentary occupations and habits are most per- 
nicious. 

There are certain kinds of exercise highly injurious to the nervous. One of those 
is bicycle riding, the perineal pressure, the jarring, the succession of shocks, the 
movements are conveyed to the spinal cord, having a disastrous effect on the prostate. 
It is more prejudicial to growing boys, because it interferes with the nutrition of that 
gland, first causes hypen\.'mia, then atrophy or wasting, and a general withering of the 
genital organs, leading to an increase of masturbation in the timid, or early sexual 
indulgence and impotency. Even horse riding is bad to the neurastheniacs, causing 
prostatic disease, atrophy or enlargement, with impotency in the strong, robust or 



BACTERICIDES. 



727 



Rest at different periods of the day, should be taken in the re- 
cumbent posture, but especially after exercise, or bathing or 
massage. 

Sleep should be prolonged to eight or nine hours out of the 
twenty-four. If bathing, massage and exercise is not sufficient 
to procure refreshing sleep, then every artifice should be resorted 
to to procure sleep — prolonged, refreshing sleep. All worry, 
care, struggle, tension and nerve tire must be wiped out. 

Amusements, of a most healthy kind, are most beneficial to 
the mind. If the theatre, never tolerate anything but the healthy 
drama. Variety shows are demoralizing. History is in all cases 
to be preferred to trashy romances ; religion and morality invigo- 
rate the brain, whereas infidelity and vice Ipwer, deteriorate, 
wipe out the fissures of thought, of deity. 

Change in all things is vitalizing, — change of occupation, of 
society, of location, of habits, of diet. Change creates a higher 
grade of mental and physical being ; whereas, monotony, same- 
ness and isolation are deteriorating, produce a cerebral wreck ; 
every gland, organ, tissue succumbs to the devitalizing effects of 
sameness. 

Travel. — Change of scene is good, provided it is not carried to 
fatigue. 

Work^ labor, and the prospect of work, an aim in life, is a 
remedial force — with rest, recreation and vacations. 

The usual avocation, if healthy, is the best ; it is rooted in the 
system by years of toil, devotion and costs, as a rule, compara- 
tively slight cerebral force, because it runs in well-worn grooves, 
with very slight friction, and therefore is less exhausting, but, 
while we recommend holding on to their trade or profession, we 
would inculcate abundance of relaxation and pleasure, gentle ex- 
ercise and no strain. 

Marriage with its duties must be restricted within proper 
bounds ; and an interval of weeks should take place between the 
sexual act. Most cases are benefited by it, while others are 
positively injured. 

Coitus to some brings prostration, while to others it rouses up 



daring — reducing or wiping out the masculine characteristics. It will even change the 
tone or pitch of the voice, cause the beard or hair to drop off. 

All bicycle riders are sexual neurastheniacs ; they are effeminate, soft, debilitated, 
ambitionless, etc., such is the outcome of this form of exercise. 

Another modern craze is roller-skating, which, if indulged in for a few years, and to 
the same extent as at present, will cause hypertrophy of the clitoris in all young ladies 
who indulge in it, ?o that nymphomania and masturbation will reign paramount. The 
modern ballet girls all suffer from enlarged clitoris as a result of their occu; aiion, 
although the exercise of moderate dancing is free from this objection. 



728 



DISEASE GERMS. 



the vital energies, and elasticity reverberates through the entire 
body. 

The medical treatment of nervous debility involves a general 
tonic and alterative course ; the use of remedies all the time, 
remedies under which a degree of vigor and vivacity is experi- 
enced. Faith in the action of drugs must be inculcated, and 
they should be changed at least once a week ; the system should 
never become habituated to any one drug. 

Cinchona and its alkaloids are always worthy of special atten- 
tion. It should be invariably administered with some mineral 
acids. 

The ozonized glycerite of kephaline must be given in all cases 
of neurasthenia. It is a brain and nerve food composed of 
C. P. glycerine and the life-giving principles of the ox brain, 
the vegetable phosphates of wheat, the most highly evolved of 
all animal and vegetable substances. It is, without a doubt, the 
best remedy in all forms of nervousness, or nervous exhaustion, 
impaired vitality or weakness of any kind in children or grown 
persons. It is a true nerve food — a true nerve vital essence, 
indicated in all cases of weakened energy ; it gives vigor and 
promotes nerve supply, a true physiological restorative in all 
cases of nervous debility. Being such, it is admirably adapted 
to imperfect development of the nervous system and active brain 
expenditure. 

Ozonized tincture of oats, prepared from the best Scotch oats, 
has been found by experience to be extremely serviceable in 
dyspepsia, indigestion, mental and physical exhaustion, insomnia, 
nervousness. It acts as a nutriment to the cerebral and nervous 
systems, restoring to their normal condition secretory organs 
that have been damaged, giving vigor where there has been 
debility, and renewed strength where there has been exhaustion. 

It causes the tiny cells of the nervous system to increase in 
size, become more elaborate, imparts intellectual vigor, brilliancy 
and vivacity of thought, a redundancy and freshness of ideas ; in- 
creases the typical fissures of thought, and creates a higher and 
nobler type of manhood. It is a remedy that is indicated at all 
periods of life ; in chronic debility in infants and children, in 
difficult or retarded dentition, where we are desirous of increas- 
ing organization and growth of brain and bone. 

This phosphated tincture of oats (avena sativa) is thoroughly 
ozonized and highly germicide, and is one of our best remedies 
in conditions of debility. 

Coca et celerina has been in use for many centuries, for nervous 
prostration, mental derangement, spermatorrhoea, impotency and 
all debilitated conditions of the generative organs, with the most 



BACTERICIDES. 



729 



gratifying results. It is a most valuable remedy, restoring 
health to millions, who, had it not been for this remedy, would 
have died prematurely. The range of action of this preparation 
is large ; being a nerve stimulant it recruits the languid, debili- 
tated, aids the brain to pick up its pabulum from the blood, it 
rejuvenates the nervous system when exhausted. 

The wine prepared from the coca leaves is never failing in all 
forms of neurasthenia, its daily use is attended with the best 
results ; it strengthens the system, restores lost vigor and ex- 
hausted vital power, debility of the brain, feebleness of digestion, 
conditions inseparable from high civilization. 

The action of coca upon the ganglia of the sympathetic is 
admirable, it introduces strength, while it nourishes, sustains, 
refreshes, being an antidote to exhaustion. It is thus prepared : 

Sherry wine, one pint ; fluid extract coca, two ounces. Mix. 
Dose. From one tablespoonful to a wineglassful every three 
hours. A powerful nerve stimulant. 

The cocaine sttppository is of great utility in all cases of nervous 
debility, or lack of nerve force, especially if there is sleeplessness 
or mental distress dependent on an enfeebled condition of vital 
power, attended by some of the following symptoms : 

Tenderness of the scalp and spine ; severe itching all over the 
skin, especially on the legs and arms ; dryness of the skin ; mova- 
ble pains; restlessness and sleeplessness; great disturbance and 
palpitation of the heart ; great prostration after slight exertion ; 
extreme sensitiveness to changes in the weather; profound melan- 
choly and exhaustion; local anaesthesia or hyperaesthesia of the 
skin ; continued pain in the back, shoulder or side ; spermator- 
rhoea ; complete impotence, etc. 

We cannot too strongly urge upon those afflicted with sexual 
neurasthenia the use of these suppositories. 

We recommend them in all the worries and vicissitude of life, 
in over-indulgence in eating and drinking, in the abuse of alcohol 
and sexual excess, in the high pressure of civilization. It is an 
open fact, that the pathological condition of all forms of nerve 
exhaustion is impotency. The desire for sexual intercourse may 
be great, but in those cases there is an inability to perform, owing 
to an insufficient nerve stimulus to produce an erection. The 
man is nervous, his heart flutters, his desire may be good, but to 
his utter amazement and mortification the organ fails to perform 
its legitimate function, and despondent and humiliated he seeks 
relief Medical science has been appealed to in vain, till the in- 
troduction of this cocaine suppository. The use of this in those 
cases is attended with the most happy results. 

The loss of semen, the most highly vitalized fluid in nature. 



730 DISEASE GERMS. 

enervates, emasculates and degenerates, produces the most alarm- 
ing e:^haustion. This cocaine suppository arrests this leakage, 
and invigorates the whole man. 

The combination of coca-calisaya is a superb and agreeable 
tonic, a safe excitant, gives great vigor to the muscular system, 
sustains the brain under extreme tension, produces rapid recu- 
peration ; as a remedy in neurasthenia, loss of nerve power, it is 
one of the best combinations, being invigorating and exhilarating 
in over exercise of the brain or intense study. It aids essentially 
the evolution of the nervous system ; enables the vital force to 
attain further development. 

The true damiana is a most efficacious remedy in all forms of 
neurasthenia, but especially the sexual. 

It is the most powerful invigorant ever introduced. Perma- 
nently restores those weakened by early indiscretions, imparts 
youthful vigor, restores vitality, strengthens and invigorates the 
brain and nerve. A positive cure for impotency and nervous 
debility, prompt, safe and sure. 

Damiana is beyond a doubt the most reliable, useful and perma- 
nent tonic to the genital organs of both sexes known ; acting, as 
it does, directly upon the nervous system, it restores, as it were, 
the debilitated functions of the principal organs of the human 
frame, and is unsurpassed as a nervine. Its merits are well estab- 
lished as a powerful, permanent and positive aphrodisiac, as well 
as an alterative aperient of remarkable fine quality. 

It has acquired the distinction of being, not only a simple, 
pleasant and convenient vegetable remedy, but one that is en- 
dorsed by all medical men, and relied on as an invaluable re- 
medy for nervous dyspepsia, debility and all weakness which 
would disqualify the human race from the arduous duties of civil- 
ized life. 

It is highly recommended in mental over-work, sexual debility, 
impotency, and decidedly beneficial in cases of nocturnal emis- 
sions, the result of excesses, mental apathy, or indifference, and in 
an enfeebled condition of the general system, with weakness or 
dull pain in the lumbo-sacral region. In disease of the reproduc- 
tive organs of the female, and especially of the uterus, it is one 
of our most valuable agents, acting as a uterine tonic, and gra- 
dually removing abnormal conditions, while at the same time it 
imparts tone and vigor ; hence, it is of value in leucorrhoea, 
amenorrhoea, dysmenorrhoea and in removing the tendency to re- 
peated miscarriages. 

It is a safe, certain and speedy cure for nearly all the varieties 
of seminal and physical debility of the generative organs of both 
sexes, whether coxistitutional or acquired. The indiscretions of 



BACTERICIDES. 



731 



youth, which produce such injurious effects upon both mind 
and body, can be rectified, and the nervous system health- 
fully invigorated, where the qualifications of manhood have 
been impaired. 

Although we give a decided preference to kephaline and avena 
sativa in nervousness, mental and physical exhaustion, there are 
cases in which the compound hypophosphites of soda, lime and 
iron are beneficial, they act as food to the nerves. Every mental 
and physical act, every motion, every thought, is attended with 
waste, literally renders effete portions of the brain. In nervous- 
ness there is an excess of waste of the phosphate, and especially 
is this augmented where the intellectual duties are arduous. 
So that in some few cases this remedy may be used with ad- 
vantage. 

The sole aim of all treatment is the elevation of the standard 
of vital power; the improvement of the race; every means to aid 
an evolution of a higher and nobler type of mankind ; all reme- 
dies, all means, an aggregation of all science and art, in atmos- 
sphere and earth ; every thing to give us a pristine vital force, a 
larger area of phrenal life. 

Besides the condition of general nervo-us debility involving the 
whole body, we have neurasthenia of special parts or organs, so 
that while we are treating a general state by alteratives, tonics 
and special agents to build up the brain, the specially weakened 
part requires attention. 

Neurasthenia in special organs is termed a neurosis, as of the 
brain, heart, stomach, bowels, bladder, uterus, prostate, eye and 
lungs. 

To a few of those we solicit attention in the order of their 
frequency. 



A common disorder of adults of both 
Neurosis of the sexes, and may co-exist with pruritus of 
Anus. the genital organs. In the large majority 

of cases this affection consists in the pres- 
ence of itching, without any characteristic morbid appearance, 
which causes intolerable annoyance, especially when heated ; in 
a small number of cases, the anus becomes infundibuliform from 
indurations ; its mucous surface excoriated ; its cutaneous borders 
seamed, puckered, eroded, fissured, often complicated with 
eczema. Piles, ascarides, chronic prostatitis, rectal impaction, 
unnatural vices, diabetes ; insanitary states, morbid secretions,, 
bowel ulcer may all be responsible for their occurrence. 

Although no appreciable morbid appearance can be seen or 
even detected in the large percentage of cases, still there are ele- 



J ^2 DISEASE GERMS. 

ments in the blood and nervous system which give rise to this 
local nervous jarring or neurosis ; there is something out of 
gear, a deviation from the normal state ; it may be obscure, 
latent, still there is a source from whence it springs. 

In all forms of neurosis, we must recognize a failure of the 
general health, the presence of a diseased germ, aggravated by 
the nocturnal exacerbation, perverted nutrition incident to the 
continuous teasing of the nervous system, or from germ>laden 
blood, or a morbid mind. 

The degree of success in treatment is in proportion to the 
skill with which it is managed. The gastro-intestinal tract, the 
liver, kidneys, bladder, uterus, prostate gland, rectum, should be 
seen to by placing the patient upon an alterative and tonic course, 
with every possible means to improve the general health. 

The substances which have been topically applied are most 
numerous, as hot baths, lotions of hot water, or alternately hot 
and cold, medicated by the addition of sodic bicarbonate, or 
biborate — the carbonate and sulphuret of potassa, the anti- 
bacterial microbe powder. Some of the following formulae 
are excellent : 

Hyposulphite of soda, half an ounce; carbolic acid, forty 
drops ; distilled water, four ounces ; glycerine, two drachms. 
Mix by shaking. First bathe the affected parts with castile soap 
and hot water ; dry well off. Then either paint on or apply the 
above. That failing, then try : 

Resorcin, half an ounce ; boroglyceride, three ounces ; water 
distilled, half a pint. Mix. 

Spirits camphor, one ounce ; boracic acid, one ounce ; water, 
half a pint. Mix. 

Sulphuret potass, half an ounce ; spirits camphor, half an ounce ; 
glycerine, two ounces; water, half a pint. Mix. 

Solution resorcin, concentrated ozone, of each one ounce ; 
water, half a pint. Mix. 

All for external use as a lotion, or to be applied on lint ; one 
grain of morphia or hydrochlorate of cocaine added to each. 

Various other valuable formulae may be made by adding 
boroglyceride, or sulphur water, alum, chloral hydrate, hydro- 
cyanic acid to a sufficient quantity of water; lime water and 
tincture of iodine ; a lotion of peroxide of hydrogen is most 
effectual ; menthol and thymol act well in some cases. As a 
rule, ointments or oils do not operate well. If desirous of trying 
one, take one ounce of ozone ointment, one drachm of gum 
camphor and the same 'quantity of chloral hydrate. Mix ; or 
hydrochlorate of cocaine, dissolve it in glycerine of the strength 
of one-tenth of a grain to the drachm ; painted on the part is 
most effectual in some cases. 



BACTERICIDES. 



733 



Neurosis of the 
Aorta. 

{Descending}^ 



Aorta is the name given to the large 
vessel which arises from the left ventricle 
of the heart, and thence conveys the ar- 
terial blood by numerous branches to the 
various parts of the body. It is an elastic 
tube about three inches in circumference at first, but afterwards 
becomes considerably narrower. In the first part of its course 
it is nearly vertical ; it then forms an arch 
and, curving from right to left, and from 
before backwards, it descends through the 
diaphragm into the abdominal cavity, and 
then divides into two terminal branches 
called the iliac arteries. From the upper 
portion of the arch arise three great trunks 
the innominate, left carotid, and left sub- 
clavian, which supply the head and neck 
and upper extremities with blood. From 
each side of the descending aorta are sent 
off numerous branches which supply the 
lungs, and the thoracic and abdominal 
walls, while from the anterior aspect in the 
lower part of its course, vessels are given 
off which convey the blood to the stomach, 
liver, kidneys, pancreas, spleen and intes- 
tines. As people advance in age, or when 
their blood becomes impoverished by dis- 
ease, the walls of this artery are liable to 
decay through receiving insufficient nour- 
ishment, and degeneration of the coats 
takes place in consequence. As a result 
of this the vessel becomes more rigid, and 
there is difficulty in the conveyance of 
the blood to the various organs ; some- 
times a uniform dilatation of the aorta 
occurs, at others a bulging of the wall 
takes place at one spot, and gives rise to 
an aneurism, a state attended with great 
danger. Aneurisms more frequently occur in the ascending part 
of the aorta than in the rest of its course, as here the strain 
upon its walls from the impetus of the blood current is the 
greatest. People who are subject to gout, or who indulge in 
drink, or those who have kidney disease, are liable to have 
degeneration of the coats of the vessel. Great exertion tends to 
cause dilatation of this vessel. Malformation of this vessel 
sometimes occurs in foetal life ; it is in rare cases given off from 




The aorta; a, arch of the as- 
cending aorta ; a a, coronarj' 
arteries; ^.innominata artery; 
^, right subclavian; c, right 
carotid ; d, left carotid ; e, 
left subclavian ; f, thoracic 
aorta; g g, diaphragm; 
h h, phrenic arteries ; /, coe- 
liac axis; k, coronary or 
ga-stric ; /, splenic ; m 
hepatic; «, superior mesen 
teric; o o, renal arteries 
/, inferior mesenteric ; p 
spermatic ; q , common iliac 
r, middle sacral. 



y^. DISEASE GERMS. 

the right ventricle instead of the left; for such cases no treatment 
can be of any avail, and death generally takes place in early life. 

In neurasthenia, or spinal irritation, or exhaustion of the lum- 
bar portion of the cord, the state of debility, with other causes of 
neurosis, gives rise to a relaxation, pulsation in the descending 
aorta, which is often mistaken for aneurism. 

The fact that it occurs in hysterical women, or effeminately 
created young men, should at least put a physician on his guard 
as to its origin. 

The treatment for neurasthenia is appropriate. 



Involves either constipation or diarrhea, 

Neurosis of the with some pain. 

Bowels. General treatment consists in the ad- 

ministration of virg. stone crop, in alterna- 
tion with ozonized liquor cerri. 

In addition to the general treatment as already laid down, 
tonics and alteratives and special remedies to stimulate a renewal 
of life in the reflex centres. We find it a good plan in all 
neuroses to resort to repeated applications of blisters to the nape 
of the neck an inch square, one on each side of the spinal column 
for six hours at one time, twice weekly. They are of great utility 
in all cases of neurasthenia. 

It is difficult to explain their action on such a limited area, but 
they cure and control morbid conditions located in the periphery 
in distant organs, vby rousing up the fibrillary connection into 
activity between the cord or nerves conducting motor or sensory 
power to organs. 

The ailments that yield to this kind of stimulation of the cord 
are all forms of diseased germs in the human blood, all nervous 
affections, neuralgias, paralysis, hysteria, nervous dysmenorrhoea, 
reflex states, vomiting pruritus, all forms of nervous irritation 
occurring in paroxysm, and sexual hybrid states, as chorea, 
•epilepsy ; asthma and bronchitis yield readily. 



Neurosis of the brain often takes place, 

Neurosis of the there are certain well defined symptoms 

Brain. which exist peculiar to this condition. 

The general health is poor, the function of 

the body and vigor impaired ; digestion weak, circulation feeble. 

The entire nervous system is in an unstable condition, and the 

patient irritable, restless, excitable and depressed or despondent. 



BACTERICIDES. 



735 



General nervousness, with headache, pains and tremors, with a 
failure of mental power, feeble and defective memory, with intel- 
lectual aberrations. The physical suffers, nutriment is imperfect, 
skin pale, muscles flabby, motor power enfeebled, culminating in 
paralysis and some endless type of mental deviation. 



Constant and distressing desire for sex- 
Neurosis of the ual intercourse, with an erectile condition 
Clitoris. of the clitoris ; may arise from disease of 

[Nympho?nania) the brain, spinal cord, inflammation of 
clitoris, from masturbation, or excessive 
venery, sedentary habits or occupations, and, above all, by the 
vascular excitement that is produced by our abominable sensu- 
ally exciting literature. 

Treatment. — Removal of cause, plenty of exercise, or hard 
work ; daily shower bath, well regulated bowels, sleep on straw 
or hair mattress, light covering ; cold water hip-baths, and vagi- 
nal injections of cold water, except during menstruation ; large 
doses of green root tincture of gelsemium and bromide of potass 
at bedtime, or camphor, belladonna, and conium, to cut off sex- 
ual desire ; alteratives and tonics administered persistently. The 
best of all remedies is the fluid extract of black willow, to har- 
monize the nervous energies of the organ ; should be adminis- 
tered persistently for six months. A strict avoidance of all light 
literature; a pure, moral atmosphere; same treatment as for 
masturbation in male. The amputation, or partial destruction 
of the organ with caustic potassa, is of doubtfifi benefit. 

In cases of inflammation, rest, open bowels freely, hot poultices, 
and general treatment for fever. 



is an exceedingly severe and distressing 
Neurosis of the form, as the affected parts are very apt to 
Genital Organs be rubbed or scratched, in order to obtain 
relief from the itching sensation ; orgastic 
effects and pollutions are often produced in early life and extreme 
age, whose moral effects are degrading. All parts of the geni- 
tal organs of both sexes may be the seat of the neuroses. 

Independent of the malarial, syphilitic tubercular, cancerous 
germ, search should be made for ascarides of the rectum or 
vagina ; saccharine urine ; uterine or ovarian disturbance ; 
urethral and prostatic damage, or a perverted sexual appetite 
may lie at the origin of the trouble. There may be associated 
with it thickening, erosions, a squamous condition, etc. 



736 



DISEASE GERMS. 



is manifested in a variety of complications, 
Neurosis of the as an aching heart, an irritable, sensitive, 
Heart unsteady organ, characterized by inter- 

missions, irregular action and intermittent 
pulse. This is brought about by anaemia of the sympathetic 
that so profusely covers the heart. Emotions, desires, affections 
and passions must be controlled, great self-denial exercised, else 
the heart will become permanently out of gear. All excitement, 
mental or muscular, with the use of tea and malt liquor must be 
avoided, coffee is not objectionable ; good, rich, wholesome food 
should be taken in moderate quantities and frequently. Fasting 
is prejudicial, giving rise to indescribable exhaustion. The 
nervous power of the heart is sensitive to over-work, to the least 
failure of power, and requires a renewed stimulant, as cinchona, 
cactus and avena sativa. No indigestible article of food per- 
mitted ; forbid nuts, pies, salt meats, pork and cabbage. Protect 
the body with silk or flannel from cold, damp and wet. Har- 
mony and equality of every vital function or process, so that the 
nervously exhausted heart may neither long for new support nor 
be over-taxed with work. Struggle, anxiety and pecuniary care 
abolish. Try matricaria, cerebrin, avena sativa, cinchona. 



The larynx is the organ of voice ; 
Neurosis of the the organ by which sounds or pri- 

Larynx. mary elements of speech is produced; 

[Laryngitis Clericorum) it takes part in the respiratory pro- 
cess, as all air passing to and from 
the lungs, must pass through it. Its construction is most perfect ; 
its various parts of the highest possible organization ; so perfect 
that the slighest alteration of its mucous surface, of its chords, 
nerves or muscles is invariably accompanied by a change of 
voice, either in its intensity, tone or modulatipn. 

No' mucous membrane in the body, so richly organized, so 
finely studded with nerves as the larynx — none to which the 
microbe of syphilis, tubercle, diphtheria have such a strong 

affinity. „ 

The larynx, like all other parts of the body, is liable to suffer a 
condition of partial death ; hence we meet with acute laryngitis 
in males of a high nervous organization, and chronic forms of 
laryngitis in both sexes. 

Chronic laryngitis exists in many forms, which have certain 
symptoms in common, such as loss of voice (aphonia) ; cough 
and expectoration, and in the sputum the disease germs, single 
or hybrid, which is pathogenic of that in the blood. 



BACTERICIDES. j^j 

II the laryngeal irritation be due to cold, damp, exposure, the 
amoeba, the degraded bioplasm of nutrition of the air passage, is 
present in breath and sputum ; if due to syphilis that microbe is 
present ; if to tubercle, that bacillus is there ; if to the blighting 
effects of masturbation, the aphonia, the squeaky voice, in the 
breath, the degraded bioplasm of nerve nutrition, the vibrio is 
present; in all cases of preachers, with aphonia, due to a want of 
harmony in volition, the same germ is present. 

The larynx, like all other parts of the body, can be improved 
and developed, up to a point in which there is an inadequate 
nerve-supply, hence development ceases and atrophic changes 
begin. 

How the larynx can be developed will be seen frgm the follow- 
ing : By massage, exercise, faradization, a system of over-feeding 
the muscular system can be developed in whole or a part; the 
arm of the blacksmith often is greatly developed. The penis 
from a mere withered stump can be made to grow to a well- 
deiveloped organ ; the testes, the mammae under the influence of 
the saw palmetto will often attain an enormous size. As there 
is a perfect anastomosing of the nerves of the reproductive 
organs and the larynx, if the former is healthy, the latter can be 
indefinitely developed. 

Experience tells us that the larynx can be developed by the 
use of the laryngotome to the finest, on& of exquisite modula- 
tion. The laryngotome is an instrument for breathing through 
by spells, say half an hour at a time, taking prolonged inspira- 
tions of the nascent .chloride of ammonia — a germicide' of great 
power. ^ 

Whenever the will is not brought into a unison of action,- or 
exercise of any muscles without the will harmonizing, there is 
apt to be a neurosis, or degeneration of structure. 

The vocal chords are made up of a series of fine muscles* abun- 
dantly supplied with nerves from brain, spinal cord and great 
sympathetic, to enable man to express his thoughts. The brain 
gives the stimulant, the nervous energy, and thus gives the 
motive power ; but this motive power must be in perfect co-ope- 
ration with their exercise — a will, an intellectual effort with voli- 
tion in the delivery of a discourse, if it is duly carried out, and 
all ranting avoided, the vocal chords will improve in their vital 
integrity. 

The disease is common among a class of clergymen who are 
wrought hard and poorly paid, who find it often difficult to put 
an intellectual effort into their words. 

.The symptoms in the early stage are simply hoarseness and 
loss of voice, with no apparent change in the mucous m.embrane ; 

47 



738 



DISEASE GERMS. 



but after a while a follicular degeneration can be detected, with 
congestion and ulceration of the mucous follicles. 

In some cases it is ushered in with a complete loss of voice ; 
in others it originates in a sort of uneasy sensation in the upper 
part of the throat, with an inclination as if there was something 
to swallow ; cough, and the larynx painful on pressure ; expecto- 
ration of a thin, viscid mucus, occasionally pus, with gradual 
loss of voice or diminution of its power ; hoarseness towards 
evening, which gradually merges into complete aphonia with 
ulceration, or unhealthy granulations, or even vegetations. As 
the disease advances, it gradually merges into tuberculae, and 
terminates, if not in recovery, in lung consumption, caries of 
cartilages. 

Symptoms' are nearly identical with chronic laryngitis, — 
aphonia, cough, and expectoration. 

The diagnosis is important ; the history of the case is always 
of great service, one who exercises the vocal chords without the 
will effort, the presence of the microbe of neurasthenia in all 
cases. 

In the treatment of this neurosis, we have of late years intro- 
duced some most valuable remedies. 

The first and most essential remedy is rest of voice, with a 
most liberal diet; and attention to every means which will im- 
prove the general health. 

Follow with a general alterative and tonic course, for altera- 
tives, the comp. saxifraga and phytolacca are most efficient ; for 
tonics, no remedies can excel the avena sativa, glycerite of 
kephaline, matricaria, Warburg's tincture, con. tincture kurchi- 
cine, wine of erythoxylon coca. 

A class of special remedies, as terebene, distillation of the pine, 
creosote, naphthaline, dioxide of hydrogen, comp. oxygen. 

Either administered internally, or by atomizer, or otherwise, 
are most efficient laryngeal stimulants and bactericides. 

The irritating plaster to the nape of neck, or else electricity 
every other day, is of rare value in all cases. 

It has long been demonstrated that the 

Neuroses of the nerves of the nose, subjected to irritation. 

Nose. give rise to certain symptoms of difficulty 

of breathing. 

Subsequently a large number of other general symptoms have 

been traced to some abnormal condition of the nasal fossae or 

their lining membrane. Thus it has come to be recognized that 

affections of the nose, though apparently slight in themselves, 

may exercise an important influence on the general health. 



BACTERICIDES. j-^^ 

Certain diatheses, such as the gouty and rheumatic, appear more 
hable to these attacks. Besides polypi, such conditions as 
hypertrophied mucous membrane, foreign bodies, and chronic 
catarrh may induce attacks of asthma, neuralgia, cough, migraine, 
hay fever, brow-ague, and certain vaso-motor phenomena, such as 
temporary redness of the cheeks and nose, giddiness, rhinorrhcea, 
and even epilepsy. We consider that the posterior portion of 
the middle and inferior turbinated bodies, with the correspond- 
ing part of the septum, are the seat of these disturbances ; 
whereas others consider they can only take place after the an- 
terior part of the lower turbinated body has become turbid. 

The duration and frequency of neurosal attacks are very vari- 
able. Sometimes patients may remain free for months : but, on 
the other hand, the attacks may recur frequently, and continue 
intermittingly till removed by suitable treatment. As a rule, the 
prognosis is favorable. The treatment will consist in removal 
by operation or medical treatment of the exciting cause. Cocaine 
in powder or solution, mild electric currents, inhalations, sprays, 
with internally, quinine, iron, arsenic, or bromide of potassium 
have in my own practice proved at times very beneficial. 

Douches of boroglyceride solution, alternated with resorcin, ot 
great utility. 

Characterized by a constant and dis- 
Neuroses of the tressing erection of the penis. 

Penis. It may be due to some injury of the 

(Priapism}) spinal cord, as fracture, concussion, occur- 

ring at the lower portion of the dorsal or 
upper lumbar vertebrae, or at the origin of the nerves in the 
brain; subacute inflammation of the corpus cavernosa, or effu- 
sion of lymph or blood into that structure. Both conditions 
may be caused by venereal excesses, or masturbation ; that is, 
effusion may take place into the corpus cavernosa from the irri- 
tation of the hand, and the irritation is transmitted to the spinal 
cord and brain, the reflex centre. 

Treatment. — If due to fracture of the spinal column at the point 
mentioned, or disease of the brain, all that can be done is to 
afford relief until the cause is removed, if it is possible ; when due 
to masturbation, if the practice can be discontinued, a cure is 
usually effected. Our chief dependence is to be placed upon 
large doses of tincture of the green root of gelsemium, with bro- 
mide of potass. The dose here must be large and carefully regu- 
lated. The gelsemium, in doses of from thirty to sixty drops 
every three hours in divided doses, so as to watch it. The 
bromide, in from thirty to sixty grains during the same period, 



y.Q DISEASE GERMS. 

with a few grains of bicarbonate ; it may be given at one dose. 
At the same time, suppositories of belladonna and camphor, this 
could be followed up by a long and persistent course of adminis- 
tration of the fl. ext. black willow. 

If due to effusion in the corpus cavernosa, arniqa lotions and 
iodoform suppositories are of utility. ^V 

Diet regulated. Cold is sometimes of utility to pehis, or ice 
to lumbar portion of spine. There is little good in camphor, 
coca, Indian hemp, lupulin, etc. A course of vegetable altera- 
tives and tonics should always be resorted to. 



is most pievalent, and may exist from a 

Neurosis slight irritation, to a grave interstitial in- 

of the flammation, with atrophy and impotency. 

Prostate Gland, a deficient prostatic secretion, as well as 

an absence of spermatozoa — a state insep- 
arable from sexual neurasthenia — one that requires (in addition 
to the genera' treatment) the long continued use of the saw pal- 
metto, a nutrient tonic, a promoter of glandular growth, rnost 
efficacious in wasting or atrophy of the testes and prostate. 
This remedy persevered with, in connection with general treat- 
ment, will restore those glands to their original integrity and 
size, even after they have shrunk into nothingness. The restora- 
tion of those important glands to their pristine condition rejuve- 
nates the whole man ; the pitch of the voice is strengthened, the 
masculine elements are built up ; vitality recuperates itself, and 
the man is as it w^ere born anew. Saw palmetto and kephaline 
are the necessities of our age and our clime, we must not forget 
it, nor permit our condition to ignore it. 



The object of medical science is to 

Neuroses ameliorate suffering, and prolong human 

of the life, as such it is necessary to examine the 

Sexual Appetite, causes at work that give rise to chronic 

inflammation, with enlargement of the 

prostate gland in 85 per cent, of all Americans over fifty years of 

age, and in numerous instances much earlier, even at thirty. 

The causes at work are bicycle riding, horse-back exercise, 
sedentary avocations, vicissitudes of temperature, cold, wet, gouty 
diathesis, gonorrhea, gleet, strictures, introduction of bougies, 
strong injections, masturbations ; unnatural methods of coition, 
as dalliance, withdrawal, use of condums, prolonged intercourse, 
falls, blows, running, jumping, prolonged retention of urine and 



BACTERICIDES. 



741 



excesses of all kinds, the tear and wear of life, the struggle, the 
tension due to a highly civilized state, worry, etc., damages the 
sympathetic, which is so freely distributed over the anterior sur- 
face of the genital organs, and in itself gives rise to aching at the 
neck of the bladder, and loss of the vital fluid at stool, and en- 
largement. 

Chronic inflammation of the prostate, enlargement, and other 
morbid states are inseparable from impotency. 

Impotency, partial or complete, resolves itself under the fol- 
lowing divisions : 

Failing power, with slight deficiency of desire and capacity. 

Deficiency of capacity, with increase of desire, blended with 
spinal anaemia, seminal emissions or oozings. 

Profound deficiency of both desire and capacity, power of 
erection weak or wanting, penis usually cold, benumbed, testicles 
shrunken or wasted, prostate hypertrophied. 

An abnormal increase of erectile power, with or without wast- 
ing of the enumerated tissues, and no discharge of seminal fluid. 

No two cases are alike, nor can they be treated in the same 
manner. Each individual case requires a special treatment of 
tonics and alteratives, and besides these a special course, involv- 
ing electricity, nux vomica, ergot, damiana, iron and kephaline 
or brain food. This latter is essential to brain life and activity. 
The majority of our people have thin brains, under-fed; as a re- 
sult, brain vitality is feeble, the organ suffers from impoverish- 
ment, hence impotency, national effeminacy. 

All cases of lost sexual power are benefited by coca, in some 
one of its varied forms ; coca strengthens, exhilarates, sustains, 
refreshes, aids digestion imparts new energy to the worn-out or 
exhausted genital organs, excites to healthy action ; besides it is 
a specific for all nervous complaint^, as headache, neuralgia, 
wakefulness, loss of memory, tremors, loss of appetite, depres- 
sion of spirits. To every impotent man there are elements of 
strength, of vitalization in coca, as it increases brain nutrition. 
No matter what the cause of impotency may be, kephaline and 
coca possess the necessary qualities for curative treatment, by 
causing a full and continuous supply of nervous or vital force. 
This brain essence increases the nutrition and growth of the 
marasmic, atrophied, or wasted genital organs, restores them to 
their pristine vigor, their full natural size. 

Saw palmetto is indicated whenever wasting of glands has 
taken place. 

Administered internally and applied locally either in the 
form of an ointment or suppository. Electricity, applied for 
half an hour each application ; thrice weekly. 



7^2 DISEASE GERMS. 

This is a condition characterized by ex- 
Neurosis of the aggerated sensibility, unattended with 
Skin. structural changes. It may be either 

idiopathic or symptomatic, general or par- 
tial, unilateral or bilateral, variable in degree or intensity. . 

In very mild cases, there is merely an unusual sensitiveness of 
the cutaneous surface to the contact of foreign bodies, a waft of 
wind, the passage of a feather, even some kinds of clothes may 
give rise to intolerable uneasiness, or be a' reflex manifestation or 
warning of some nervous disease or explosion of nerve force, as 
chorea, epilepsy, hysteria, tetanus, paralysis. Its chief manifes- 
tations are itching and pain. Active symptoms of cutaneous 
congestion give rise to heat, formication, tickling, dripping or 
pouring of liquids. 

Pruritus is essentially a neurosis, a functional disorder of the 
nerves of the skin ; a state in which the sensient nerves are 
teased, altered, irritated or otherwise damaged, characterized by 
itching. 

The causes which give rise to pruritus are disease germs in the 
blood, as the presence of the microbe of syphilis ; the bacilli of 
tubercle ; the germs of carcinoma, malaria, variola, etc., or the 
fungus of diabetes ; most common reflex causes are disturbance 
of the alimentary canal due to intestinal worms; hemorrhoids; 
genito-urinary disorders of both sexes ; dietitic and medicinal 
agents, depressing passions, mental distress, etc. 

All forms of neurosis of the skin should be treated by sooth- 
ing applications. 

A peculiar nervous disease that attacks 
Neurosis of the both sexes, but especially females between 
Spinal Cord. puberty and cessation of the menses. It 
{Hysteria.) consists in peculiar, nervous hyperaemia, 

which occurs in paroxysms, and simulates 
other diseases. 
Causes. — It is, or has been, caused by some irritation of the 
genito-urinary organs, as exciting the sexual organs to irritation 
by works of fiction, lascivious thoughts, luxurious living, seden- 
tary habits, causing congestion; heated rgoms, ti^jht lacing; 
undue excitement of sexual organs, masturbation. The sympa- 
thetic nerve covering the front of the uterus is often involved, so 
that depressing passions may be regarded a: a cause ; besides, it 
is a general symptom in all uterine diseases, and is thus caused. 
The patient commonly is of a nervo-sanguine temperament, with 
a weakened reflex centre, involving both cord and bulb; and 
there is, or has been, an irritation in or about the uterus, which 



BACTERICIDES. 



743 



is, or has been transmitted to the seat of reflex action. It is a 
genuine nervous malady, of grave importance. It is not neces- 
sary for a cause that there should exist present irritation ; it may 
have been twenty years ago, but it has left an indelible impres- 
sion on the centres that is easily roused into action by the 
slightest nervous ruffle, or tire. 

Symptoms. — The common characteristic symptoms are convul- 
sive movements of the trunk and limbs ; beating of the breasts with 
clenched hands ; or tearing the hair or clothes ; shrieks, screams,, 
violent agitation ; a feeUiig of suffocation, as if a ball was in the 
throat (globus hystericus); the attack probably ending in an out- 
burst of crying, sobbing, or laughter, or hiccough. The patient 
may fall to the ground insensible and exhausted ; soon recover- 
ing, tired and crying. The urine is of a low specific gravity,, 
loio, or even less, and may be passed involuntarily during the 
excitement. The portion of the cord down to where the sympa- 
thetic emanates is chiefly weakened, consequently we find organs 
supplied with spinal nerves from that part exhibiting or simulating 
disease, as loss of voice, cough, pleurisy, consumption, paralysis, 
suppression of urine and affection of the lower parts. Passive 
paralysis may take place ; even increased sensibility of the parts 
supplied with special spinal nerves, as tenderness of uterus, 
ovaries, and even loss of sensibility may take place. The appe- 
tite is generally diminished ; still it may be increased, or even 
depraved, the most extraordinary substances being craved and 
eaten. 

In some cases the expression of the countenance is peculiar : 
fulness of the upper lips ; drooping of the upper eyelids. Abrupt 
in manner. The menstrual flow usually irregular, and there is 
generally leucorrhoea, or some uterine trouble. Symptoms are 
not always feigned ; they may be exaggerated, but there is a real 
morbid condition at the base, and that may be a nerve prostra- 
tion, or nerve tire, from some old disease. A not uncommon 
form of hysteria is where they take to the bed. They are lan- 
guid, cheerful, have good digestion, hut lie in bed, and greatly 
appreciate the attention of kind, sympathizing friends. They are 
fully convinced that their disease is of the most serious charac- 
ter, and involves the spinal cord or womb. Menstruation may 
be normal, or there may be endometritis, with leucorrha^a, or 
some form of displacement, or perhaps coccygodynia. Any 
defect must be rectified, and the case managed on the general 
treatment. 

Many of the confirmed invalids scattered far and wide over the 
the country, who have been to one doctor and then another, and 
subjected to all kinds of uterine medication, mechanical and 



7'H 



DISEASE GERMS, 



Otherwise, with no lasting improvement, and have become chronic 
sufferers, a burden to themselves and families, have had originally- 
uterine mischief; for we cannot minimize the local irritation on 
the general health, but the cases have drifted from their original 
condition. The pain, the backache, the leucorrhoea, the uterine 
partial death, the difficulty in locomotion, the disordered men- 
struation, which are the usual attendants, have ended in a general 
disturbance of all the bodily functions. The nervous system is 
profoundly affected, the blood impoverished and the general nu- 
trition at the lowest ebb. 

After the disease has become confirmed, or chronic, there are 
a few prominent symptoms that are well marked. One of the 
most common is wasting of the fatty tissues of the bod}^, com- 
bined with anaemia, loss of appetite. Associated with this we 
often find chloral, morphia or stimulants resorted to; exercise is 
abandoned, and the patient becomes confined to the house or 
bed. Her vitality is at a low point ; her emotional or hysterical 
condition craves sympathy, and the whole household becomes 
victims of her morbid selfishness. 

Same treatment as for neurasthenia. 



An altered condition of the nerves that 

•Neurosis of the supply the mucous membrane and sphinc- 

Vagina. ter muscle of the vagina. An irritable, 

( Vaginismus.) spasmodic condition of the sphincter 

muscle of the vagina, with such excessive 

sensitiveness of the parts and of the surrounding tissues as to 

form a complete barrier to coition. 

It may exist in various forms or degrees. In some cases, it is 
a mere tenderness, or increased sensibility ; in other cases, the 
sensitiveness is great, amounting to a distress, or severe agony, 
the slightest touch giving intense pain. This super-sensitiveness 
is due to a pure neurosis from altered nutrition, and we can find 
nothing tangible to account for it ; or the cause may be clear, 
as some irritation, which causes inflammation of the mucous fol- 
licles above the vulva, and spasm of the muscular fibres ; a true 
closure, or tonic spasm of an involuntary muscle. What the 
irritation may be that gives rise to this is somewhat varied. 
There are various examples of spasm, or contraction, to be found 
in the uterine appendages ; for example, irritation of the clitoris 
causes contraction of the uterine horns; irritation of the urethral 
orifice causes contraction of the fundus of the bladdeh In the 
largest number of cases of painful or difficult connection, the 
trouble is not discovered until sexual intercourse is attempted, 



BACTERICIDES. ^ac 

and then the mere touching of the parts throws the woman into 
a paroxysm of intense agony. 

In the more simple forms, nothing cin be detected in the lady 
to lead us to suspect its existence. It may even come and go, 
• and its coming and going has nothing whatever to do with the 
sexual appetite, because it is not necessary for conception that a 
woman should have sexual desire. Women affected with pain- 
ful connection may conceive and have a child, and the birth of 
the infant may not cure the disease; but it generally happens 
that the great distension and laceration of the vagina causes it to 
become less. 

In a large proportion of cases the true condition is found, in 
newly married women, in a redness, or fissure, at the anterior 
margin of the perina^um, or in the fossa navicularis around the 
hym.en. In some cases a true ulcer or an imperfectly ruptured 
hymen with ulcer which may heal and break out again and 
again and form little hypertrophies at seat of hymen, which are 
intensely tender and irritable. These ulcers are of a lupoid or 
eczematous character generally. It is only when pain and sensi- 
tiveness exists, and are extreme without textural difference that • 
the condition may be said to exist 

In all cases the patient should be placed upon a general alter- 
ative and tonic course of remedies, as comp. saxifraga ; aleteris 
cordial ; glycerite of kephaline ; avena sativa. Vaginal injec- 
tions of either boroglyceride, creolin, resorcin, naphthaline,, are 
of great benefit, much superior to lime-water and tincture of 
iodine, or bicarbonate of soda and gelsemlum. 

Cones prepared from boroglyceride and cocaine, rarely fail to 
effect a radical cure. Pastiles of boric acid and cocaine are also 
excellent. 



There may be a neurosis of every or- 
Neuroses ot gan of the body. 
Various Organs. Neurosis of the bronchi, very common 
in our latitude, and the affected regard the 
weather as a natural foe, their bodies are a subtle meteorological 
machine, they keep in a warm room for long periods, become 
additionally enervated. No exercise, thus the liver is deprived 
of its proper stimulus. The bronchitis is a bronchorrhoea. 
There becomes engrafted in the brain a decided hypochondriasis. 
Neurosis of the stomach, manifests itself under a general condi- 
tion, technically termed dyspepsia, which arises from deficient 
brain elements, so that the microscopical cells or bladders which 
profusely cover the lining membrane of the stomach are scantily 



746 



DISEASE GERMS. 



or deficiently filled with gastric juice, and other acids essential; 
a brain failure reduces this active living principle so indispensable 
for chylification to a minimum. In such cases the avena sativa, 
from oats, and kephaline, with some bitter tonic, will supply the 
stimulus until the neurosis subside. 

Neuroses of the teeth, due to the want of phosphates in the 
food, which early give rise to tooth-starvation, caries of the 
teeth, overcrowding of the teeth ; abnormal state of the gums 
preventing their egress ; the presence of disease germs in the 
mouth. 



This is. a peculiar condition of the nerve 

Nightmare. centres, consisting in a true anaemia of the 
{Iiiaibj^s) brain and sympathetic system. It is impos- 
sible to locate it precisely, although the co- 
ordinating chemical centre at the base of the brain is chiefly 
affected. 

The exciting causes are indigestion, debility, late and heavy 
suppers, great fatigue, worry, over-study, breathing impure air, 
sewer gas, badly ventilated room, intoxication, sleeping on back, 
food indigestible, anything that would be likely to load the blood 
with any impurity. 

Syj}tptoins.—ThQ patient in sleep feels an oppression, a weight 
about the stomach and breast ; he groans, is in great distress, 
dreads suffocation ; he fancies himself in imminent danger, and 
tries to escape, but cannot move ; he imagines himself about to 
fall over a precipice, to be drawn into a river, or eaten by wild 
beasts, or consumed in a burning house, etc. 

Treatment. — The affected person should eat a very light sup- 
per or none at all ; keep the mind free from care and anxiety ; 
no study ; have a well-ventilated room to sleep in, free from 
gases, growing flowers ; must sleep on right side ; have a daily 
bath and massage; bowels to be well regulated and abundance 
of exercise in the open air. 

It is to be looked upon as a true condition of cerebral debility, 
so the diet is to be essentially of a brain-nourishing kind ; oat- 
meal porridge, boiled white-fish, animal food, steaks, chops, 
poultry, eggs, corn bread, fruit and vegetables. He must eat no 
pies, pastry, cabbage, nuts, salted meat or fish, nor any red fish, 
like salmon, for that abounds in oil, and, although very stimu- 
lating and nutritious, is heavy and does not agree well with a 
weak stomach. 

As remedies, glycerite of ozone, kephaline, aromatic sulphuric 
acid and quinine, and other tonics. 



BACTERICIDES. 747 

The accumulation of fat a non-vital element, 

Obesity, under the skin, around the viscera on the posterior 
abdominal walls, constitutes what is termed obesity. 
It must in no instance be confounded with what is termed fatty 
degeneration. There are certain conditions, aside from heredi- 
tary, which give rise to it, as indolence, prolonged sleep, over- 
eating ; the consumption of large quantities of fluid ; the exces- 
sive use of fatty, farinaceous, saccharine foods, malt liquors, an 
avoidance of care, worry, anxiety. 

Obesity is not by any means conducive to longevity, as the 
increase in weight and bulk impedes the working of vital organs 
Hke the heart and lungs, as the presence of fat diminishes both 
mental and physical activity, disturbs respiration, circulation and 
digestion ; greatly affects the elaboration of the blood, causing it 
to become deficient in vital elements. Usually the victims of 
obesity suffer from gout and neuralgia. 

Partial obesity, as fatty tumors, fat around the heart, fatty 
omentum, is common. 

In the removal of fat from the body, the first thing which 
should be attended to is the regulation of the diet, which should 
consist of meat, white-fish, green vegetables, biscuit, dry toast, 
tea without sugar, at the same time forbid as much as possible 
all articles which contain starch — potatoes, puddings, beets, beans, 
peas, bread, milk, butter, broths ; moderate exercise, and if patient 
can afford it, horseback exercise. Bathing should be resorted to 
daily, it should be alkaline and followed by the most thorough 
massage for over half an hour. Sleep must be restricted to six 
hours out of the twenty-four. Bowels stimulated by salines to 
two evacuations per day. 

The medical treatment to get rid of fat are few but reliable. 
The best is unquestionably the fluid extract of the fucus vesicu- 
losis, a bactericide of some power, from the fact that it is highly 
charged with dioxide of hydrogen, iodine and bromine. 

From one to two teaspoonfuls administered thrice daily in 
water, regulating the dose by the loss sustained by the patient, 
one pound per week being about the proper amount. 

Other remedies, as liquor potassa, iodide potass, are very apt 
to give rise to irritation of the stomach. 



Of 1000 cases, one-half men, the other 

Old Age. women, between seventy and ninety years of 

{Its Maladies) age, the immunities from disease and failure 

of particular organs are in favor of the women. 

Affections of the urinary organs preponderate in men, being 

more than twice as frequent as among women. Brain affections 

are more common in men. 



748 



DISEASE GERMS. 



Bronchitis is the dominating malady, and superadded to it, 
debility. It is the most frequent malady at all times of life. In 
the aged it is persistent, increases gradually with enfeebled circu- 
lation and general weakness. The demands on the activity of 
the respiratory functions are diminished in the aged in propor- 
tion to the diminished activity of the nutritive and other pro- 
cesses. 

Heart, some irregularity and intermission of pulse, attributable 
to atheroma and calcareous degeneration. 

Brain affections are the most remarkable, passing attacks of 
unconsciousness, a suspension of cerebral activity, with no per- 
manent diminution of mental power. Motor power impaired. 

We are often astonished to find grave attacks in the aged, not 
infrequently recovered from. 

While considering this point we do not forget that in the aged 
person the brain is gradually and progressively shrinking, and 
the interspace between it and the skull caused by this shrinkage 
is being filled by fluid effusion in the sub-arachnoid or pia mater 
tissue ; and there may be temporary irregularities and imperfec- 
tions in this compensating adjustment of pressure of fluid on the 
surface and of the blood circulating in the interior, which would 
to some extent account for these cerebral attacks, and also for 
the recoveries from them. The senile alterations in the arterial 
coats must also be an important item ; but our knowledge of the 
physiology of the cerebral circulation is at present scarcely suffi- 
cient to enable us to make clear deductions respecting its path- 
ology. 

In only 1 1 out of the 340 returns of men between 80 and 90, 
and in only i of the 92 returns between 90 and 100, is prostatic 
disease said to have existed \ in one of these it had existed sev- 
eral years, and in others two, three, and four years respectively. 
In one the affection is said to have given less trouble than for- 
merly. The condition of retention relieved by frequent use of 
the catheter may be extended with care over many years ; but the 
enlargement of the prostate, with its associated bladder-symp- 
toms, is, I fear, a malady from which recovery; even in old age, 
is scarcely to be expected. It is something to find that our re- 
ports confirm the view that it is a malady from which age gives, 
after 70, a gradually-increasing exemption. 

Fifty-two were troubled with rheitmatism in some of its many 
forms, which include pains in the limbs, aching in the bones, etc., 
for which, I suppose, a remedy is not very easily to b: found. 
Indeed, it is difficult to define precisely, or clearly account for, 
the various pains, rheumatic and other, which old people often 
complain of, and which disturb their comfort without materially 



BACTERICIDES. y^g 

affecting their health. The women suffer from these even more 
than the men, probably in consequence of the nervous system in 
them being more on the alert; 5 of the men and 6 of the women 
had gout, all these being between 80 and 90. 

Two cases of se?ii/e gangrene were noted. They were in men 
above 90. 

The severe forms of malignant disease are rare. One man, 
above 80, had rapidly advancing sarcoma of the shoulder ; 5 
women, between 80 and 90, had cancer of the breast ; 5 men and 
I woman had epithelioma ; and i man and i woman had rodent 
ulcer. None of these maladies are mentioned in the men or 
w^omen above 90. Still, although the very aged appear to be 
less liable to some of the more severe diseases, such as cancers 
and diseases of the urinary organs, they are, on the whole, rather 
more liable to the ordinary maladies, the proportion of those 
above 90 who were altogether exempt from malady being 34 per 
cent., while the proportion oi those between 80 and 90 was 43 
per cent. 

With regard to the eyes, 8 per cent, are stated to suffer from 
cataract, 80 per cent, are said to have good sight, although 83 
per cent, use glasses. Some have used glasses for many years, 
which is confirmatory of what has been stated regarding cen- 
tenarians, that "the occurrence of presbyopia does not seem to 
be associated with, or to be a prelude to, inconvenience or im- 
pairment of sight beyond that which may be corrected by 
glasses."- 

The more frequent failure of the organ of hearings which is 
noted in more than one-half (56 per cent.) of the returns, is 
probably due in great measure to the liability to impairment of 
the delicate mechanism of the middle ear — the tympanum with 
its membrana tympani, its ossicles with their joints, its muscles, 
its eustachian tube, and its lining membrane — in consequence of 
colds, shocks, and a variety of causes. But in comparing the 
organ of hearing with that of sight, in this respect, we must not 
forget that the lessening of elasticity and muscular activity — 
which we must assume to induce defects in hearing in old persons 
corresponding with the visual defects classed under the term 
presbyopia — does not, like the latter, admit of alleviation by an 
early applied physical apparatus. At least, nothing correspond- 
ing to the portable and convenient lenses for presbyopia has yet 
been adapted to meet the auditory defects which may be attrib 
uted to a presbyotic condition. 

In 4 per cent, only is the digestion said to have been bad. In 
71 per cent, it is reported as good, and in the remainder moderate. 
Very few were troubled with constipation. In 62 per cent, the 



j^O DISEASE GERMS. 

appetite is reported to be good ; and by far the greater number 
are stated to be good sleepers. 

I am continually seeing and hearing of instances confirmatory 
of the inference as to the reparative powers of the aged after 
fractures, wounds, and ulcers, which were based upon the returns 
furnished in reply to collective investigation inquiries. These 
inferences are so contrary to preconceived notions, indeed, to 
probabilities, that it takes some time and effort and frequent 
repetition to obtain for them a fair measure of acceptance ; but I 
think the reparative powers of age are becoming more accredited, 
and that we shall ere long cease to have age adduced as a reason 
against the hopeful, and therefore careful treatment of fractures, 
wounds, and sores in the. octogenarian, the nonagenarian, and 
even in the centenarian. 

What is even more remarkable than the healing powers of the 
aged after local lesions are the reparative powers evinced by 
them after illnesses, as shown by numerous examples of those 
between 80 and 100, and also by some of the centenarians. 
Indeed, the recoveries from severe attacks of bronchitis, pneu- 
monia, apoplexy, and paralysis indicate the reparative powers 
after illness as well as after accident to be among the most inter- 
esting of the senile features. It is certainly strange that, when 
the other nutritive forces are failing — wearing out, as it were — 
those which are concerned in the work of repair, which m.ay be 
regarded as, next to development, the highest effort of nutrition, 
should hold their ground so well. Instanced some other condi- 
tions in which the same contrast is observed, notably that of the 
healing of the stump after separation of a part following gangrene 
senilis, where the structures next to those which .were unable to 
maintain their vitality at all often evince so much granulating 
and cicatrizing energy. 

High breeding in most animals conduces to a marked diminu- 
tion in the bodily recuperative capacity ; also that the higher 
bodily recuperative capacity shown to be possessed by all men 
living in a rude state, whether in the form of savages or in the 
gypsy or tramp wanderer among ourselves, arises from the fact 
that the refining influences of civilization materially diminish the 
animal recuperative capacity. We are familiar also with the 
great reparative powers exhibited in some of the lower animal 
forms as compared with those in the higher animals. It would 
seem that the greater sensitiveness — that is, irritability or suscep- 
tibility of the nervous system and of the tissues generally — 
which is associated with higher organization, where we may 
suppose the balances of nutrition to be most delicately swung, 
are, in a measure, unfavorable to reparative work. We can quite 



BACTERICIDES. 



751 



conceive that the calm, quiet processes upon which it depends 
are less likely to proceed in an orderly and uninterrupted manner 
under conditions of high excitability, where stimulus easily 
engenders disorder, than under lower vitality and less suscep- 
tible circumstances. Herein, possibly — namely, in the lower 
and slower excitability of their tissues — may be found an expla- 
nation of those recuperative powers of the aged to which I have 
referred, and of which it is practically important that we should 
take due account. 



The first cranial nerve is not of such vital im- 
Olfaction. portance as the auditory, or optic. In the Cau- 
casian, it may be said, to exist in a refined but 
very rudimentary condition ; whereas in the colored races it is 
peculiarly large and well developed, probably two-thirds greater 
than in the white. In animals, and some fishes, as the shark ; it 
is immense in the latter, being reflected over twelve square feet of 
mucous membrane. The peculiar structure of the cavity of the 
nose shows that there is one nerve for sensation and another for 
olfaction — that the lower portion of the nose possesses epithelial 
cells ; the upper portion pigmentation, the latter lying in grooves. 
In ordinary quick breathing little air enters these olfactory chan- 
nels, for most of it passes through the posterior nares into the 
pharynx. If we desire to smell keenly, we instinctively resort to 
the use of the dilator muscles of the nose, whereby the olfactory 
channels or grooves are opened or enlarged. This nerve gives 
us protection against poisonous gases, but does not in all cases 
prevent their absorption, although not near so active as the 
salivary glands of the mouth. 

The specific stimulation of the olfactory nerves are, odorous 
gases, scents and odors of flowers, which come in contact with 
the flattened-out ends of the olfactory, causing a peculiar vibra- 
tion in the molecules of the nerve, which is transmitted to the 
brain, where it is appreciated. The sense of smell is often lost 
in catarrh, polypus in the olfactory channel, also, in injury to the 
head or nose ; disease of brain may exalt or destroy smell. In- 
flammation of nerve is rare. The nerve may be absent or but 
very rudimentary, or it may be covered over with lymph, or de- 
stroyed with ulceration ; and owing to these states, there may be 
an entire absence of smell, anosmia; or from a high state of 
nervous development the sense may be very keen, excessively 
sensitive hyperosmia. 

Functional disturbance of the fifth nerve is very rare, but when 
it occurs, it gives rise to anaesthesia of the mucous membrane. 



y^2 DISEASE GERMS. 

The most pungent odors are not perceived, nor do they give rise 
to sneezing. 

The treatment of most use are alteratives and tonics, with 
mild electrical currents. 

Hypersesthesia is more common, chiefly due to reflex irrita- 
tion, nasal irritation, itchiness, caused by tape-worms, ascarides. 

Anosmia, or loss of smell, may be complete or only partial ; in 
one nostril or in both ; and congenital or acquired. A variety of 
causes may produce either total or partial anosmia, such as ab- 
sence of the olfactory bulbs, injuries from blows, or compression 
or concussion of the brain, cerebral tumors, and insufficient nu- 
trition of the mucous membrane, or excessive dryness of the 
same from paralysis of the fifth nerve. P'.ralysis of the seventh 
may also affect smell by paralyzing the dilator and contractor 
muscles of the nose and the orbicularis of the eye. Any cause 
which prevents ocjors entering the olfactory portion of the nose 
will also have the same effect, e. g., polypoid tumors, hypertrophy 
of the mucous membrane, perforation of the septum, or presence 
of foreign bodies. To these may be added dryness of the 
Schneiderian membrane, careless or excessive use of the nasal 
douche, inhalation of excessively strong vapors, snuft^-taking in 
excess, over stimulation of the olfactory nerves, and some authors 
add, absence of pigment. 

The prognosis is not very favorable unless the cause, such as 
polypi, foreign bodies, or unhealthy mucous membrane can be 
removed. The treatment should be alterative and tonic, chiefly 
cerebral and spinal tonics. 

As far as our present knowledge goes, there are only two reme- 
dies which have a decided and antagonistic influence on olfac- 
tion. Strychnine will exalt, while morphia will impair and deaden 
it. Strychnine rubbed up in some inert body and used as a snuff, 
or taken internally in suitable doses, wonderfully increases the 
keenness of the sense; the snuff is the most effective. It acts so 
well that it causes a sensitiveness to pungent odors, almost 
amounting to pain ; whereas, morphia confuses the appreciation 
of odors to such an extent as to produce a kind of chaos. The 
olfactory nerve is narcotized, and odors appear at an enormous 
distance. Other remedies possessing analogous properties have 
a lesser influence; belladonna causes dryness, and pilocarpin the 
opposite state; both conditions unfavorable for good smell. 

The prolonged use of the* ozonized wine of erythroxylon 
coca leaves exercises the same salutary action on the olfactory 
nerve as it does upon the nerve of taste and vocal chords, 
being a true vitalizer of all the senses. 



BACTERICIDES. 



753 



Othsematoma, 

{Sanguineous Tumor 
of the Auricle}) 



Othaematoma, or sanguineous tumor 
of the external ear, is, with very rare- 
exceptions, solely met with amongst 
those affected with cerebro-mental dis^ 
and has hence been termed "the 



ease^ 

insane ear. 

Nature and Appearajice. — Othaematoma consists of an effusion 
of blood from the perichondrium investing the cartilage of the 
auricle, appearing as a tense and shining tumor of a reddish-blue 
or livid color, varying in size, and occupying some portion of the 
concavity of the organ, rarely forming on the posterior convex 
surface. One such case has, however, come under my observation ; 
here, however, the tumor was not confined to this region. When 




Othaematoma in the acute 
or primary stage. Tu- 
mor of moderate size 
filling up the cavity of 
the concha ; full and 
rounded above where it 
is bounded by the ridge 
of the antihelix, being 
lost below iu the lobule. 
Result: Disappearance 
with but little subse- 
quent deformity. 




Othsematoma in the acute or pri- 
viary stage. Tumor of moder- 
ate size occupying the entire 
cavity of the auricle, and oblit- 
erating its ridges and hollows. 
Surface uneven, and in parts of 
a plum color. Result : Slow 
absorption, with extreme con- 
traction, and finally the almost 
complete distortion of the au- 
ricle, and obliteration of its 
several component parts. 



it commences in the concha, the tumor is generally localized 
above, and externally by the ridge of the antihelix, and extends 
inward toward the meatus externus, which it may occlude, causing 
deafness according to the degree of occlusion. In this situation 
the tumor presents itself as a smooth, and usually even swelling, 
about as large as a pigeon's egg ; when the fossa of the helix is 
the site of the effusion, it is confined below by the ridge of the 
antihelix, and the sweUing then assumes a somewhat kidney- 
shaped outline. 

In exceptional cases the tumor becomes extended over the en- 

48 



yq4 DISEASE GERMS. 

tire surface of the auricle, and when this is the case, the various 
iridges and cavities become wholly obliterated, the hollow of the 
^ar being filled by an egg-shaped swelling, fuller above, and 
losing itself inferiorly in the lobule, which is never implicated. 

As to the etiology of the affection various theories have been 
advanced. One of the best : 

" Under the influence of this profound disturbance of the 
•economy, there occurs a ramollissemeJit which plays a considera- 
ble part as a predisposing cause in the production of sanguineous 
tumors." 

M. Bonnet is of opinion that the sanguineous .tumors of 
the ears are veritable congestive apoplexies due to degenera- 
■ tion of the sympathetic, which results in turgescence of the ves- 
sels of the ear, and, as a result, the apoplexy is produced. 

" The formation of sanguineous tumors of the auricle is most 
often preceded and accompanied by a general disturbance of the 
cephalic circulation." 

Pathological Appearances. — The morbid appearances presented 
by the shrivelled ear differ according to the age of the formation. 
When a few months old a fine section under the microscope 
showed it to consist of somewhat loose fibrous tissue with de- 
posits of fine hyalin cartilage, and a little within a centre a trian- 
gular-shaped mass of bone containing wide channels with lacunae 
and canaliculi. The condition of the ears here, as I have men- 
tioned, was of very long standing, and between this and the or- 
ganized clot of the earlier stages I noticed fibrous tissue and 
V cartilage in varying degrees of development. 

Forms of Mental Disorder in which Othcematorna Occurs. — 

^IDthaematoma is not confined to any one form of insanity ; it has 

feeen found in mania, melan^cholia and dementia, but it occurs 

most frequently in general paresis, and insanity associated with 

.epilepsy. 

In the treatment of such cases, there is considerable difficulty. 

In some few cases indeed, where, on other grounds, a hope of 

final recovery from the mental disorder exists, and when it may 

be important to prevent the possibility of the after deformity 

which will in all probability result if the swelling be allowed to 

run its course undisturbed, the aspiration of the sanguineous 

effusion may perhaps be attempted, and an endeavor be then 

made to induce rapid and equal adhesion between the cyst walls. 

\ Painting the surface of the tumor with vesicating fluid has been also 

s suggested, and I believe tried successfully in several cases, though 

as far as I am aware it has not come into extended use. 



BACTERICIDES. 



755 



Otomycosis. 

{Aural Fungus, 
Aspergillus Nigrans.) 



Vegetable microscopic organisms 
are found in the outer ear. 

In the etiology of otomycosis the 
favorable character of the external 
meatus for the growth of fungi and 
schizomycetes has to be remembered. The partial occlusion of 
the canal in ordinary healthful states of it by hairs and cerumen, 
its shape, the temperature of its walls, the presence of moisture, 
at once strike us as affording in it a favorable situation for the 
generation and development of micro-organisms and the occur- 
rence of fermentative changes. In the limited supply of air, in 
the heat and moisture, we have the most important elements of 
fermentation. The further tendency to otomycosis and the de- 
velopment of parasitical fungi is increased by the nature of the 
substances introduced into the meatus. It is chiefly with the object 



C^ 





Aspergillus nigrum ; mag- 
nified 400 ; the first ap- 
pearance of the fungi in 
the ear. 



Aspergillus nigrum ; magnified 
400 ; second staee ; fruit stalks 
or frurtifer: us hyphens; the 
mycelial filaments ; the sten- 
igmata on the free ends are 
the spores. 




Aspergillus nigrum ; full-grown 
spores; unripe fruit stalks: 
the ripe aerial fruit; fully- 
grown spores literally drop oflF 
in myriads. 



of preventing the possibility of the dissemination and engrafting 
this very painful and obstinate cjisease upon the community at 
large, that we call attention to it. In a great number of cases 
the affection is provoked by the introduction of an oily substance 
into the external ear, such as olive oil, oil of almonds, etc., at 
times lard, balsam, or pomade. In employing these oily sub- 
stances, it is not sufficiently remembered that they all undergo 
rapid decomposition once they remain exposed to the atmo- 
sphere, even at an ordinary temperature; how much more so at 
the more elevated one of the auditory meatus. Oils contain in 
solution azotic substances which, under the influence of the 
oxygen of the air, provoke special fermentation, becoming ran- 
cid. This raises the temperature rapidly ; the neutral fatty mat- 
ters contained in the oil are changed into glycerine and fatty 
acids. Thus the spores of the musty fungi, which are abundant, 
are provided with all that is necessary for their germination', 



756 



DISEASE GERMS. 



viz., oxygen, watery vapor (in the air), sufficient heat, organic 
decomposition, and the acidity which favors their development. 
The filaments of the mycelium grow rapidly. The acid pro- 
ducts of the decomposition on the one hand, and the vegetable 
foreign body on the other, irritate the ear and set up this inflam- 
matory process, causing the watery secretion, and exciting the 
formation of the organic azotic substances that are so easily as- 
similated by these cryptogames. 

Various astringent lotions in common use induce this fungus. 
The presence of cloudy collections of mycelia and spores, which 
form in those solutions after being kept a few days ; bottles not 
carefully corked are often teeming with these fungus spores. 

The fungus when once generated in the ear, encysts itself in a 
flat oblong bag, completely closed on all sides. 

When the fungus has reached its maturity, completed its 
growth, it becomes encased in an oblong flat bag, closed 
on all sides ; it measured from 1 1/3 to i ;^ centimetres in 
its longest diameter (corresponding to the long axis of the 
meatus), and about one centimetre in one of the transverse diam- 
eters, and half a centimetre in the other. These measurements 
varied slightly in different cases. One of the flat faces was 
obliquely truncated at the end, and showed an exact cast of the 
membrana tympani. The color was yellowish-white in one 
case, light brown in the second, and whitish-gray, turning to a 
dirty brown, in the third. These bags were composed of 
mycelium, sporangia, free spores, and epidermic cellules. On 
examining such cases the otoscopic aspect is very puzzling, the 
growth entirely filling the fundus of the meatus, and hiding the 
membrana tympani. After removal of the bag, which is followed 
by great relief, the drumhead is found injected, and marked with 
white specks on a red ground. 



In nearly all cases we have small boils or fur- 

Otdrrhea. unculi in the ear. These are the result of a mi- 
crobe affliction, proceeding from the internal 
media, the invasion taking place by the cutaneous follicles. The 
successive appearance of furunculi is due to the migration of cocci. 

The micro-organisms most frequently is the staphylococcus, 
albus, aureus or citreus, all generally found in the boils. 

The correct treatment in all cases is anti-bacteric, which may 
abort the affection and prevent its occurrence. 

This is best effected by the ozonized oil of mullein dropped 
into the ear thrice daily. 

Before this is done the ear should be carefully syringed out 



BACTERICIDES. 



757 



with tepid one-per-cent. solution of the dioxide of hydrogen 
and subsequently the mullein oil dropped in ; by this plan of 
treatment the micro-organisms are destroyed. 



A chronic inflammation of the mucous 
Ozaena. membrane of the nose, characterized by 

(^Atrophic RJdnitis.) enlargement of the nasal fossae, and ac- 
cumulation in the enlarged cavities of 
crusts, having a peculiarly repulsive odor. 

The affection is so common and so serious that clear notions 
of its etiology, diagnosis and treatment are absolutely indispens- 
able. Not essentially dangerous to life, its existence is most dis- 
tressing, as the overpowering foetor of the breath renders their 
society a burden to friends and strangers, who both alike turn 
away from them. Such persons gradually become isolated. 
They dread meeting others, and often lead aimless and disap- 
pointed lives. Until a comparatively recent date all affections of 
the nasal fossae characterized by foetor were grouped under the 
generic term " ozaena." Improved methods of examination of 
the nasal fossae and diagnosis have, however, eliminated these 
errors, and have placed ozaena as a distinct symptom due to or 
associated with atrophic rhinitis. There need, therefore, be no 
difficulty in separating it from syphilitic, tubercular or trau- 
matic ulcerations of the nasal bones, which' are also attended 
with foetor. 

Etiology. — Among the causes which conduce to ozaena, con- 
stitutional dyscrasi^, such as tubercular or syphilis, undoubtedly 
hold a chief place. Most authors mention the influence of here- 
ditary syphilis, but this, though probable, cannot be considered 
as absolutely demonstrated. A debilitated or broken down state 
of the general health is also an important factor in the causation 
of ozsena. Among the large number of cases which I have seen 
in hospital and private practice, I cannot recall one in which 
there were not some traces of either anaemJa, chlorosis, scrofula, 
or inherited specific disease. According to some authors ozaena, 
and, therefore, atrophic catarrh, is a direct sequence, a more ad- 
vanced stage of hypertrophic rhinitis, or of ordinary chronic 
catarrh. This view is undoubtedly correct, as there is an evolu- 
tionary link between all three states. As regards the age of pa- 
tients, adolescence is the period when the disease is most com- 
mon. It is seldom seen in elderly persons, though I have known 
cases as late as forty-five years of age. The female sex is more 
liable to it than the male, in the proportion of nearly two to one. 

Amongst imrtiediately exciting causes of ozaena is the entrance 



758 



DISEASE GERMS. 



of irritating vapors or dust, especially if from any cause such as 
undue patency of the nostrils, absence of vibrissae, or a faulty 
direction of the nostrils, this entrance should be facilitated. Mal- 
formations of the bony framework of the nose, deviations of the 
septum, narrowing of the nasal passages, with obstruction to the 
removal of secretion, the relative smallness of the turbinated 
bones, or the disproportionate size of the nasal fossae, are all 
factors in the development oi ozaena. 

The symptoms are both subjective and local. Among the 
former, patients frequently complain of headache, pressure over 
the brows, impaired power of hearing, with noises in the head. 
Along with these there is often associated naso-pharyngeal catarrh, 
characterized by difficulty in swallowing, dryness of the throat, 
with a constant desire to clear it. There is, moreover, especially 
in children, a very characteristic type of countenance, exhibiting 
many of the signs of scrofula. The normal bones of the nose, 
instead of forming the bridge, are sunk below the level of the 
frontal bone, so that the nostrils are directed forwards instead of 
downwards. 

The general appearance is that of being intensely tubercular. 
Smell is either generally diminished or destroyed, so that pa- 
tients are not aware of their unpleasant odor. The secretion of 
the nasal mucous membrane is scanty, dries in the form of crusts 
or concretions in the nose, and are expelled by violent efforts. 
They are all colors, owing to the germ present, and aerial germs 
present. The crusts emit a pungent, nauseating odor of putre- 
faction, bacilliLS saprogcmis, pathogenic of the same odor which 
patients diffuse around them. 

The cause of this foetor has been by no means satisfactorily 
explained. According to some authorities it is due to the 
abnormally large size of the nasal fossae, whereby the force of 
the current of expired air — the air draught — is notably diminished. 
Another author, while partially adopting this explanation, con- 
siders that the secretions from the sphenoid and ethmoid sinuses 
are also at fault. In individuals with rudimentary inferior tur- 
binated bones the ethmoid is imperfectly developed, a fact which 
is in favor of this theory. Others consider atrophy of the mucous 
membrane and degeneration of the mucous corpuscles with pro- 
duction of fatty acids, as the cause of the fcetor. Other authors, 
on the other hand, believe it to be due to the presence of a 
specific coccus, formed by the union of the amoeba, bacillus sapro- 
genus pyogenes, tubercular and syphilitica, and others to a special 
ferment; while all see "in the physical and chemical changes 
of the secretion the condition necessary for the occurrence of 
foetor." 



BACTERICIDES. 



759' 



The diagnosis is at once established by the pecuHar and charac- 
teristic odor which will be readily recognized, and cannot be mis- 
taken for the stench arising from a foreign body, diseased bone^ 
or syphilitic ulceration. Any strong disinfecting lotion will 
remove the odor of the ozaena, but not of caries or ulceration. 
Moreover, the atrophy of the tissues, coupled with the absence 
of ulceration of the mucous membrane, cartilage or bones, becomes 
distinctive and characteristic features. 

The prognosis is not hopeless, neither is it difficult to effect^ 
under bactericides and the cavities of the nose, to become normal 
once more. As far as the characteristic odor is concerned, it can 
be kept completely in check by suitable treatment, and using 
daily a douche of boroglyceride, resorcin or creolin. 

In the treatment of ozaena two distinct objects must be kept 
in view : destroy the various microbes and build up the general 
health of the patient. 

The former is best effected by the occasional use of the ozone 
et chlorine wash or douche, which will dislodge the crusts; as 
this is severe once a month will be sufficient for its use. Excel- 
lent bactericide lotions are made of boroglyceride, resorcin, 
creolin, thymol, benzoate of soda, distillation of jequirity, morn- 
ing and night. Sprays are very useful of glucozone, sulphur 
water, iodide of ethyl, oil peppermint. 

The improvement of the general health must be carried out 
on general principles, and such remedies as glycerite of kephaline, 
avena satina, matricaria, chloride of gold and hydrastis cana- 
densis. Kephaline combined with iron and strychnine most effec- 
tive. Change of air, seaside. 

Moreover the above treatment, as a whole, must be scrupulously 
carried out night and morning by the patient, for months, perhaps, 
in succession. With young girls the appearance of the catamenia 
often exercises an unfavorable influence on ozaena, aggravating 
both the discharge and the foetor. It is also a matter of observa- 
tion that in adult females, the odor is always most intense and 
obstinate just before or after the menstrual period. 



In all cutaneous diseases there is either a mi- 

Papulse. crobe, fungus vegetable growth, or parasite pres- 

(Lichcn}) ent ; with our limited knowledge of the habits of 

disease germs, we are unable to say why some 

micrococci cause a general erythema, why they swarm in 

patches, or seek the follicles, and form a papula. 

Lichen is a papular affection of the skin, with minute hard, 
red elevations, either distinct or scattered in clusters, with a 



760 



DISEASE GERMS. 



tingling irritation and slight desquamation. The contents of the 
follicle are usually microbes, either of mal-nutrition, or syphilis, 
or tubercular, etc. 

The following embraces the principal forms : 

1. Lichen Scrofulous, or tooth rash, or red gum rash; pecu- 
liar to infants and young children, may appear on any part of 
the body. It is caused by derangement of stomach and bowels, 
and is characterized by an eruption of minute, hard, red, clus- 
tered or scattered pimples. 

2. Lichen Simple. — Cause, mal-assimilation and bacteria; 
eruption red, inflamed papulae on face, arms, legs and body. 
There is itching, tingUng and fever ; in spring and fall will 
probably return. 

3. Lichen Pilaris, or hair lichen, appears at the roots of the 
Siair in young persons, about puberty ; involves the hair sac 
■and root sheath. The general cause is want of cleanliness, mal- 
nutrition, use of alcoholic drinks. 

4. Lichen Circumscriptus , or clustered lichen ; patches ot 
papulae with well-defined margins, and irregular circular form. 
The eruption consists of rings and small groups of papulae, 
which tend to spread at their circumference into rings, the pap- 
ules forming a bright, well-defined margin, while the skin in 
-centre is yellow, owing to spores of a fungus. 

5. Lichen Agrius, or wild lichen. Usually a severe form; 
rigors, nausea, fever, slight erythema, with the papulae upon the 
inflamed base. In a short time inflammation subsides ; skin 
peels off; papulae exhibit intense itching, tinghng ; their points 
become scratched or rubbed off, and cracks or fissures form, 
which are painful, and discharge a sero-purulent fluid. 

6. Lichen Lividus. — When the eruption has a purple, or livid 
iiue, and is not accompanied with fever. 

7. LicJien Solaris, or prickly heat ; due to exposure to heat, 
'l)efore system has become acclimatized. 

8. Lichen Urticatus, or nettle lichen. Skin presents the ap- 
pearance of wheals, like those produced by bugs, gnats, mos- 
•quitoes, etc. The wheals subside, and leave papulae, with itch- 
ing, pricking, tingling. 

In the treatment of all papular eruptions of whatever form, the 
condition of the stomach, bowels, diet, bathing, merit close at- 
tention. 

Comp. tincture cinchona and matricaria for the stomach ; 
bowels opened with the cascara sagrada lozenge ; alcoholic 
vapor bath twice a week, otherwise alkaline baths. If there be 
fever, aconite and serpentaria. Plain nourishing food, forbidding 
shell- fish and drinkingr water from a calcareous base. One of 



BACTERICIDES. 76 1 

our best remedies here is the lycopodium tincture ozonized, in 
ten to twenty-drop doses every four hours, keeping the bowels 
well regulated. 

A partial or complete loss of sensibility, or of 

Paralysis, motion, or of both, in any part of the body. It 
is said to be perfect or complete when both sen- 
sibility and motion are lost ; imperfect when one or other is 
either lost or diminished. The term local is used when a small 
part of the body is affected, as a limb or hand. It is termed re- 
flex, when it commences in the periphery of a nerve, and is re- 
flected to its origin in the spinal cord, and from thence reflected 
back to the muscles. There are, in addition, some peculiar 
forms, due to the presence of special poisons, disease-germs, in 
which special symptoms predominate, as wasting, tremor, etc. 

There are certain general features, which prevail and predis- 
pose in all cases of paralysis, either a condition of hypercemia, or 
congestion, or one of ancemia of either the brain, spinal cord, or 
some nerve ; both being essentially devitalized conditions, and 
either of these two states are usually associated with an exciting 
cause, as apoplexy, embolism, or thrombosis ; abscess, softening, 
induration, the microbe of tubercle, syphilis, cancer, poisons of 
mercury, lead, diseases of the urinary organs, intestines, uterus, 
prostate, masturbation, epilepsy, chorea, disease of the spinal 
cord, as inflammation and its results ; lesions or compressions 
by which its working power or conducting medium is impaired. 
A very large percentage of all cases of paralysis is due to disease 
germs localizing on weakened nerve tissue, and to the direct 
action of such poisons as lead, mercury, nitrate of silver, bis- 
muth. 

The condition of general paralysis cannot exist without death, 
although occasionally cases do occur in which general loss of 
sensibility and motion are much impaired, not wholly destroyed, 
but nearly so. 

The general division of all cases into one of congestion or 
anaemia is a good one, on which to base a scientific treatment. 



Paralysis of one-half of the body, extending 
Hemiplegia, from the crown of the head, clean down through 
the median line, involving one side, arm and 
leg, half of the face, tongue. It is* the most common form, and 
usually spoken of as a paralytic stroke or attack. The left side 
is more frequently affected than the right side, and the arm 
somewhat more than the leg. Occasionally we meet with cases 



762 



DISEASE GERMS. 



of transverse or crossed paralysis, due to accidental conditions — 
the causes either due to congestion or anaemia. Under the 
former, we must look carefully for apoplexy, clot, tumor, nodule 
of tubercle, cancer, etc. ; under the latter for chronic inflamma- 
tion, white softening, epilepsy, chorea, blood poisons, etc. A dis- 
tinction or true line of demarcation is important as leading to 
correct treatment. Cases due to congestion are accompanied 
with headache and other symptoms of plethora, and are sudden 
in their seizure, whereas those due to anaemia exhibit such 
symptoms in the white face, nervous temperament, etc., and 
come on slowly and insidiously. 

Symptoms. ^\xi both are the same ; muscles of the side of the 
face and brow affected ; paralyzed cheek drops loosely ; mouth 
is drawn to one side by non-contraction of paralyzed muscles ; 
tongue usually implicated ; when protruded, point turned to the 
paralyzed side, owing to the vigorous action of the healthy mus- 
cles ; articulation is imperfect. Third nerve not involved in the 
common form of hemiplegia, but temporary lateral deviation of 
both eyes, and persistent turning of the head to the sound side 
in severe cases. As the hemiplegia is either due to the effects of 
congestion or anaemia, the pathological result usually takes 
place at the base of the brain of the right side, or on the side 
opposite from the one paralyzed, so the condition of the eye, as 
to contraction or dilatation of pupil, closed or staring open, will 
depend on the location of the difficulty. The arm is always 
more paralyzed than the leg, and recovers more slowly. Para- 
lyzed limbs are soft, flabby ; in rare cases, rigid. The muscles 
of the chest and abdomen may not be affected chiefly in sensa- 
tion, if at all. The mental faculties afe less or more damaged — 
reason, judgment, memory, a tendency to shed tears. In effusion 
of blood from congestion, muscles often rigid or contracted; in 
anaemia, with white softening, the softening or degeneration de- 
scends the cord from want of nutrition, and the muscles waste or 
shrink away. Where muscles waste, case is hopeless. When 
the leg regains power first, the case is very hopeful ; whereas, if 
the arm before the leg, always unfavorable. 

Some cases of hemiplegia occurring in persons advanced in 
life occur without cerebral lesion in individual suffering from 
subacute and chronic nephritis. 

Treatment. — In all cases, whether due to congestion or anaemia, 
the following is to be recommended : Secretions from liver, kid- 
neys, bowels to be promoted ; skin to be daily bathed with alka- 
line washes ; feet to be kept warm by capsicum ; head cool ; sleep 
to be prolonged to nine or ten hou*-s by extract of hyoscyamus ; 
the efficacy of repeated blisters, say for six hours at a time, three 



BACTERICIDES. 



763 



times per week, or the irritating plaster constantly exciting free 
suppuration of both sides of the spine below nape of neck can 
never be doubted. The most satisfactory results are to be obtained 
from this proceeding. We need not ignore the fact that at least 
two-thirds of all cases are due either directly or indirectly to the 
syphilitic germ in the blood irritating a weakened patch of brain, 
and thus causing the paralysis. If satisfied that it is due to con- 
gestion, cerebral hemorrhage, effusion, active cupping to neck 
and shoulders, free action of bowels, and a persistent persever- 
ance in alteratives and tonics, with iodide of potassa ; the idea 
being, if possible, to procure absorption. If due to ansemia, or 
softening, then no cups nor free purgation, but a treatment highly 
constructive, rich diet, excess of phosphates ; and to rectify the 
defective nutrition or anaemia, the glycerite of kephaline in alter- 
nation with the tincture of avena sativ^a. 

An alterative and tonic course is often beneficial, such as the 
comp. saxifraga and phytolacca, and such tonics as columbo, 
cinchona administered. 

A very large percentage of this form of paralysis is due to 
phrenal syphilis, the microbe burrowing in the brain. This fact 
is often overlooked by the physician either through delicacy or 
otherwise. 

The copper-colored appearance of the roof of the mouth, the 
nocturnal languor, insomnia, point to syphilis, it is unnecessary to 
call for a history of the case, but invariably to push a course of 
treatment which will kill the syphilitic germ, with massage, elec- 
tricity, etc. 

Paralysis of the lower half of the body. 

Paraplegia. There are two forms, one due to congestion, 
the other to ansemia or want of nutrition ; the 
former may be caused by falls, mechanical violence, causing 
spinal meningitis, myelitis, with effusion of blood or lymph on 
the membranes or substance of cord, causing a thickening, tumor, 
tubercular, cancerous, or syphilitic deposit; the latter, defective 
nutrition, caused by masturbation, sexual excesses, disease of 
kidneys, uterus, and other parts, a condition in which, in its first 
stage, the reflex impressibility of the cord is increased — due to 
an insufficient amount of blood in the cord. 

There is a form of reflex spastic paraplegia due to uterine dis- 
placement, very common during the child-bearing period of life. 
This is easily seen when we look at the nervous relation of the 
parts. 

We have, therefore, to return to the sympathetic or reflex caus- 
ation, and in considering this the nervous supply of the uterus 



764 



DISEASE GERMS. 



and its ligaments must be noted. This is, to a large extent, 
through the sympathetic system, which is also intimately con- 
nected with the spinal cord. Thus the uterus derives its nerves 
from the hypogastric plexus, which is in connection with the 
twelfth dorsal, and first, second, third, and fourth lumbar nerves, 
and also from the pelvic plexus, which is in connection with the 
second, third, and fourth sacral nerves through the fifth lumbar 
and upper three sacral sympathetic ganglia. The round liga- 
ments derive their nerve supply from the genital branch of the 
genito-crural nerve. Thus there is a wide area of the spinal cord 
in intimate relation, through the sympathetic ganglia, with the 
uterus and its ligaments ; and the phenomena which are present 
can all be traced to the same region of the cord. Further, there 
is the fact that when the uterus is replaced in position the symp- 
toms vanish at once, which would not be the case if any severe 
pathological lesion had been at the root of such cases.* 

Symptoms. — If not due to mechanical violence, it comes on 
slowly and insidiously, with great weakness, numbness and 
tingling of the feet and legs. These symptoms increase until 
there is a total loss of sensibility and motion in lower extremi- 
ties, paralysis of bladder and sphincter ani follow, decomposition 
of urine in bladder, involuntary movements of the legs, often 
very distressing, marked deterioration of general health. 

Note special symptoms — if the congestion or pressure or nod- 
ule be on the membranes of cord, there is severe pain in limbs 
or back, especially on movement or coughing, resembling rheu- 
matism, reflex movements sometimes exaggerated, paralysis of 
sphincters later. 

In myelitis, dull pain, sensation as if there were a cord around 
the body ; paraplegia more decided ; reflex action in parts below 
segment attacked ; often exaggerated ; sphincters early affected. 

In the anaemic forms symptoms are less definite ; worse 
on being in recumbent posture. When not due to mechanical 
irritation or reflex action, as in spinal irritation, often syphilis 
is the cause, which will be recognized by its concomitant symp- 
toms. 

Treatment. — The first point in the consideration of treatment 
is — Is it one of congestion or anaemia ? The land-marks must be 
carefully drawn as to that point. 

If there is congestion or inflammation, with increased deter- 
mination of blood in the cord, there will be symptoms of irrita- 
tion of motor nerve fibres, as convulsions, cramps, twitching, 
priapism, with indication of sensitive nerve fibres, as itching, 
crawling, pricking sensations, heat and cold feeling alternately, 
and symptoms of irritation of vaso-motor or nutritive nerve 



BACTERICIDES. 



765 



fibres, as wasting of muscles, bed sores, alkaline urine. There 
is also pain corresponding to the upper limit of congestion, 
tenderness on pressure, or a burning or sore feeling on the ap- 
plication of a hot sponge or pole of battery. 

In treating these cases, the quantity of blood sent to the cord 
must be diminished, and the normal integrity of the cord re- 
stored ; apply cups, blisters, irritating plaster ; better than all 
the galvanic cautery on both sides of spine above and below the 
difficulty, followed with hot poultices or continuous application 
of irritating plasters on both sides of spine, two inches wide on 
each side, subsequently belladonna plasty, or some stimulating 
liniment. Internally, iodide and bromide of potass, with calabar 
bean ; to be alternated with belladonna, ergot, salol, camphor, 
henbane, conium, Indian hemp, to relieve distress and procure 
sleep ; as case progresses, glycerite of kephaline and oats, ery- 
throxylon coca. Skin, liver, bowels, kidneys to be well stimu- 
lated, and diet to be generous to a fault, containing as much 
phosphates as possible. The nutrition of limbs must be main- 
tained by olive oil inunction, friction, shampooing, at least twice 
or thrice daily, for twenty or thirty minutes. 

In the paraplegia due to anceinia or white softening, the object 
in view is to cause an increased determination of blood to the 
cord and its membranes and restore its vital integrity if possible. 

The diet should be such as will liberate brain elements, ani- 
mal food, boiled fish, oatmeal, corn-bread, extract of meat. 

Local stimulants should be applied to the spine, concentrated 
ozone with chloroform ; irritating plaster, very efficacious in 
causing a determination of blood. Our best internal remedies 
are the glycerite of kephaline, avena sativa, quinine, nux vomica, 
matricaria, concentrated tincture of kurchicine. 

If the paraplegia be due to rheumatism, salol, manaca, should 
have a fair trial. 

If it can be traced to syphilis, saxifraga and phytolacca, with 
bactericides over the spine, as menthol or thymol dissolved in 
chloroform and alcohol and applied ; ammonia can be added, 
which will increase its power. 



The paralysis of ataxia is due 
Paralysis, to an excessive formation of 

{Due to Excessive Formation connective tissue, with wasting 
of Connective Tissue}) and disintegration of nerve- 

fibres of the posterior columns 
of the dorsal and lumbar portion of the spinal cord, which gives 
rise to a peculiar form of imperfect paraplegia. 



766 



DISEASE GERMS. 



It is supposed to be caused by sexual excesses, the germs of 
syphilis tubercle ; by the poison of gout, rheumatism, exposure 
to cold, damp ; falls or blows being simply exciting causes. 

It is almost invariably met with in males about the middle 
period of life. In well-marked cases there is atrophy and disin- 
tegration of nerve-fibres of posterior roots of spinal cord, with 
formation of amyloid corpuscles, and great hypertrophy of the 
connective tissue of the cord. The lesion is not, in all cases, con- 
fined to the posterior columns of the cord. There is often a gray 
defeneration of cerebral nerves, of spinal nerves, and various 
lesions of gray structure. 

Sclerosis of lateral toliumis of cord, or excessive formation of 
connective tissue, with wasting and degeneration of nerve-fibre 
of lateral columns ; invading also the anterior cornua of gray 
matter. 

The symptoms are gradual paralysis of muscles and contrac- 
tion of limbs ; no loss of sensation ; the sphincters often unaf- 
fected. Treat same as ataxia. 

Disseminated Sclerosis . — Patches of sclerosis in different parts 
of brain and cord. 

In this there is a general loss of power, with tremor and agi- 
tation of the muscles whenever they are called into exercise. 
Lips and tongue tremulous in speaking ; chin kept on breast to 
avoid the effort of supporting the head, which brings on tremor. 
Limbs quiet till moved, then agitated. 



The inhalation or absorption of mercury pro- 
Paralysis, duces a characteristic form of palsy, chiefly affect- 
[Mercurio) ing the nerves that supply the voluntary muscles, 
causing a convulsive agitation, which is very much 
increased when volition is brought to bear upon them. 

It is much more common than is generally supposed. The 
finer soluble preparations used by physicians acts very deleteri- 
ously on their patients. The amalgam used by dentists is made 
up of pure mercury, and the coloring matter of much of their 
vulcanites is of the same metal. Besides, the workmen are ex- 
posed to its fumes in various mechanical and scientific pursuits, 
as looking-glass makers, button-gilders, glass and metal-platers, 
barometer- makers, etc. Chemists are much exposed, and should 
observe the greatest precautions to avoid the inhalation or absorp- 
tion of this deadly poison. 

The symptoms of mercurial poison of nerve -tissue are variable, 
but embrace impairment of articulation and mastication, and 
often the power of locomotion. Delirium and acute mania are often 



BACTERICIDES. 



7^7 



present; the use of the hands are almost entirely lost; often 
epilepsy ; great weakness and restlessness ; skin acquires a dirty 
brown hue ; soreness of gums ; teeth turn black and decay ; 
other bones become affected with inflammation, caries or necrosis, 
or nodes form on them ; anaemia. All symptoms aggravated by 
a change in the weather. 

Treatment. — Removal of cause. Very liberal and nutritious 
diet, attention to bladder and bowels ; baths, sulphur or else sul- 
phuret of potassium with electricity ; chlorate of potassa as a 
mouth-wash, of which some may be swallowed ; due attention to 
other symptoms. From the moment of its recognition till weeks 
after recovery, iodide of potassa in doses of from five to fifteen 
crrains thrice daily in sweetened water. .The iodide unites with 
the mercury in the body, forms an insoluble compound, which is 
readily eliminated by the kidneys and to some extent by bowels 
and skin. In some cases it is advantageous to combine it with 
bicarbonate of potassa or carbonate of ammonia. No drug is of 
any real value but the iodide. 



Lead exerts a very deleterious influence on the 
Paralysis, nervous system and blood. Its poisonous effects 
{Lead) seem to manifest themselves on the finer nerves 
that supply the muscles of the forearm and duo- 
denum. It usually finds access to the body by inhalation, in 
water, food and through the skin. Lead poisoning is more com- 
mon than is generally supposed. The inner surface of the lead 
water-pipes of cities, oxidizes and finds its way into the water 
and is drunk. Lead enters into the composition of culinary ar- 
ticles, as glazed earthenware. Acetate of lead is freely introduced 
in claret wine, and sailors who drink water from casks that once 
contained claret are often affected with lead poisoning. Opera- 
tives in lead mines, workers in lead, either as metal, medicinal or 
chemical agent, paint, all suffer to a great or less degree. Those 
engaged in preparing the finer preparations, as carbonate, acetate, 
oxide, etc., are more common victims than plumbers, painters, 
oil-cloth workmen, paint-grinders. 

Symptoms, — General indications of debility, with paralysis of 
the nerves that supply the muscles of the forearm and hand ; ex- 
tensor muscles of hand and fingers get paralyzed and hang down 
by their own weight when arm is stretched out — called wrist- 
drop. Frequent attacks of lead colic. Taste and breath have a 
lead odor. Formation of a blue line on the edge of* the gums 
just where they join the teeth is nearly always present and is 
typical of lead poisoning. It rarely affects lower extremities. If 



768 



DISEASE GERMS. 



the patient's vital forces are impaired by drink and excesses, or 
frequent attacks of gout or rheumatism, it may cause death. 

Treatment. — Same as for mej'ciiry. Iodide has the same action 
on lead as on mercury. All operatives in lead should be strictly 
temperate ; use no alcoholic drinks, endeavor to maintain a high 
standard of health, promote the function of skin by daily alkaline 
bathing, and should drink sulphuric acid lemonade daily. 



Shaking palsy, characterized by an in- 
Paralysis Agitans. voluntary tremulous agitation of mus- 
cles, which is independent of exertion 
and goes on while the muscle is at rest. Usually makes its ap- 
pearance from fifty-five to sixty-five years of age; generally met 
with in men. 

Its cause and pathology are unknown. It commences in the 
hands, chin or knees, and gradually extends over the entire body. 
Fingers and thumb generally in contact, as if taking a pinch of 
snuff. Associated with great nervous debility, restlessness and 
sense of heat ; muscular power greatly diminished ; intellect and 
senses damaged. Disease progresses slowly, usually taking 
about seven years before general paralysis and white softening 
set in. When well advanced, agitation or tremor may be so bad 
as to prevent sleep ; deglutition and mastication performed with 
difficulty ; a propensity to bend the head forward and to pass 
from a walking to a running gait ; inclination of the body for- 
wards, with bending of chin on sternum : slobbering, involun- 
tary escape of urine and faeces ; delirium, fatal coma. 

Treatment. — Cases are so utterly hopeless that few remedies 
are of much avail. Nevertheless, a general alterative and tonic 
course should be inculcated, with baths, friction, shampooing, 
local stimulation to spine. Diet to be very generous, containing 
an excess of vegetable phosphates. 



The essential paralysis of children, 
Paralysis Infantile, from its being thought to be peculiar to 
early life ; not infrequently do we find 
it in adults. It is, properly speaking, a systematic myelitis, a 
circumscribed, well-defined lesion of the cord, not involving 
neip-hboring parts. It is usually confined to the anterior horns 
of the gray matter of the cord ; hence the term anterior polio- 
myelitis has been applied to the disease, whether occurring in 
infants or adults. As it occurs in infancy, or to children under 
two years of age, who have received a fall, blow, or suffered 



BACTERICIDES. 



'6g 



from teething, worms, there is following a febrile excitement, 
one or more or all of the limbs become paralyzed; the muscles 
of the trunk being also sometimes involved, and very exception- 
ally those supplied by the medulla oblongata. There may have 
been convulsions, coma or a transient loss of cutaneous sensi- 
bility, or temporary trouble with bladder or rectum ; but to a 
great extent the brunt of the disease falls upon the motor power 
of a limb or limbs. After the attack, the limbs does not gen- 
erally become more paralyzed; on the contrary, after a few 
weeks or months there is a gradual clearing off of the difficulty, 
as regards some of the limbs, one or more remaining unim- 
proved. Many of the affected muscles begin at once to waste, 
and lose all power of contractility (degeneration sets in) ; others 
again resume their tone and function. The paralyzed muscles 
are soft and flaccid. After a variable period, there may be a 
gradual return of power, and some recover, while others rarely 
do so. In the end, in the affected muscles, atrophic changes are 
well marked, which may be so wasted as to leave the limb in a 
skeleton-like condition, or fatty substitution may mask the real 
loss of muscular substance, and give a false air of plumpness to 
the limb. The development of bone is also arrested, so that in. 
several years after it may be shorter and thinner than its fellow. 
There is diminution of the calibre of blood-vessels, leading to 
comparative coldness and blueness of the limb, which often 
shows a strong liability to chilblains. The tonicity of unaffected 
muscles would seem to increase and overpower those whose 
function is destroyed, giving rise to deformities which no efforts 
can reduce. 

In treating cases of this kind, the cause, if possible, should be 
removed, the mouth examined, and gums lanced, if necessary ; 
confine the patient to bed for many months. Bromide of potass 
and ergot should be given early ; muscles tested electrically for 
the first few weeks ; any electrical treatment better to be avoided ; 
discourage all attempts of voluntary movements of the damaged 
muscles or limbs, as it tends to excite action in their antagonistic 
muscles, and thereby increase the deformity ; baths, oil inunc- 
tions, shampooing twice daily ; stimulating liniments to spine ; 
secretions attended to, and the general health built up ; a general 
alterative and tonic treatment persevered in ; diet rich in fibrine 
and phosphates. 

The best agents of this class are the glycerite of kephaline, 
alternated with the ozonized wine of coca erythoxylon ; the 
tincture of oats, alternated with some preparation of cinchona. 
A persister.t use of those remedies, with massage, effects excel 
lent results. 
49 



770 



DISEASE GERMS. 



The microbe, amylobacta of rheumatism, 

Paralysis, may be a cause of paralysis, by exciting an 

Rheumatic, hyperaemia, excitation, or exaltation of the 

sensory and motor nerves, either the nerves 

themselves or their origin in the spinal cord. 

The same treatment as laid down under the head of rheu- 
matism. 

The ptomaines of the microbes of diphtheria 

Paralysis, and typhoid fever are highly toxical alkaloids, 

Diphtheric, which have a special affinity to poison and 

paralyze nerves, more especially those of a fine 

or delicate character, as the facial, laryngeal, pharyngeal, cardiac, 

etc. 

In some instances they cause irreparable damage ; more gen- 
erally, with rest, country air, good diet, they make a good 
recovery. 

Paralysis from the ptomaines of diphtheria should be treated 
by the administration of glycerite of kephaline, nux vomica and 
quinine, or by the tincture of oats. 



Wasting Paralysis. 

[Progressive 
Muscular Atrophy) 



Wasting paralysis involves, as its 
name implies, a gradual wasting of the 
involuntary muscles. It is well known 
that in cases of lead-poisoning, wrist- 
drop is apt to occur from atrophy of 
some of the muscles of the fore-arm. In this affection, however, 
the atrophy or wasting is much more general. As a rule it be- 
gins in the arms, and is 
often most noticeable in 
the upper arm and shoulder, 
so that the patient is pre- 
vented from raising his 
hand to his head. It affects 
both sides, and extends 
pretty equally on both sides. 
Causes. — These, at present, are not understood ; it may occur 
in children as well as in adults ; it has been known to be heredi- 
tary in families, so that several children of the same parents have 
been carried off in turn. It is though a very rare disease, nor is 
it yet determined whether it depend on an alteration of the ner- 
vous system or of the muscular system, although most authors 
are in favor of the former view. It is a disease which is very 
chronic ; it goes on gradually from worse to worse, until finally 




Microscopical appearance of the nerves, exhibiting a 
sclerosis of the neurilemma in wasting paralysis, 
with muscular atrophy. 



BACTERICIDES. y^I 

the muscles of respiration become iiivohed, and death may 
ensue from suffocation. 

Symptoms. — The first symptom generally noticed is a wasting- 
of the muscles of the arm or leg, but more commonly the former ; 
the fingers are used awkwardly in picking up anything ; there is 
a numbness and tingling in the extremities, and occasional 
twitchings of the muscles of the part. In time the wasting is 
more marked, and the loss of power is proportionate to the 
amount of wasting. The patient cannot raise his arm nor flex it 
properly; if bent, he cannot resist any one trying to unbend it; 
he cannot make his hand reach his head without assistance. 
On examining the parts chiefly affected, great wasting will be 
noticed, and the bones can be felt through the emaciated tissues ; 
when the muscles of the shoulders waste, the head drops for- 
ward slightly, and the patient has a high-shouldered appearance. 
In a similar way the legs waste, so that walking is performed 
with difficulty, and finally the sufferer has to keep his bed. Yet 
all the while the general health is not much impaired ; he can 
eat, drink, and sleep well ; the mental faculties 
are not affected, and his chief distress is the ~^^ 

progressive weakness. But in time other parts 
get affected ; as long as only the extremities 
are atrophied, loss of power alone ensues, and 
locomotion is rendered difficult ; after a while, 
the muscles of the chest will begin to waste, 
and the patient becc5mes short of breath. As 
this goes on, the expansion of the chest is in- ^^^ -*//^'".^r,^ 
terfered with, and the sufferer is liable to bron- ' "^^ ^°-'' ''^•" 
chitis and congestion of the lungs ; he has not '^^^"^0^ Ihe^pYrSi 
strength to spit up the accumulated phlegm cord jn a wasting par- 
in his air-passages ; exposure to cold or damp 
air makes him have a distressing cough and aggravate his symp- 
toms. Hence it is always a bad thing for them to have catarrh 
or bronchitis, as it generally carries them off suddenly ; in very 
severe cases hardly any expansion of the chest-walls occurs, and 
death really occurs by suffocation. 

Treatment. — For this disease, when once developed, but little 
good can be obtained by any drug. Iron, quinine, strychnine, 
kephaline, avena, und various tonics have been tried, but none of 
them seem to have any influence in checking the onward pro- 
gress of the disease. Shampooing, electricity and massage 
should be tried, and for a time benefit seems to result. The 
general health should be kept up by a nourishing diet ; the body 
should be kept warm, and flannel must be worn next the chest. 
All exposure to cold and wet should be avoided, and although 




7^2 DISEASE GERMS. 

out-door exercise should be taken when fine and dry, yet such 
people should not go out after sunset nor risk an exposure to 
the night air, as they might in that way catch cold or obtain 
some lung complication. In the later stages the patients have 
to be propped up in bed, as they are too weak to support them- 
selves ; in such cases all that can be done is to adopt any means 
that may please or give comfort to the patient, and so render 
more easy the inevitable end. 



There are many varieties of local paraly- 
Local Paralysis, sis, extending from the head to the foot, 
(^Various Forms) and dependent on very varied causes — 
such as facial ; paralysis of the muscles of 
the eye, supplied by the third nerve ; ptosis ; immobility of eye- 
ball ; outward squint, double vision, dilated pupil. Of external 
rectus, supplied with sixth nerve, inward squint, etc. Paralysis 
of fingers and thumb in needle-women, of the supinators and 
extensors of the fore-arm and hand in dish-washers ; hemiplegia 
of penis often present in the sensualist. 

It is unnecessary to go overall ; the point is to ascertain their 
cause and remove it : If due to congestion, an active counter- 
irritant and antiphlogistic course ; if to anaemia, rest, stimu- 
lants, etc. 

Nearly all forms of local paralysis about the face are due to 
syphilitic disease at base of brain ; some due to other blood- 
poisons ; others to sameness, overwork, excess. General altera- 
tives and tonics seldom fail to benefit. 



Paralysis of the bladder may be due to 
Paralysis of the irritation of the spinal cord ; to the pres- 
Bladder. ence of the bacillus of rheumatism, tuber- 

cle, syphilis ; to the urate of soda of gout ; 
to over distension of the bladder, and excessive stretching of the 
muscular coat, brought about by retention of urine; to debility, 
old age, enlarged prostate ; and in ladies by the long-continued 
pressure of the head during labor. 

Symptoms. — When the bladder is paralyzed its contents are 
retained ; but when the distension becomes very great the mus- 
cular fibres of the contracted sphincter are stretched apart, and 
the urine begins to dribble away by the urethra; hence the in- 
experienced are apt to be led astray, taking it for a. case of incon- 
tinence. But if the hand be placed above the symphysis pubis 
the bladder can be felt, as an immense enlargement. Urine is 



BACTERICIDES. 



773 



highly ammoniacal, loaded with mucus, pus and phosphates. 
Pain at the neck of the bladder and glans penis is not to be de- 
pended on as a symptom, because the bladder loses its sensi- 
bility, and the desire to void urine is not experienced. 

The constitutional disturbance is usually severe ; the pulse 
becomes quick, wiry, feeble ; the tongue coats ; appetite fails ; 
great restlessness and depression ; vital power grows feeble, and 
the patient, if not relieved, sinks into a state of stupor, and dies 
of exhaustion. 

In such cases the bladder should be immediatel}^ emptied by 
the catheter, and then washed out by injecting it with a tepid 
solution of boroglyceride. 

The cause, if possible, should be removed, and the case treated 
with such remedies as avena, kephaline, nux, matricaria, comp. 
coca, erythroxylon, iron, quinine. With general alteratives and 
tonics. 

Constriction of the foreskin behind the 
Paraphimosis, glans penis, due to an irritation of the 
nerves that supply the circular muscular 
fibres of the foreskin ; there is a preternatural contraction, 
but the tight prepuce is behind the glans penis, that is 
drawn back over it, whereby the head of the penis becomes con- 
stricted, swollen, and in some cases so engorged with blood that 
the prepuce cannot be replaced. 

The causes are the same as phimosis. 

Symptoms. — Great swelling before and behind the constriction 
at the neck. The mucous membrane forms a thick, brawny 
girdle, like a tightened rope. Great congestion of glans penis. 
Pain, inflammation, ulceration, gangrene of head, if neglected. 
Violent constitutional disturbance. 

Treatment. — Hot bath ; then warm hip-bath, with tobacco ; 
enemata of lobelia ; then sit patient down in a chair, the physi- 
cian or operator sitting opposite with a yard of silk ribbon in his 
hands, the width of the glans penis. Place the centre of the rib- 
bon on the dorsal or upper aspect of the glans penis, drawing 
each end downwards, forming a loop ; then place one end of the 
ribbon round the second finger of the right hand, to form a loop; 
the other on the same finger of the left. That will leave the 
index finger and thumb on each hand free for manipulation; 
then tighten, compress glans gently but firmly ; keep com- 
pressing steadily, and as soon as you perceive a decrease in size 
taking place, persevere still, and while thus compressing, catch 
the constricted prepuce with index finger and thumb of each 
liand, still compressing ; pull the prepuce over the glans penis. 



yy^ DISEASE GERMS. 

If you are unable to accomplish that, a notch, although we are 
partial to incision of the prepuce at several points, if only one, 
let it be a free one, at the tight, preputial collar. . 

If several incisions are made, say five or six, it is equal to 
circumcision, for in the process of healing, the foreskin entirely 
disappears. 

Unless there is some legislative enactment made to prevent 
the spread of syphilitic disease, it would be well to reinstate 
one of the best and wisest methods of protection or prophylaxis, 
the Mosaic sacrament of Circumcision. There can be no 
doubt but that the circumcised are a highly-favored and chosen 
people, having a great immunity from this terrible disease-germ. 



The term parasite is applied to living crea- 

Parasites. tures which take up their abode on or in another 
living substance and feed on it. The animal or 
plant which supplies food and lodging to a parasite, is termed its 
host. 

Parasites are common in both the animal and vegetable king- 
dom, when there is a state of vital deterioration present, when 
vitality is low, the soil poor. Parasite existence is very complex, 
presenting every extreme, every variety of gradation between 
one case and another, every form of dependence between the 
parasite and its host, the benefit or injury one receives from the 
other. Usually the benefit is one-sided, the parasite deriving 
its entire means of subsistence from the metabolism of its living 
host, or from its tissue, while the host receives nothing but injury 
in return — the parasite drawing off its nutritious means of 
growth and reproduction from it — and also giving rise to me- 
chanical, chemical and reflex changes, which are productive of 
disease. 

The maladies caused by the presence of parasites are most 
numerous, from simple states of innervation to violent convulsive 
attacks. 

Some parasites, by means of their spores, ova, germs, may be 
transferred from their host to others and produce disease, and 
these maladies may be transferred from host to host and others in 
which it will produce disease. 

Parasites may be said to make a selection of the host which 
they will occupy; it will attack one host, thrive well in him, re- 
fuse altogether or grow less vigorously in another ; the choice of 
a host by a parasite, is marked by a one-sidedness; a narrow 
cycle of affinity ; the physiological causes of these preferences 
are an inherent predisposition to weakness, debility. 



BACTERICIDES 



77S 



Parasite affections of the skin possess many features in com- 
mon, all induced by a parasite of either vegetable or animal 
origin, and as a consequence characterized by special features. 
They involve the skin or its appendages. 

They are all contagious, induced by local and tangible causes.. 

The fact that there is often associated with entozoa, more espe- 
cially trichin?e and tape-worm, epilepsy, chorea, convulsions and 
other nervous affections, has induced some observers to imagine 
that these parasites, like disease-germs, emit ptomaines, alkaloid 
bodies, such as are isolated from pathogenic bacteria. This idea 
has not been confirmed. 

The predisposing causes as to why parasites take up their 
abode in or on the body, is some depressed, weakened or devi- 
talized condition, for in a condition of perfect health, no disease- 
germ, parasite or fungus can germinate or breed in the human 
body. 

There is no such thing as spontaneous evolution of a parasite, 
in all such cases, the larvae, spores or eggs must find their way 
into the body by the skin, breath, drink or food. 



Spores, ova, find their way into the alimentary 
Parasites. canal, hatch, and produce a parasite of its own 
[IntcstiJtalis) kind or species, giving rise to some of the fol- 
lowing symptoms: These are variable when 
worms exist; still, the following are nearly always met with: 
capricious appetite, acid eructations, pains in the stomach, grinding 
or grating of teeth during sleep ; fetid breath, coated tongue, 
picking at the nose, white or pasty appearance of the counte- 
nance, dark ring about eyes and mouth, hardness of abdomen, 
griping pains about umbilicus, itching at rectum and fundament, 
irregularity of bowels ; an indescribable feeling of debility, often 
heats and colds ; short, dry, hacking cough ; general emaciation ; 
often febrile paroxysms; irregular pulse. Reflex symptoms; 
epilepsy, convulsions, chorea, twitching. In girls, even very 
young, leuchorrhcea ; in boys or men, irritation of the ejacula- 
tory ducts, spermatorrhoea, or masturbation. The only conclu- 
sive sign of worms is their passage, or a joint of them in the 
stools. 

In the trcatvioit of all varieties of intestinal parasites general 
principles must guide us, ever bearing in mind that the reason 
they have lodged and hatched there has been owing to the poor 
health of the individual, so that the greatest possible attention 
should be paid to the improvement of the general health. 

Remedies calculated to give tone and strength to the bowels ; 
to improve assimilation. 



776 



DISEASE GERMS. 



Special remedies, in each individual case, should be adminis- 
tered for either the expulsion or destruction of the parasite. 
Germicides or bactericides are not as a rule efficacious, except in 
some rare instances, we need here parasiticides. 

We employ germicides, parasiticides outside of the body, 
without regard to anything but their power to destroy microbes, 
yet when we use them for intestinal parasiticides, we must con- 
sider the effect they will produce on the organism. 

When the contents of the stomach are undergoing decomposi- 
tion, either from the yeast plant, sarcinae or bacteria, we may 
then get good results from the use of creosote, carbolic acid, salol, 
naphthaline, resorcin ; because these agents in small doses will 
disinfect the bowels, and render the intestines uninhabitable for 
parasites. In very many cases, when one of those drugs are ad- 
ministered regularly in intestinal parasites, and the bowels 
thoroughly disinfected, the parasites leave. The usual treatment 
is parasitical. 

A very common variety ; white, thread like ; 
Ascarides. very slender, and only from one-fourth of an inch 

(S^ai- Wojins) to an inch in length. They possess great celerity 

in their movements, and, when touched, contract 

to about half their length. Their seat is the large intestines, and 

are most abundant near the termination of the rectum, although 

they are occasionally met with higher up. 

Signs of Ascarides. — Irritation, and intolerable itching and 
pricking sensation, and often some swelling at the extremity of 
the rectum; occasionally congestion, e^en inflammation, and 
discharges of blood, with tenesmus; often heavy muco-purulent 
leucorrhoea. 

Treatment for Ascarides. — In addition to the general manage- 
ment of the case, enemas are of the greatest utility. It is im- 
possible to effect a cure without them, such as injections of 
salt and water, lime-water, camphor-water, aloes, gentian, golden 
seal, etc., in infusion. Any of the above will kill and remove 
them from rectum. 

Resembles the common garden or earth 

Parasite. worms, in appearance round and white, like 

(Lunibricoides.) a goose quill ; varying in length from six to 

twelve inches. Their principal seat is the 

small intestines, but they are occasionally found in the colon and 

rectum. 

Signs of the Lumhricoides. — Pricking and rending pain about 
the umbilicus ; colic, with rumbling noise in the abdomen, occa- 



BACTERICIDES. 



777' 



sioned by the worm nibbling or irritating the mucous membrane 
with the sharp, cutting point of its head. 

In the treatment our best drug is santonine, which acts upon 
the worm with powerful certainty. In the administration of 
santonine, always see if it is of a snow-white color ; if it is, it is 
good ; if yellow, or even slightly so, it is worthless — perfectly 
inert. It is a peculiar drug; acts on the brain, the coats of 
stomach and bowels, as a bracing tonic ; improves assimilation, 
and thus aids nutrition. On account of its irritant action upon 
the brain in larger doses, especially upon the children of highly- 
civilized parents, it should seldom, under five years of age, be 
given in larger doses than a grain every other night ; from five 
to ten vears of ag^e, in two-P"rain doses. Dissolve in a little hot 
water ; cool, and give before retiring. Early next morning a 
dose of compound licorice powder, or neutralizing mixture, or 
oil, sufficient to move the bowels ; continue this treatment for 
two or three weeks. Santonine may chemically destroy the 
worm, or it may mechanically tear it up in shreds, which will 
float on top of water, if poured into the chamber. 



or commonly known as tape-worm. Of 
Parasite. this species of worm, some 250 are said to 

{TcFiiia Solinni), exist, and out of that number some eight or 
nine have been found to exist in the alimen- 
tary canal of man ; still, none of these, except the taenia solium, 
have been able to maintain an independent existence, and if it 
were not for his hooks and suckers he, too, would not long be a 
denizen of the human bowels. 

The tape-worm is a true parasite, restricted to vertebrated ani- 
mals, which derive it from the hog generally, but also from other 
sources. The cysticercus cellulose, or pork measles, is the larva 
or scolex of the taenia solium, consequently it is very common 
among pork eaters. A heat of 212° F. effectually destroys it. 
The imperfect cooking of pork, its conversion in a partially raw 
state into sausages which are eaten, is a fertile source of the para- 
site. Early vegetables, as lettuce, spinach, onions, cabbage, are 
often sources through which the ova or eggs reach the intestines, 
as they are frequently manured from cesspools teeming with the 
ova of this parasite. All drinking water into which sewage 
enters is literally loaded with millions of the eggs of this worm, 
and acts disastrously upon the inhabitantsnvho are compelled to 
drink it, and is a prolific source of this parasite in man and 
animals. 

Every tape-worm passes through several distinct phases during 



778 



DISEASE GERMS. 



its life history. There is no doubt but insanitary states, bad 
food, eating of rats, and drinking water are common sources 
from which pigs swallow the eggs, and the moment they are 
transferred to its stomach they hatch out from their egg shells, 
bore their way through the living tissue of the animal and lodge 
themselves in the fatty portion of the flesh to await further trans- 
formation. The animal becomes measled, its flesh constitutes 
measly pork. In this state the parasite is partially developed, 
drops its hooks and awaits developments. It is called the cysti- 
cercus cellulose as in the annexed cut. 

Whether from the hog or from water impregnated with sewage 
or from vegetables, the ova find their way into the human body 
by the mouth, but the eggs do not hatch until they reach the 
duodenum ; in that delicate, 'velvety, eider-down bed it germi- 
nates and makes an attachment. There may be a large number 
of eggs swallowed, as they are very minute 
even when the shell is broken and the cestoid 
worm set free; with its microscopical hooks it 
may hold on, but it possesses the power of 
migration, and even at that embryonic period 
can perforate the stomach, get lodged in the 
capillaries, from which it may extricate itself by 
perforation, wander around until it finds a suit- 
able place in some of the tissue, serous cavities, 
flesh or some organ like the brain, liver, spleen,, 
kidneys, and 6nce domiciled it rapidly increases 
in size, and, if in a vital organ like the brain, 
causes death. 

The common tape-worm derives its name (taenia solium) from 
the idea that there is only one, which is not always the case, as 
three or four have been found in one patient, varying in length 
from ten to thirty-five feet. 

The natural history of this worm is of the utmost importance 
to mankind and domestic animals, as when it is present there is 
always danger. 

The cestoid worms in a perfect state are really compound ani- 
mals, like many zoophytes and ascidians. They have no mouth, 
but are nourished by endosmosis from the surrounding medium. 
The head of a cestoid worm is furnished with organs by which 
it affixes itself to the inner surface of the intestines of a verte- 
brated animal. 

At first there is the egg, its hatching, its getting into proper 
position, and as soon as fixation takes place it begins to develop 
joints which appear as transverse striae and gradually increase 
in size, form segments or joints, each of which is a perfect ovary 




The cysticercus cellu- 
lose as seen in the 
fat of the hog. 



BACTERICIDES. 



779 




loaded with eggs. Each joint of a cestoid worm is androgynous. 
As the posterior joints are thrown off new joints are continually 
forming in the part nearest the head. When segmentation takes 
place from the parent the various joints thrown off are a living 
mass, possess some independent motion, can creep on grass, 
plants, or humid ground, but they 
soon burst, and the eggs or em- 
bryos begin their career by getting 
into some solid or liquid which is 
eaten or drank, and then develop. 

In the ordinary colonial or tape- 
worm state it is termed the stro- 
bila ; the separate joints of which 
the strobilia is composed are 
termed proglottides or zooids. The 
anterior segment forms the head 
and remains barren ; those of the 
neck and front part of the body 
being sexually immature during 
the process of strobile formation. 
The mature proglottides, at the 
caudal end, are capable of realizing 
an independent existence, and the 
eggs which they contain develop 
the six-hooked embryos in their 
interior. These bodies become 
metamorphosed with scolices or nurses, representing 
ceral state, which, in its sterile or aborted condition 
common hydatid. 

The true tape-worm, tceiiia soliitni, may be distinguished from 
all others of the group, by the possession of a small distinct 
head, furnished with four round or oval suctorial discs (suckers) 
and with a more or less rostellum (proboscis), placed at the sum- 
mit of the median line. This prominence when largely developed 
is retractile, and when not in use is lodged with a flush-shaped 
cavity, lined by a sheath, and supplied with special muscles ; it is 
also armed with a single or double crown of horny chitinous 
hooks, often five or six circular rows of these. The head is 
usually about the size of a pin's head, with black pigment en- 
graved on it. The joints or segments represent the body, and 
each seg^ment contains both male and female organs of genera- 
tion. The entire series of joints is traversed by a set of vascular 
canals, constituting the aquiferous system which consist of two 
main channels, one passing down either side of the worm, both 
connected with narrow vessels which coalesce at every joint. 



Head, neck and upper joints of taenia 
solium magnified; a, the circle of 
hooks; b and c, two of the sucking 
discs; ^. the neck. 2. One of the lower 
or sexually mature joints of the same, 
showing the water-vascular canals and 
the branched uterine organ oistended 
with ova. 



the cysti- 
forms the 



78o 



DISEASE GERMS. 



It is only in the alimentary canal of man that a tape-worm can 
live along for years and reach the highest pitch of maturity. No 
doubt millions of eggs are daily finding ingress into the stomachs 
of large masses of our people and, simply because they are 
vital, there is no hatching out, 7io attachment. It is only on 
weakened tissue, reduced by disease, medicine or errors of diet 
of a highly civilized state, where the worm can flourish, and how 
fortunate it is that fecundation never takes place before being 
discharged. 

The mature segments are usually passed off or expelled at the 
rate of six or eight daily. Their greatest danger consists in their 
liberation in the rectum, and finding their way iilto other and 
more vital parts. 

Signs or Symptoms of Tcenia. — General languor, lassitude, 
debility ; a dark circle around the eyes and mouth ; fetid breath ; 
transverse fissures on the tongue ; livid 
complexion or else pale and doughy; di- 
lated pupils ; vertigo, nausea, often vomit- 
ing ; a feeling as if there was something 
alive in the bowels with a sense of weight ; 
a biting sensation at pit of stomach ; ab- 
domen swells and subsides at intervals ; 
appetite may be capricious, usually vora- 
cious ; the presence of the parasite may 
by reflex irritation give rise to convulsive 
tremors, spasms ; epilepsy, if it occurs, 
;mall portions of the worm pass with the 
faeces like gourd seeds. 

Treatment. — The armed tapeworm is found exclusively in 
the human subject, and it is often difficult to effect its expulsion, 
as it is completely armed so as to hold on tenaciously to the 
mucous membrane ; besides, it must ever be borne in mind that 
the parasite propagates from segments of the neck, that it is of 
vital importance in its removal to effect its entire expulsion, espe- 
cially the head. As every physician has his or her own remedy 
or formula for causing its expulsion or death, a brief enumera- 
tion of the remedies will sufifice. Pomegranate root-bark, pump- 
kin seeds, kousso, male fern, kamula, turpentine, naphthaline. 

The properties of those remedies is due to an active principle 
termed valdivine, or to an alkaloid pelleturin. These active 
parasiticide elements are more abundant in the pomegranate 
root-bark, kamula, and male fern. Valdivine and pelleturin are 
the most reliable and eleg^ant preparations ever introduced, 




The double crown of hooks 
highly magnified. 

usually very severe 



very positive 
and all. 



in 



action, seldom failing to bring the worm, head 



BACTERICIDES. 



781 



The bark of the wild or sour pomegranate is much richer in 
taenicide properties than the cultivated. The bark is sometimes 
administered in powder or decoction, the latter is preferred. It 
is made by macerating two ounces of the pulverized bark in two 
pints of water for twenty-four hours and then boiling down to 
one pint. 

Before drinking the above the patient should fast twenty- 
four hours, and drink the pint inside of an hour ; follow with a 
brisk purge. The decoction will nauseate, cause emesis, and 
often purges. 

The following is a good formula for the expulsion of the 
worm : 

Pumpkin seeds, crushed, one ounce ; ergot pulverized, two 
drachms; pomegranate root, pulverized, one ounce; water, one 
pint. Macerate twenty-four hours, then boil down to four ounces 
and strain ; then add : croton, two drops ; gum arable, two 
drachms ; male fern, two drachms. Mix. After fasting twenty- 
four hours, give little by little so it is all taken in. 

For the valdivine, as its properties are very volatile, it is best to 
be given in soft capsules, the entire quantity inside of half an 
hour, followed by a large dose of castor oil. 

The experience of six thousand physicians confirm all we 
have urged in favor of this remedy, the best criterion of all is 
the remedy bringing away the head in nearly all cases. 



Trichiniasis is the name of a diseased 
Parasite. condition induced in man and animals, 

{TricJiinia Spiralis) by the ingestion of food or water con- 
taining the trichinia spiralis, a minute 
worm, measuring one-sixteenth of an inch in 
length and one one- hundredth of an inch in 
breadth, a minute cyst, scarcely visible to the 
naked eye. These cysts are more or less cov- 
ered externally with calcareous matter accord- 
ing to the time in which they are encysted and 
the degree of degeneration their walls have un- 
dergone. 

Cysts are often absent. These larval worms 
exhibit a well marked digestive apparatus, and 
afford evidence of the presence of reproductive 
organs, which are often sufficiently developed The worm lying coiled 
as to enable the observer with a small mag- up m muse e. 

nifying glass to determine the sex of the parasite. 

The number of the larval trichinia that may exist at one time 
and in one case is enormous, being estimated at twenty millions. 




7^2 



DISEASE GERMS. 




Sexually mature female trichinia spiralis 
magnified. 



A single trichiiious pig, if its flesh is eaten without being sub- 
jeoted to a heat of 212° F. for some time so as to destroy the 

vitaUty of the larval trichinia, may 
establish a local epidemic of the 
disease. 

Suppose an animal was fed with 
flesh containing the larval worm 
and is killed a few days afterwards, 
there will be found in the intes- 
tines a large number of minute 
worms ; on closer examination, the 
larger ones are the female, and the 
smaller the male. On the second 
day after being swallowed, the 
trichinia attain full sexual maturity, 
and in six days the females contain 
innumerable perfectly developed 
and free embryos. 
The female is a slender worm in length from one-eighth to 
one twelfth of an inch. The anterior end presents a beaded ap- 
pearance, from which the intestinal 
canal proceeds ; the posterior portion 
three-quarters is mainly occupied by 
the reproductive organs, which are 
filled with eggs and free embryos in 
various stages of development. When 
the embryos attain maturity they pass 
out of the genital aperture and begin 
life on their own account. The ac- 
companying diagram shows the em- 
bryo in various stages of develop- 
ment. The males are less numerous, 
and shorter lived than the females. 

How pigs acquire the trichinia is unknown ; beet-root, earth 
worms, moles, rats, have been suggested as their infectors, but 
nothing is really known hov/ widely this parasite is diffused 
through the animal kingdom. 

By ingestion of food of rare pork, underdone sausages, and 
flesh in which the larvae of this worm are present, the following 

symptoms would 
be likely to put in 
an appearance in 
a few hours after 
being swallowed — loss of appetite, nausea, vomiting, with great 
languor, lassitude, debility — general undefined prostration. 




The embryo of the trichinia. 



Sexually mature male trichinia spiralis magnified. 



BACTERICIDES. 



783 



These symptoms last about a week, when pain, stiffness in all 
the joints and muscles supervene ; then oedema of the face, re- 
peated rigors, fever, with high temperature, and frequent pulse ; 
great thirst, nausea and vomiting continue. Constipation with a 
most offensive diarrhea, copious fetid perspiration. The tongue 
exhibits great gastro-intestinal irritation. 

Synchronous with the trichinous brood migrating from the 
stomach and bowels into the muscles, the second stage com- 
mences when the patient lies on his back like one paralyzed ; 
pressure or any attempt to move the swollen muscles is attended 
with most excruciating pain ; sleep is impossible, even respira- 
tion is difficult and prolonged ; the oedema of the face disappears, 
which is replaced by a swelling of the feet, which proceeds up- 
wards to the body. The tongue still presents the appearance of 
one with gastric fever, and diarrhea often prevails ; urine scanty, 
loaded with lithates. 

In about the fourth week of the disease, the trichinia may be 
regarded as having permanently settled and of having completed 
their destructive action on the muscles. 

Now begins what is termed the third stage, which is character- 
ized by extreme exhaustion, the gastric symptoms abate, appetite 
returns ; in favorable cases, the muscular pains and swellings 
gradually diminish and disappear ; while in some cases this third 
stage is the most critical, the diarrhea is often severe, and accom- 
panied with tenesmus ; involuntary discharges of faeces and urine; 
pallor of the skin, which becomes enormously distended with 
fluid. Various complications very apt to set in as aphonia, 
pleurisy, pneumonia, peritonitis, etc. 

The fourth and last stage, that of convalescence, takes place 
about the fifth week, sooner or later, and may last a few weeks 
or even months. No definite line can be drawn. Death may 
occur at any time. 

The diagnosis of the disease rests chiefly on the history of the 
case, the gastro-intestinal irritation when the parasite burrows 
through the mucous coat of the stomach and bowels, then it 
bears a strong resemblance to cholera, or typhoid fever; the 
muscular pains resemble rheumatism ; the oedema or swelling, 
Bright's disease. 

No reliable treatment can be laid down, as poor success has 
attended the use of our best remedies. 

More recently an effort has been made to destroy or sterilize 
the parasite by the use of germicidal remedies. 

Such bactericides as glucozone, naphthahne, salol, would be of 
some utility if the parasite were located in the bowels ; but when 
encysted in the muscles, they fail to reach it. 



7H 



DISEASE GERMS. 



The human body may be infested with 
Parasite. three different kinds of lice ; the head-louse, 

[Pediculosis, Lice?) body-louse and crab- louse. 

Uncleanliness, insanitary states, perverted 
nutrition of skin, bad food, filth, etc., give rise to a depraved con- 
dition of skin, which render it a chosen pasture-field, or seat, for 
the hatching and breeding of the larvae of those parasites. The 
three species are oviparous, the eggs being known as nits ; sexes 
distinct ; young are hatched in five days, and in eighteen days 
are capable of reproduction. The numbers of eggs laid are im- 
mense. Each of the three has its favorite location or abode. 
On the head they are very easily got rid of by daily washing 
and using vaseHne or ozone ointment as a hair-dressing ; on the 
body, it should be thoroughly bathed and lightly sponged with 
tincture of lobelia. The crab-louse, on pubes, axillae, eyebrows, 
may be got rid of at once, by washing thoroughly, drying off 
and damping the affected parts with a lotion of two grains of 
corrosive sublimate to an ounce of water. The stavesacre, or 
cocculus ointment, is excellent. 

Peroxide of hydrogen makes an exceedingly efficacious 
remedy for all varieties. 

To destroy the larvae on head, body, pubes, warm vinegar is 
very efficacious, applied morning and night. Bedclothing, and 
also body-linen, should be boiled and subjected to a strong heat 
with hot iron, and all due precautions taken for thorough de- 
struction. 

Itch or psora, a contagious vesicular dis- 
Parasite, ease of the skin, attended with great itch- 

{Acarus Scabiei.) ing, which is increased by warmth and use 
of stimulants. All parts of the body, ex- 
cept the head are liable to be affected, but the most common 
seats of the disease are the wrists and hands and finer portions 
of the skin between the finger. Commences as a papular, vesicu- 
lar, or pustular eruption, with an itching sensation, which, 
upon minute examination is found to proceed from a minute 
conical vesicle, while the adjacent portions of epidermis present 
a more scaly appearance than natural. 

The cause of this condition of the skin is due to the presence 
of the acariis scabiei, a microscopical animal parasite, which bur- 
rows within the epidermis and excites the cutaneous vesicular, 
irritation, and as it is utterly impossible to refrain from scratch- 
ing, the vesicles get more or less broken, causing patches of ex- 
coriation. 

The itch is always communicated by contact, shaking hands, 



BACTERICIDES. 



7^3 



drinking 



vessels 




articles of clothing, sheets, blankets, towels, 
used by a person suffering from the disorder. 

The female is much larger than the male, and after impregna- 
tion burrows herself beneath the skin, and forms a furrow or 
ditch, in which she lays her eggs. 

The males have itinerant habits and wander about the skin. 

The diagnosis of the presence of the itch insect is most im- 
portant. Rupture a vesicle, place the exudation under a micro- 
scope, and the figures in 

the annexed cut will be /, j 

seen. Eczema, prurigo, '^ '^ ^ ^ 

and lichen are affections 
most likely to be con- 
founded with it ; but 
eczema, though a vesi- 
cular disease, presents 
round, and not conical 
vesicles, and at most only 
a pricking sensation, and 
nothing like the irritation 
of the itch ; while pru- 
rigo and lichen are papu- 
lar disorders, and are not 
accompanied by the presence of vesicles, moreover none of 
those disorders are contagious. 

Different names are applied to it in various sections of the 
country, as the prairie or lumberman's itch. 

Treatment. — As it would be somewhat of an expensive cure to 
resort to vaseline, ozone ointment, glycerine and oil of berga- 
mot, or the like, which are destructive to the parasite, the cheapest 
plan is to take two or three pounds of common lard, deprive it 
of its salt, and stir into it as much sulphur as it will hold, still 
retaining its properties as an ointment. The patient being bathed 
all over with an alkaline wash, into which a handful of lobelia 
has been introduced, well dried, and the sulphur and lard well 
rubbed into every part of the body except the head. He must 
be put in a clean bed, and his contaminated clothes either fumi- 
gated with sulphur, or else washed with sulphurous acid water. 
This process is to be repeated every night for three or more 
nights in succession, on each occasion the body to be thoroughly 
washed before the application of sulphur and lard. The immer- 
sion of the body-linen, bedclothes, or ordinary clothing in water, 
acidulated with sulphurous acid, is sufficient in all cases to de- 
stroy the larvae and the parasite; so is a heat of 212° Fahr, 



Itch-mite, i, abdominal view of female itch-mite, magnf- 
fied 65 diameters; 2, one of its manibles, magnified 65 
diameters ; 3, manible of male sugar-mite, magnified 390 
diameters. 



either in boiling or by hot irons. 
50 



There need be no detention 



786 



DISEASE GERMS. 



from business ; the first application could be made on a Friday 
night, and the two succeeding ones on a Saturday or Sunday 
evening. 

The following is highly esteemed : 

Lard, one hundred parts green soap, fifty parts ; naphthaline, 
fifteen parts ; white chalk, ten parts. Mix. 

The same may be used in acne with success. 

One of the following formulae may be substituted for the 
ordinary sulphur ointment : 

Sulphur flor., twelve drachms; potass, subcarb., six drachms; 
adipis, nine ounces. 

Styracis, liq., one fluid drachm ; petrolei, ol. olivcX, of each, 
half fluid ounce; balsam. Peruv., two and a half fluid drachms ; 
spts. sapon. virid., five fluid drachms. 

Potass, sulphuret., five drachms ; sapon. alb., twenty drachms ; 
ol. oliv., four fluid drachms; ol. thym., fifteen drops. 

Sulphur, sublim., balsam. Peruv., of each, half a fluid drachm ; 
adipis, one ounce. 

For use especially in the scabies of children : 

Styracis liquid., one ounce ; adipis, two ounces. Melt and 
strain. 

Styracis liquid., one fluid ounce ; spts. rectificat, two fluid 
drachms ; ol. olivae, one fluid drachm. Ft. liniment. 



An affection due to the presence of the 

Parasite vegetable parasite tricophyton tonsurans. 

Trichophyton. Most common on hairy parts — especially the 

(Ringworm.) scalp — but non-hairy parts may be affected ; 

the nails may also suffer. Most common in 

children, and spreads readily by contagion. Hence common in 

schools, where it may be conveyed from one to another by 

means of combs and brushes, hats, towels, etc. ; the spores of 

the psrasite have also been found floating loose in the air of 

schoolrooms. May last for years if untreated, being especially 

obstinate when attacking the hairy parts. 

Ringworm of scalp {T. tonsurans) begins in circumscribed 
patches, with redness of skin, which becomes covered with 
slight scales. Tendency to assume crescentic or ringed form. 
Slight itching, flairs brittle and break off, leaving bald patches, 
over which numerous stum.ps of hair are seen. Ringworm of 
the" beard {T. barbce, T, sycosis) is similar in appearance; often 
confounded with ordinary sycosis. In many cases of ringworm 
of scalp diagnosis often obvious at once. The bald patches 
covered with broken stumps of hair present a marked contrast 



BACTERICIDES. 



787 







to the smooth, perfectly bare " bilUard ball " patches of alopecia 
areata. Absence of discharge or crusts will differentiate from 
eczema, though either may occur 
from irritation in long-standing 
cases. Diagnosis only rendered 
certain by identification of pa- 
rasite under microscope. On scalp 
or beard, extract broken stump 
with forceps, place on glass slide 
with a few drops of liquor po- 
tassae, and examine with quarter- 
inch — preferably after soaking for 
a few hours in liquor potassse. 
Rows of spores of parasites seen 
on hair and between its fibres, 
splitting them and making hair 
appear thicker than normal. Para- 
site invades the hair bulbs on the 
one hand and the epidermis on the 
other, where mycelial filaments 
may be found between fine epider- 
mic scales. 

On the non-hairy parts of the 
body the affection is known as 
T. circinata or T. corporis. Slightly raised reddened patches are 
seen. These are frequently more or less rounded, and may at- 
tain an inch or more in diameter. Their margin is red and ele- 
vated ; often papules or vesicles seen on it. The centre becomes 
yellowish and desquamates. When the eruption attacks the 

inner side of the thigh, genitals, or 
perinseum, it is known as Eczema 
marginatum, and presents a some- 
what different appearance. Owing 
to the natural warmth of the parts 
and the friction of the opposing sur- 
faces, the presence of the parasite 
excites more or less inflammation 
(eczema), and this may persist even 
after the parasite has been destroyed. 
Not merely vesicles, but pustules 
and crusts are frequently to be seen 
on the margins of the patches. In 
T. circinata the presence of the para- 
site may usually be readily ascertained by scraping with a pen- 
knife some scales from the inner edge of the outer ring, placing 



A microscopical appearance of a section of 
the skin in which the trichophyton has 
made its appearance. 




Tinea capitis. 



788 



DISEASE GERMS. 



them in a drop of liquor potassae, and examining them under 
the microscope. Long slender irregularly-jointed threads of 
mycelium are seen and spores occurring singly or grouped. 

Ringworm of the nails is very intractable and is, fortunately,, 
not very common. The nails become thick, soft, opaque, and 
assume a yellowish tint. 

Of all the vegetable parasites of the skin, the trichophyton is the 
most common ; it produces three distinct forms of skin disease, 
tinea circinata, or ringworm of the body ; tinea tonsurans, or 
ringworm of the scalp ; and probably a special form on the face. 
This parasite gives rise to considerable irritation of the skin, 
which results in the formation of circular, circumscribed patches 
of various sizes, slightly elevated above the level of the skin, of a 
dull red color, and usually covered with brassy scales, while 
round the edges, there may be found vesicles, and sometimes 
even pustules. 

On the scalp, ringworm shows itself as one or more circum- 
scribed patches of a grayish or slightly ruddy color. The hair 

of the affected parts is short,, 
lustreless, easily drawn out, 
breaks readily, and the extremi- 
ties are ragged and uneven, the 
skin is covered with numerous 
thin white scales, and occasion- 
ally with crusts. 

In all these three situations 
the trichophyton presents simi- 
lar microscopic appearances. 

The parasite is frequently met 
with in both children and adults 
of both sexes, wherever over- 
crowding exists, schools, chari- 
ties, reformatories. It is highly contagious, but yet requires a 
suitable soil for its growth and development. The most com- 
mon methods of transmission are close contact, brushes, combs, 
sponges, towels, clothing, domestic animals, as dogs, cats. 

The indication for the relief of the disease is the destruction of 
the parasite, and the improvement of the general health of the 
individual. 

Prominent among the parasiticide remedies may be enumer- 
ated ozonized sulphur water, ozonized boroglyceride; solution of 
hyposulphite of soda; tincture of iodine; iodized oil; solution 
of thymol in chloroform ; ointments of iodine of sulphur ; ozone 
ointment ; ichthyol ; chrysarobin ; gutta percha, dissolved in 
chloroform with resorcin added and painted on ; iodine crystals 




Trichophyton {ringjvorm). 



BACTERICIDES. 



789 



-dissolved in oil of tar. Among the most recent and effective 
remedies in ringworm is the tincture seigesbeckie orientalis ; 
equal parts of this drug and glycerine rubbed into the affected 
parts morning and night, immediately kills the spores. The 
parasite breaks up into isolated dead patches, and these speedily 
peel off, leaving the skin underneath slightly red, which disap- 
pears in a few days. 

Older remedies are chrysophanic acid dissolved in chloroform ; 
may be painted on and will soon prove effectual. In ringworm 
of hairy parts, difficulty arises from impossibility of reaching 
seat of disease. Applications to surface of scalp do not reach 
roots of hair. To facilitate treatment, cut hair short; in severe 
cases, shave. Then apply some parasiticide regularly once or 
twice a day, Most authorities recommend frequent washing of 
'head with soap and water ; others oppose. Various opinions of 
value of epilating broken stumps. Local remedies innumerable. 
Following amongst most useful : — Unguentum hydrargyri am- 
moniatum, unguentum hydrargyri oxidum rubrum, unguentum 
acidi chrysophani, ten grains to one ounce ; hydrargyri olea- 
tum, five or ten per cent, solution in oleic acid, sulphurous acid, 
U. S. P. acid used as a lotion with equal part of water, head being 
covered with cap to prevent evaporation, salicylic acid as lotion 
dissolved in rectified spirits, twenty to forty grains to one 
•ounce of acetic acid, painted on with brush. Any or all of these 
may be tried in succession in severe cases. Spontaneous cure 
sometimes by formation of kerion, which is the name applied to 
a boggy swelling formed by inflammation of the hair follicles. 
Resembles subcutaneous abscess. Parasite perishes in inflamma- 
tory process, and, not unfrequently, some destruction of hair- 
bulbs also occurs. In chronic cases it may be desirable to pro- 
duce kerion artificially by painting scalp with croton oil or other 
irritant, watching the process carefully. No case of ringworm of 
scalp must be pronounced cured till absence of the parasite 
proved by careful and repeated microscopic examination. If an; 
left it may spread again over the whole scalp and be as bad as 
ever. After the parasite has been completely removed a scurvy 
condition of the head is frequently left. 



This is a cutaneous affection occur- 

Parasite. ring chiefly upon the trunk, neck, upper 

i^Microsporon Furfur, and lower extremities of adults of both 

Tinea Versicolor}^ sexes, characterized by irregularly 

reticulated, macular lesions, yellowish 

or brownish in hue, over which the epidermis may exfoliate in 

delicate scales, owing to the presence of the cryptogamic plant, 

the microsporon furfur. 



ygO DISEASE GERMS. 

In warm weather it grows most luxuriantly, in beautiful, mot- 
tled, copper-colored patches over a portion or the entire body, 
which is covered ; in cold weather it contracts and often disap- 
pears. 

This vegetable parasite makes its habitation in the pigmentary 
gland. Hidden in its recesses, below the cuticle, it is difficult to 
reach with antiseptics. This also renders its capabilities for con- 
tagion far inferior to other vegetable parasites. 

The disease is propagated by scales or spores, prevails in mid- 
dle life, irrespective of social position and personal cleanliness. 

It is easily recognized by the microscope, by the history of 
the case, by the fact that it never invades hairy parts ; avoids 

light and air, its characteristic 
yellow, or fawn-tinted color, the 
exfoliation of the epidermis, which 
it excites by its superficial pene- 
y-^;^^!^ ^' %\o >«*fM^'/)>x tration of the outer layer, produc- 

hke exuvmm, will enable any one 
to diagnose i£ from chloasma or 
liver spot. The germ of syphilis 
upon the skin may be mistaken 
for this plant, but the microbe of 
Photograph of the micrococcus versicolor syphiHs cncroachcs anvwhcre, is 

— small cocci which are seen form in- j-rr i. r 

descent colonies— growing in the form of mOrC dlllUSe, CrCCpS OVCr the laCe, 
yellowish beads. ^^^^^^ ^^^^^ ^^^ ^^^^^ .^ j.j^^j^ ^^ ^^ 

either adenopathy, alopecia, mucous patches, palatine hyperaemia, 
polymorphic tendency. The nature of the sensations, with its 
initial growth copper-color patches might be due to liver torpor. 

The destruction of the microsporon iurfur is not invariably as 
successful as it might be, owing to its location in the pigmentary 
gland, below the cuticle. In order to be successful this must be 
either weakened or removed. For this purpose, for three or four 
successive nights, the patient should be immersed in a hot bran 
bath, in which abundance of bicarbonate of soda has been dis- 
solved — he should be thoroughly macerated, and subsequently 
well rubbed or scrubbed with a flesh brush, then dried and 
bathed with cider vinegar, in which boroglyceride has been dis- 
solved. This is often successful in an entire rooting out of the 
parasite. 

If this is not efficacious, proceed as above, but try half an 
onnce of the hypophosphite of sodium dissolved in a quart of 
water — this also often removes the last vestige of the germ. 

Other parasiticides, very popular, are ozonized sulphur water, 
sulphuret of potassium ; boroglyceride combined with resorcin ; 
iodine, chrysarobin. 




BACTERICIDES. 



791 



In all cases the inner clothing should not be worn after the 
bathing and application, until it has been immersed in water 
acidulated with sulphuric acid. When untreated, the parasite, 
after quite a lapse of time, undergoes spontaneous exfoliations,, 
the fungus fails to find in the epidermis the nutriment upon which 
it thrives. 



Parasite. 

{AcJiorion Schonleinii, 
Tinea Favosa^ 



A contagious disease of the scalp, 
due to the presence of the vegetable 
parasite achorion schonleinii. The 
scalp invaded by this parasite presents 
the characteristic appearance of a 
honeycomb in the form of small, dry, yellow, cup-like crusts, 
commonly traversed by hairs. 

Under the micro- 
scope, the fungus 
presents this ap- 



this 
pearance. Take a 
particle from any 
small scab or crust 
in the root sheaths, 
or bulbs, or the 
hairy filaments. 

It is easily de- 
stroyed in either of 
the following meth- 
ods. Packing the 
affected part for a 

few consecutive nights with boroglyceride paste, or chrysarobin 
is very effectual in an ointment, or sulphur in almost any form, 
ozonized sulphur water ; or thymol dissolved in ozone ointment, 
or painting it over every third day with iodine crystals, dis- 
solved in oil of pitch, or rhinacanthin rubbed up in petroleum 
ointment ; ichthyol also is of great service, naphthaline. 




Achorion schonleinii ; a, spores ; b, c, sporophores. 



Parasite. 

( Fh ngus Trie J L ophyton . ) 



Tinea sycosis^ or barber's itch, due 
to the p-esence of the fungus tricho- 
phyton in the beard of the adult. 
This parasite is readily recognized by 
its location, its fig-like appearance, by the irritation or itching. 
Its presence gives rise to the presence of macula, papula, vesi- 
cular, pustular or tubercular lesions — it has greatest growth in 
devitalized individuals and blonds ; extremely contagious. 
The chin and beard are its favorite locations. 



792 



DISEASE GERMS. 



In the destruction of this parasite, the patient should for sev- 
eral consecutive days macerate the eruption with oHve oil, then 
shampoo it effectively, that is, wash off all crusts, with castile 
soap and water as hot as can be borne ; this tends to reduce the 
inflammation of the perivascular spaces, removes the incrustation. 
Beard to be shaved, and a saturated solution of boroglyceride 
should for several minutes be applied to the entire beard and face, 

followed by some one or 
other of the following 
ointments, to be kept ap- 
plied over night : either 
the iodide of sulphur 
ointment; or thymol ; or 
ichythyol ; naphthaline, 
chrysarobin, resorcin, sul- 
phuric acid ; gunpowder 
made into a paste by the 
addition of lem.on juice, 
and applied and reapplied. 
More recently equal parts 
of tincture of siegesbeckie 
orientalis and glycerine, 

The fungus trichophyton of barber's itch. rubbcd WcU intO thc partS 

affected, have proved wonderfully effective in destroying the 
germ, and promoting a rapid cure ; although any one of the above 
is brilliantly effective in destroying the fungus. 

In the morning, whichever application is used should be 
washed off and the boroglyceride wash reapplied ; when dry the 
anti-microbe powder should be freely dusted on during the day, 
and in the evening a re-application of the hot bathing, borogly- 
ceride and the selected ointment. This should be repeated for 
several weeks after all appearances of the parasite has ceased to 
exist. 

The following formulae are used by some : If the beard is not 
shaven, first wash with an antiseptic soap and apply night and 




Ung. simp., 20 parts ; resorcin, 2 parts ; hydrarg. bichlor., 0.05 
part. 

If the beard is shaven, a zinc paste, viz. : 

Ung. zinc, benzoat., 90 parts; terrse siliceai, 10 parts may be 
substituted for the ung. simp, in the above prescription. 

If the disease is very superficial it may be sufficient to touch 
the part with sublimate or resorcin pencil, or use a spray of: 

Resorcin, 5 parts ; hydrarg. bichlor., O.05 part ; aq. cologniensis, 
spiritus, of each 50 parts; ol. ricini, i part. 



BACTERICIDES. 



793 



When the disease is deeper and nodes have formed, the follow- 
ing plaster mass should be applied and bound down : 

Empl. hydrarg-., lO parts; ac. carbolici, lo parts; sublimate, 
1 part. 

Epilation should be practiced if pustulation has occurred, but 
not otherwise. 

A high standard of health is proof against this and other 
micro-organisms ; if it were not so the frequenters of our barber 
shops would be more generally affected. 




An eruption consisting of bullae (blebs, blis- 
Pemphigus. ters) of varying size, seated on a more or less 
erythematous base. Some vesicles may also 
be present, intermixed with the bullae. The eruption is often 
preceded by itching and tingling, and may be accompanied by 
some fever. The bullae are more or less flattened, frequently 
irregular in contour, and may reach the size of an egg. They 
contain serum, which, clear at first, soon becomes opaque, and 
contains pus. The serum is effused 
into the malpighian layer, where it accu- 
mulates between the filaments uniting 
the cells, but finally makes its way to the 
granular layer. The bullae are bounded 
externally by the horny layer of the epi- u ^^v 

dermis. In a few days they begin to 000(1 

lessen in size. Many burst, allowing ^' n 

escape of their contents; the outer epi- Bacteria of pemphygus. 

dermal coat of bullae then drops off in 
a feV days, leaving reddened patch, on which epidermis soon 
forms again. The attack may be acute, and terminate in a 
few days in spontaneous recovery, or successive crops may 
occur, and the eruption thus be prolonged for days or weeks 
(chronic pemphigus). Pemphigus may occur on any part of the 
body ; the syphilitic form (syphiloderma bullosum) is more com- 
monly seen on the palms and soles. It may occur at any age. In 
new-born children it is termed P. infantilis^ and may proceed to 
gangrene, in which case it is generally rapidly fatal. Repeated 
attacks are not without danger, especially in old people, or where 
an extensive portion of the surface is attacked ; in such cases 
patients may emaciate, and be reduced to a very low state. 

P.foliaceus is a rare and peculiarly obstinate form, which may 
last for months or years. It is said to be incurable. Successive 
crops of bullae form and burst, but after the detachment of 
the epidermis in flaky scabs it is not reformed, but a raw surface 



794 



DISEASE GERMS. 



remains, to which fragments of epidermis may be seen adhering. 
In cases of long standing, almost the entire cutaneous surface 
may be affected, and but little epidermis be seen remaining. The 
patient passes into a hectic condition, and the eruption usually 
ends fatally. Another variety of pemphigus occurs on the hands 
(occasionally on the feet) and is known as cheiro-pomphylyx. It is 
termed dysidrosis, and is due to obstruction of sweat-ducts. It is 
now regarded as a neurosis. Consists of vesicles as small as a 
pin's head, or larger blebs, and makes its appearance on or be- 
tween the fingers. The vesicles or blebs have a peculiar translu- 
cent appearance, and burst in a few days. 

All varieties may be met with in either an acute or chronic 
form, and all characterized . by the production of a series of pea 

or egg-shaped vesicles, variable in size, 
the smallest being about a pea, the 
largest that of a large ^g^, irregularly 
distributed over the surface, from a few 
to some hundreds, filled with serum or 
blood, loaded with bacteria. 

The causes which give rise to this 
rare cutaneous affection are poverty of 
nerve force, nervous prostration or 
debility, mental worry, exhaustion from 
sexual excesses, the presence of syphil- 
itic germ in the blood, the empirical 
use of the mercurial preparations, vis- 
ceral disorders, impairment of nutri- 
tion, squalor, filth, uncleanliness. 

The presence of such prodigious 
herds of the bacteria in the blood and 
their migration in colonies to the skin 
is usually attended with either con- 
tinuous remittent or intermittent py- 
rexia, appearing with each crop of vesicles. There are always 
headache, pains in the back, gastric and intestinal disturbance. 
The contents of the bullae or blebs consist almost entirely of 
bacteria ; arranged in chaplets or joints interspersed through it 
are cocci. 

Like all morbid states dependent on the presence of a disease- 
germ, it is highly contagious and infectious. Bacteria are ubiqui- 
tous, ever present in atmosphere in a range of fifty feet around 
the patient. 

The treatment is essentially constructive and germicidal. The 
stomach and bowels merit attention ; diet should be rich, gener- 

remedies as iron, oats, quinine, nux^ 




Microbe of pemphigus typhilicija. 



ous, blood-forming ; such 



BACTERICIDES. 



•95 



matricaria compound are unexcelled ; the latter remedy is deemed 
the best, as it destroys the micro-organism and stimulates a re- 
newal of vital force. 

The sulphide of zinc in alternation with ozonized sulphur water 
are the best remedies to give internally. 

The syphilitic form requires the general treatment for syphilis. 

Locally puncture the vesicles with a fine needle, and with a 
sponge saturated either with a solution of boroglyceride or resor- 
cin, wipe up the germs as they exude from the puncture. Then 
all over the collapsed bleb, dust 
on the anti-microbe powder. 
The aim of all treatment is to 
raise the standard of vital force, 
so a* to prevent further degrada- 
tion of bioplasm into a disease- 
germ. 

When tl>e microbes die in the 
vesicles, they dry up into black 
crusts or scabs, become flat- 
tened, then the affection re- 
ceives another name — rupia. 

Those crusts, after a time, may 
fall off, leaving deep, perforating 
sores, which* may heal, or again 
fill up. If the case is properly 
appreciated, by a reconstruction 
of vital power, they heal up rap- 
idly. They receive different ^"p'"' 
names, according to their size, consistency, and tendency to eat 
in, as rupia simplex, when the crusts are thin, small, superficial ; 
if crusts are large and prominent, rupia prorninens ; if deep, 
extensive and still penetrating, rupia eschar otica. 




Perineal Pressure. 

(The Disease of the Scythians. 



Horse riding causes com- 
plete impotence in the 
strongest and most daring 
men, with wasting of the 
testes, dropping of the beard, and change in the pitch of the 
voice. 

If, then, these sad results are the outcome of immoderate 
equitation, where there are an extensive seat and a stable foot 
rest, and where the adductor muscles of the thighs are used, 
what are we to look for, where our boys of ten and upward 
spend the greater part of their own time riding bicycles, and get 



796 



DISEASE GERMS. 



over thousands of miles in the year, perched upon a saddle no 
bigger than the hand, which conveys every jolt of the machine to 
the body; where the jolts are a thousand times more numerous 
than those experienced by the equestrian, and occurring with- 
out any approach to rhythm, are conveyed unexpectedly to the 
person ? 

Cycling is doubtless a very healthy and pleasant mode of ex- 
ercise when used in moderation, but now that tens of thousands 
of our boys ride bicycles daily, and '' get up records '' of thous- 
ands of miles in the year, it may not be out of place to point out 
some alarming evils which are likely to arise from this abuse of 
an otherwise healthy pastime. Some time ago it was pointed 
out that obscure nervous complaints would probably be devel- 
oped by the continual jarring, the succession of shocks conveyed 
to the spinal column in bicycle riding; and this, I believe, has 
proved correct in many instances, notwithstanding "Arab 
springs '^ and " rubber cushioned " machines. But it is to some- 
thing much more serious than this that I would now call atten- 
tion : it is to the amount of pressure brought to bear upon the 
perinaeum in growing boys, affecting directly the prostate, the 
muscles of the bulb, etc., and indirectly the whole generative 
system. 

The bicycle saddle is now reduced to the smallest possible 
limit. It is just wide enough at its posterior part to cover the 
ischial tuberosities, and it tapers off quickly to a long narrow 
horn in front, upon which the perinaeum rests. Let us consider 
the position of the body and limbs when the rider is mounted, 
and we can then appreciate the amount of body weight which 
must be thrown upon the perinaeum. In bicycle riding the legs 
are, when extended, vertical, and the pelvis is flexed upon the 
thighs or rolled forward. This rolling forward of the pelvis is slight 
in easy riding, and very marked in fast riding and hill climbing. 
Now, when the body and pelvis are bent forward, the ischial tuber- 
osities are raised from the saddle, and the whole weight of the 
body, save what is transmitted to the pedal by the then extend- 
ing leg, is thrown upon the perinaeum. It is not much of the 
body's weight that is conveyed to the pedals. In easy riding on 
the level the weight of the limb from the hip down is sufficient 
to move the machine, and in hard riding the extra pressure if 
gained not so much by throwing the body's weight upon the 
pedals as by pulling upward on the handle-bar, and so further 
increasing the pressure of the body upon the saddle. But even 
admitting that the pressure upon the perinaeum be only a few 
pounds, I hold that it must be injurious in the extreme, for were 
the pressure nil when riding upon a perfectly plane surface, it 



BACTERICIDES. jg^ 

must at times be considerable when the machine is ridden over 
an unequal surface such as is afforded by our best country- 
roads. Let those who talk of " the beautiful gliding motion of 
the bicycle " try to play a game of billiards after a ride of twenty 
miles, and then explain where all their " shakiness " comes 
from if their motion has been that of a skater. Now this pres- 
sure on the perinaeum, whether it be continuous and increased at 
every jolt, or whether it be made up of jolts alone and be nil '\w 
the almost imperceptible and irregular intervals, must be injuri- 
ous, more especially to growing boys. It must cause irritation 
and congestion of the prostate and surrounding parts, tend to- 
exhaust and atrophy the delicate muscles of the perinaeum, and 
also call attention to the organs of generation, and so lead to a 
great increase in masturbation in the timid, to early sexual 
indulgence in the more venturous, and ultimately to impotence 
in both. 

The deplorable effects of self-abuse in 
Perversion of the early life, and excessive indulgence in 
Sexual Sense. later years, give rise to seminal weak- 
ness, varicocele, nocturnal and diurnal 
emissions, impotency, sterility and phrenal bankruptcy. The 
prevalence of self-abuse, its widespread and destructive effects on 
mind and body, its degrading and ravaging effect upon the vital 
elements of nature, render the subject one of vast importance 
to our well-being as a nation. Its victims are found among the 
very young, before and after puberty of both sexes, in every vil- 
lage, town, and city, and, unfortunately, the religious, or so- 
called virtuous, are most addicted to it. 

The perversion of the sexual sense is much on the increase.. 
Our entire population, with their nervous constitutions and ex- 
cessive nervous susceptibility, leading to cerebral debility, tend 
to induce the habit of mental masturbation, as well as both natu- 
ral and unnatural excess in sexual indulgence. The creation 
of a purely nervous temperament in the people of our country, 
under their special mental strain of tension, operates disastrously 
upon the procreative faculties ; very different indeed from the 
well-balanced temperaments of those who live out of doors and 
work with the muscle more than with the mind ; these usually 
are strong, healthy, and are not, as a rule, tormented with 
sexual desire in the same degree as the sensitive and nervous. 

A perversion of the sexual appetite is the result of excessive 
nervous development. This perversion is a true monomania, a 
positive insanity, manifested in society under what is termed 
crankiness. 



798 



DISEASE GERMS. 



Some inherit this effeminacy, this deterioration of brain, this 
wiping out of the typical fissures of thought! Some come into 
it as soon as the sexual passion dawns ; some acquire it as the 
result of sexual debility. 

A perversion of the sexual appetite is usually brought about 
through excess, or masturbation, partial impotency, with cold- 
ness or indifference to the opposite sex. 

Confirmed, long standing masturbators, of either sex, care 
little for the opposite sex. Excess creates hate for the partners 
of excess ; perverts the sexual sense and the characteristics 
change ; men become women and women men. When a man 
suffers from sexual perversion he becomes feminine in his 
thoughts, ideas, tastes, occupations, dress, even permits his hair 
to grow, and is silly in his behavior. 

Disgust follows debauch ; repeated excesses create indiffer- 
ence, fear, and sexual perversion comes on. 

Many who perish from its effects are supposed to die from 
other causes, such as consumption, chorea, epilepsy, heart dis- 
ease, debility and failure of vital powers. It destroys the mind 
as well as the body. In its milder form, it produces loss of 
memory, melancholy, evil forebodings, timidity, loss of spirits 
and loss of energy ; tn its worst form, idiocy and insanity. 
Many maniacs owe their loss of reason to no other cause. In 
the tabulated reports of every insane asylum are a great number 
of cases in which the cause of insanity is set down as '* Mastur- 
bation." No affection so completely unfits for either the duties 
or the pleasures of life. The semen of those who have abused 
themselves in this way, or who have been guilty of excessive in- 
dulgence, is like that of old men, often scanty, thin and watery, 
and when examined under the microscope, the active principle 
(the spermatozoa) is deficient and imperfectly developed. Such 
semen cannot propagate healthy offspring. If the spermatozoa 
are absent, or imperfect, as is always the case if the emissions are 
frequent, the individual is either sterile, or the offspring is weak 
puny, deformed and short-lived. It is thus one of those sins 
which are visited upon the children. This alone is a powerful 
reason why no masturbator should marry before he has received 
competent medical advice. But there are other reasons. The 
sexual powers of such persons are not equal to those duties of 
marriage which appertain to perfect manhood. Owing to sex- 
ual debility, connection is imperfect ; the emission is premature, 
so that the wife cannot reciprocate ; or. erection is feeble, or will 
not occur at will, so that connection is impossible. Much do- 
mestic misery results from this cause, the lives of many a couple 
are passed in wrangling, misery and discontent from it ; many 



BACTERICIDES. ^qq 

divorces have their origin in it ; for if the wife is denied her 
natural rights, a divorce, or what is worse, unfaithfuhiess, is a 
logical sequence ; many men have become desperate upon find- 
ing themselves united to beautiful and lovely women, but in- 
competent as husbands. 

It is true, many other conditions or states of the body give rise 
to emissions — anything that weakens the nervous system, as 
fevers, affections of the brain and spinal cord. 

Amoncr some of the other effects of this vice are aversion to so- 
ciety, love of solitude, specks and spots before the eyes, pain in 
the back of the head, pain in the back, left side of breast ; 
frightful dreams ; sensations of falling in the sleep ; bashfulness 
<ind timidity, especially with ladies ; palpitation of the heart ; 
flushes of heat; chilly sensations; rush of blood to the head; 
restlessness ; cold feet ; at times voracious appetite, at others, 
loss of appetite and indigestion ; dryness of the skin ; pale, sal- 
low complexion, with dark rings under the eyes ; pimply erup- 
tions and blotches on the skin ; dimness of the eyes ; indisposi- 
tion to study, exertion, or to concentrate the faculties on one 
subject for any length of time ; a constant dwelling on their 
disease in the mind ; often causeless anxiety and dread of death ; 
despair of recovery, etc. Indeed, young men are inclined to 
worry, fret, become hypochondriacal and mentally depressed. 
The explanation is, the great sympathetic is at fault, this nerve 
has been perverted; the genital apparatus, brain and stomach are 
in constant telegraphic communication. 

In view of the intricate mechanism of the damaged parts, the 
habit having the effect of paralyzing and blighting vital organs, 
self-treatment should in all cases be avoided. This affection, 
above all others, needs the experience and skill of an honest 
medical adviser in whom the patient can place perfect confidence. 
The worst results come when patients treat themselves, and all 
the time read and worry about their disease. 

The sexual sense, whose origin is in the base of the brain, is 
the last (together with the reproductive organs, the power to 
reproduce species) in the series of development, and it is a rule 
in the animal economy that when the nervous system is attacked 
by disease, sameness, isolation, vices of civilization that the late 
evolved functions suffer first, and suffer before any other function 
is disturbed, so that a denizen of the United States living under 
the influence of our highly oxygenized atmosphere, our perni- 
cious moral area of fictitious literature, exciting food, unrestrained 
passions, solitary confinement, use of stimulants, tea, coffee, 
tobacco, whiskey, suffer through the nervous system a perver- 
sion of the sexual sense. The habit of self-abuse, before and 



gQQ DISEASE GERMS. 

after puberty, is often inherited, implanted in children who have^ 
been begotten with either parent in a state of inebriation. 

The philanthropist is eagerly scanning the horizon to see what 
modern medicine can do to stem this current of irreparable 
waste and national ruin. 

The growth, vigor and future prosperity of every nation de- 
pend upon the strength and energy of its young men, and if this 
practice is not arrested, effeminate, weak, nervous, and physically 
drained-out youths are to appear upon the scene. 

Victims of this, our national vice, need sound religious and 
moral instruction on their duties and responsibilities ; daily cold 
water baths ; flannel clothing ; avoidance of all insanitary states 
and isolation ; a liberal dietary ; open air exercise ; a daily pas- 
sage from the bowels, as a rectum loaded with foecal matter 
pressing upon the prostate urethra is an irritant, and anything 
that would re-invigorate the general health. 

The first indication in the correct treatment of a perversion ot 
the sexual sense is to cut off all sexual desire ; let the irritable 
prostate have the soothing, cooling influence of a genital seda- 
tive. This is best effected by the administration of large doses 
of the green root tincture of gelsemium, or the spermatorrhoea 
pill, or the cocaine suppository, which are infinitely superior to 
all bromides. These genital sedatives should be continued until 
the damaged parts regain their pristine strength or vigor. 

The second indication is to bring remedies to bear upon the 
sexual sense in the brain, to correct the perversion in or from 
which the habit originates. 

The first remedy that should be used is the phosphated tinc- 
ture of oats, which is of great utility in all cases of nervous 
bankruptcy as a remedy to feed and vitalize the brain, deepen the 
typical fissures of thought, to energize and rejuvenate the morbid 
sense, wipe out the atrophic paralysis and aid in a perfect renewal 
of nerve tissue. This preparation of oats consists exclusively of 
avena sativa, which is invaluable. 

Another invaluable remedy to wipe out this perversion of a 
natural sense is the ozonized glycerite of kephaline. 

No class of remedies are so valuable, in all states of perver- 
sion, as the chemical elements of the brain itself — '' cerebrin,'* 
which is of the highest order of vitalized bodies — the true elixir 
of life. If there be any failure in the absorption of this form ot 
phosphates, add to it small doses of some bitter tonic, as strych- 
nine. 

The damiana is a remedy of priceless value. In the cure of 
sexual perversion or self abuse it is a great vitalizer of the 
urethra, the prostate gland, the seminal vesicles, ejaculatory and 



BACTERICIDES. 



80 1 



the differential ducts and the tubes ; exerts a powerful effect upon 
the functions of generation, whether that effect be due to the ex- 
tension of morbid action through continuity of structure, or to 
reflex action, or to a morbid state of the brain, inherited or 
acquired. 

The true damiana must in no case be overlooked in the cure 
of any given case, as it is of great efficacy in sexual perversion, 
debility or lethargy, when due to abuse ; very effective in partial 
or complete impotence arising from this source. 

The comp. damiana soluble gelatine bougies are of great effi- 
cacy in correcting the perversion of the sexual sense. The in- 
troduction of one of those twice or three times a week up to the 
prostatic urethra, allowing it to remain, melt, run over the irri- 
tated, inflamed or strictured parts, the congested prostate and 
the orifices of the seminal ducts, absorb the remedy, which corrects 
the abnormal state of the sexual sense at the base of the brain. 
This forms the most efficient and successful treatment ever pre- 
sented for self-abuse, spermatorrhoea and impotency ; it has met 
with universal success, and effected the most astonishing cures 
of deplorably hopeless cases. 

It is local ; it is direct ; it acts reflexly upon the nerve centres, 
the diseased portions, the urethra, seminal ducts and vesicles ; 
good results are apparent from their very first use. 

The use of those bougies meets the pathological condition of 
the deep urethra, into which the seminal ducts open ; they 
soothe, heal, contract all the congested parts, stop the drain of 
the vital fluid, which by and by becomes thicker and healthier, 
the parts increase in size and the distressing nervous symptoms 
are relieved. 

In the perversion of the sexual sense, which give rise to self- 
abuse, we have seen that there is a tissue-starved brain ; and, in- 
cidental to that, there is always more or less damage done to the 
■parts. To repair this damage, the saw palmetto fills a gap that 
has long been needed. In its action it is a nutritive tonic to 
glands, as the parotid, mammae, ovaries, testes, prostate. When 
those glands have suffered atrophy and withered into nothing- 
ness, if administered it will cause them to bud out and grow, 
often to exceed their normal size and activity. In this class of 
cases it operates well ; it often overcomes the blight of varioco- 
cele, the atrophy of the testes, the spasm at the neck of the 
bladder, due to irritable prostate, and, take it all in all, the saw 
palmetto is of great value in all cases of sexual debility. 

The coca et celerina is a powerful nerve stimulant, promotes 
cohesion of cineritious substance of the brain, and exercises a 
healthy, invigorating action upon the perverted sexual sense, and 



802 DISEASE GERMS. 

relieves the mind of the depression incidental to the disease. 
The coca et celerina, internally, and coca suppositories, are very 
valuable preparations, if isolation has been at work, wiping out 
the typical fissures of thought, in creating this perversion of the 
sexual sense, or if mental strain and worry have given rise to 
genital and phrenal incapacity. 

A preternatural contraction of the foreskin 

Phimosis, over the glans of the penis, preventing it being 
drawn back. 

In infants, it is congenital, obstructs micturition ; in adults it is 
acquired by a variety of causes, as the irritation from the presence 
of sebaceous secretion, by clothing irritating the parts, by mas- 
turbation, irritating discharges (cocci) from the female, by gonor- 
rhcea, balanitis. 

Symptoms. — In children and adults, there is the long, con- 
tracted foreskin, which gives rise to obstruction in urinating, re- 
sembling stricture, or stone in the bladder. In some cases, an 
inability to urinate. In adults, the swelling, elongation and 
contraction are generally due to masturbation, gonorrhoea, 
chancres, and often causes great swelling of the areolar tissue, 
and balanitis. 

Treatment. — Warm bathing, hot hip-bath, with tobacco and bel- 
ladonna ; the local application of lobelia and belladonna ; inject- 
ing a hot infusion under the foreskin. If once back, a thorough 
ablution with warm water and lobelia; cotton-wool, with ozone 
ointment, around head and neck ; and then pull foreskin over, 
and repeat three times a day, inculcating rest, and bowels 
freely opened with salines. Get rid of cause upon which it 
depends. 

If all means fail, circumcision should be performed. This is 
performed in a variety of ways. 

As introduced by that great pathologist, Moses, to prevent the 
dissemination of venereal disease, it consisted in a simple slit- 
ting up of the entire length of the foreskin to the rim or neck on 
the upper or dorsal aspect, and excising a small piece like a V. 
This answers well enough in children or very young persons, be- 
cause the two bags or ears that are left are easily and quickly 
absorbed. The better plan in adults, is an entire excision round, 
only not interfering with the fra^num or bridle on the inferior 
aspect ; first slitting it up, and then clipping it off neatly with the 
scissors ; inserting eight or nine lead-wire sutures ; stitching the 
edges of the mucous membrane to the skin. Subsequently 
dressing with some antiseptic lotion, as lime-water, tincture of 
iodine, boroglyceride or resorcin, or creolin ; keeping all the time 
moist ; changing and destroying dressing twice a day. 



BACTERICIDES. 



803 



During parturition, especially if labor 

Phlegmasia Dolens. be tedious or severe; a condition in 
^Milk Legs) which the vitality of the uterus suffers ; 

or we could suppose a case in which 
ergot had been administered ; or the uterus had remained for 
some time contracted upon a placenta, or clot ; absorption by the 
ovarian lymphatics had taken place, and embolism of the blood 
eng-endered, thrombosis of the internal iliac and femoral veins 
taken place, giving rise to obstruction of the veins, radicles and 
capillary vessels, with implication of the lymphatics, giving rise 
to a painful, non-oedematous, hard, brawny swelling of the limb, 
attended with great prostration. 

Symptoms usually commence from one to six weeks after labor. 
On its first appearance there are rigors, fevers, thirst, nausea ; 
great pain, swelling, loss of motion of the affected extremity ; 
limb hot, tender, non-oedematous, but swollen and twice its natural 
size, of a pale white color, tense and elastic, having a glazed and 
shining appearance ; and even after acute symptoms have sub- 
sided, and limb remains enlarged for many weeks, even months. 

As there is a micro-organism in the origin of embolism and 
thrombosis, the same organism is present here, all efforts have 
failed in its cultivation, hence it is not pathogenic, but it bears a 
very close relationship to the micrococcus of puerperal peritonitis. 

The same treatment as for thrombosis, perfect rest, simple diet, 
anodynes to relieve pain, germicides, sedative and alkaline fomen- 
tations. 

An excellent fomentation is made by adding one pound of 
bicarbonate of soda, half a pound of peroxide of hydrogen and 
four ounces of poppies to one gallon of tepid water. The flan- 
nels should changed frequently ; applied over the entire limb, 
over the groin and lower part of the abdomen, whenever there is 
pain and tenderness. The heat and steam are to be retained by 
wrapping up the limb in impermeable cloths. Internally dioxide 
of hydrogen, acetate of ammonia and salicylate soda ; sulphide 
of lime, belladonna, general alteratives and tonics ; later on no 
remedy so efficient and beneficial as bandaging and bitter tonics. 



The medical press, and the entire profession 
Phosphorus are unanimous in advocating and urging upon 
•Disease. the people a diet containing more brain ele- 
ments, as oatmeal, corn m.eal, flour not de- 
prived of its phosphates, boiled white-fish, as being more condu- 
cive to health and longevity, and better calculated to increase the 
intellectual power of the nation ; that in these natural forms, 



8o4 



DISEASE GERMS. 



phosphorus does increase the depth of the typical fissures of 
thought, and improves the mental, still, we must say that phos- 
phorus as a remedy, isolated, and in various forms, is too reck- 
lessly and indiscriminately prescribed. Phosphorus water, tinc- 
ture of phosphorus, phosphorus et nux pill should not be admin- 
istered to any one who indulges in alcohol or tobacco, even in 
small doses, as it is very prone to irritate their stomachs an4 
cause either acute or chronic gastritis ; besides in the same class 
of patients it tends to engender fatty degeneration of the invol- 
untary muscles, and also of such glands as the spleen, liver, kid- 
neys, uterus. 

Operatives in phosphorus in match factories inhale its fumes,. 
which in a very short time produces progressive pernicious 
ayicemia, with great debility, albuminuria, loss of hair. Later on 
a peculiar form of necrosis of the bones, especially the superior 
and inferior maxillary. 

This form of partial death is due to disordered innervation, a 
failure on the part of the lymph canals, pink marrow, etc., to 
raise or elevate the blood discs. 

There is no known antidote to the presence of this poison in 
the system ; a change of occupation, a sea voyage, and a most 
generous diet is about all that can be done. 



In diabetes, chronic alcoholism, disease of 

Piarrhaemia. the liver and kidneys, degeneration of the 

(Fatty Blood}) suprarenal capsules, pneumonia and other 

morbid states in which the microbe " indican " 

appears in the blood. 

The presence of free fat and molecular albumen in the blood 
may be the result of indigestion, pregnancy and lactation. In 
the process of digestion the lactescence of the serum begins 
about two hours after the ingestion of food, and continues for a 
few hours. 

The serum is found turbid, opalescent and semi-opaque, a 
condition, however, which is only transitory, and due to the ab- 
sorption of fatty matter, formed into an emulsion by the pan- 
creatic juice and absorbed as such in the duodenum. It is en- 
tirely due to the presence of fat granules, and molecular granules 
of albumen. The passage of chyle into the blood renders the 
serum turbid^ the turbidity lasting until fatty matters enter in 
combination with the free soda of the blood. This condition is 
the result of disease. 

Various explanations have been offered as to the occurrence of 
fatty blood in disease. Some attribute it to the passage of un- 



BACTERICIDES. 



805 



altered chyle into the circulation ; others declare that the fat is 
set free in the blood for the want of a free alkali ; while another 
class maintain that it is fatty degeneration of the albumen of the 
blood ; and others insist that it is dependent upon a new combi- 
nation of fat. It is never found existing as an independent affec- 
tion, being invariably associated with some other disease, usually 
of the liver or kidneys. 

A chronic, non-contagious squamous affection 
Ptyriasis. of the skin of parts usually covered by hair, 
[Dandruff.) characterized by the exfoliation of minute white 

scales or scurf in large quantities. 
Sometimes acute, with a red base ; chronic with a white skin. 
Relapses and recurrence of the disease not infrequent. 

In all cases the skin, bowels, and especially the kidneys must 
be stimulated. The scalp should be washed with a borogly- 
ceride lotion, and the following mixture used as a hair dressing : 
Bay rum, one pint ; boroglyceride, one ounce : tincture lobelia, 
half an ounce ; tincture of cantharides, one ounce. Mix. Inter- 
nally, glycerite of kephaline, four ounces ; tincture nux vomica, 
half an ounce ; sulphate of quinine, one drachm. Mix. Dose, 
thirty drops added to water every three hours. Avena sativa 
excellent. Food nourishing, not stimulating, rest of mind. 



Peptone is a hydrated albumen, which nor- 
Peptonuria. mally, in passing from the gastro-intestinal 
tract, is mostly dehydrated, becoming the serum 
and albumen of the blood. Some of it appears to be taken up by 
the white blood-cells ; and when these are multiplied or broken 
up, as in acute suppurative processes, or scorbutic and septic 
affections, the peptone is discharged, and passes away by the 
kidneys. In gastro-intestinal maladies, it is possible that the 
peptone is not all dehydrated in its passage into the blood, and 
hence peptone reaches that fluid and circulates with it. 

Peptonuria is thus classed by Bourchard as gastro-enteroge- 
nous, hepatogenous, haematogenous, and phlegmasic. Looked 
at from another point of view (Ultzmann), it may be said to be 
present in three conditions : one a general one, including scurvy, 
typhoid, diphtheria, tertiary syphilis, pernicious anaemia, small- 
pox, cerebro-spinal fever, phosphorus poisoning, in which it 
seems to be connected with a general disorganization of leuco- 
cytes ; the second, a local condition, including pleurisy, croupous 
pneumonia, pericarditis, acute inflammatory rheumatism, in which 
It is connected with absorption of exudates rich in leucocytes ; 



3o6 DISEASE GERMS. 

the third, also a local condition, including gastro-intestinal dis- 
eases associated with imperfect absorption and dehydration of 
peptone. 

It also occurs from local causes in nephritis and genito-urinary 
catarrh. 

Peptonuria does not occur in large amount in the urine. ' The 
best of ordinary tests is, perhaps, prussic acid with heat and cold. 
Prussic acid precipitates peptones ; but the fluid if heated clears 
up, and then is clouded with peptone again on immersion of the 
test-tube in cold water. 

These are spots, or dots, which make their ap- 
Petechia. pearance in various microbial diseases. Chief 
among these are typhoid fever, typhus, small-pox, 
purpura, scurvy, but they may appear even from the ordinary 
bacteria of mal-assimilation. In these spots, whether a mere red 
spot, or an irregular patch of a dusky hue, indicative of blood 
lesion and alteration, the special germ is always to be found — 
the microbe which gives rise to the disease. 

Petechial spots require no special freatment, simply push mi- 
crobicides, which are the remedies in every case. 



The entrance of air into the pleural cavity 
Pneumothorax, usually gives rise to collapse of the lung. 

The most common causes are when 
the microbes of tuberculosis or pneumonia eat their way into 
the pleura. 

In additon to the symptoms of the disease under which the 
patient has been previously suffering, there will be sudden pain 
on the affected side of the chest, great pallor 
of the face, much difficulty and distress in 
breathing, and a general collapse of the vital 
powers. In most cases such an accident puts 
an end to the hfe of the sufferer. Pneumo- 
thorax may also be produced by external 
T^. .,, ^ conditions, as when a man is stabbed between 

Diagram illustrating the i ., i i i • r 11 

physical signs of pneu- the ribs, or whcn the chest is perforated by a 
"""^ °'^^'^' pistol-shot, etc. In both cases air enters the 

cavity, the lung collapses, and the patient breathes with the 
greatest difficulty. 

Invariably there is a shock, which must be met by the admin- 
istration of stimulants and opium, either in the form of pill, or 
morphia hypodermically. 

Diffusible stimulants, as ammonia, brandy, with inhalations of 




BACTERICIDES. 



807 



iodide of ethyl, or nitrate of amyl. The patient must be care- 
fully watched for signs of increasing pressure within the chest ; 
should be frequently nourished with small quantities of food of 
easy assimilation. 

Mercurial poisoning is very common, as it is 
Poison. used quite extensively in the arts. Artisans mak- 

{Merairy) ing barometers, thermometers, looking-glasses, 
etc., become thoroughly saturated with mercury. 

The amalgam used by dentists contains a very large percen- 
tage of pure quicksilver, which saturates the system of those who 
have their cavities filled. The finer the preparation, the more 
highly it is triturated, the more likely it is to be absorbed into- 
the system. There is much less danger from a blue pill, fol- 
lowed by a saline purge, than from high graded triturations. 

Physicians are aware of its destructive effects upon the blood, 
liver, and bones ; when it enters the blood it attacks the red 
discs and impoverishes them, later on, if persevered with, chronic 
inflammation of the liver, mercurial aphtha, stomatitis, destruc- 
tion of mucous membrane, especially of the throat, causes inflam- 
mation of the bones and periosteum ; nodes form, necrosis 
follows. 

. All who imbibe or inhale mercury either by the skin, bron- 
chial mucous membrane or stomach, for some time exhibit a 
peculiar metallic color of the skin ; emit a pathogenic foetor of 
the breath ; and have destructive bone pain in climatic changes. 

It is a bactericide of immense power, being co-equal with the 
dioxide of hydrogen, it will destroy, if it is administered, the 
syphilitic microbe, but unless it is given conjointly with the iodide 
of potass, it will create a mercuric diathesis, making the taker a 
living barometer. 

The practice recently of introducing the bichloride of mercury 
into lotions, washes, dressings for parturients, for all classes of 
wounds, should be discouraged by all Christian physicians, as 
we now have so many superior germicides for those purposes. 

So long as no organic changes have taken place, either in the 
liver or bones, from the use of mercury, it can be eliminated 
from the system by the administration of iodide of potass ; elec- 
trical baths, medicated with sulphuret of potassium. 

The chlorate and iodide of potass have a remarkable affinity 
for mercury in the body, they unite with it and eliminate it. 

Whether the human blood can be sterilized by the exhibi- 
tion of mercury, so as to resist the ingress of the syphilitic 
microbe, it is unnecessary to discuss ; true it is, that it operates 
that way in variola, and why not in syphilis ? 



8o8 



DISEASE GERMS. 



This is a term applied to all pear-shaped excres- 

Polypus. cences, or tumors, which grow from a cavity lined 

with a mucous membrane, such as the nasal fossae, 

ear, pharynx, uterus, vagina, bladder, more rarely in the stomach, 

intestines, bronchial tubes. 

);;^The predisposing cause is a peculiar modification of the tuber- 
cular diathesis, the exciting causes being in all cases, irritation. 








Microscopic appearance of the polypoid growth 
from a deep section in its embryonic state. 



Microscopic appearance st-ill 
later on, showing the zoo- 
type form. 



The two conditions, co-existing do not produce a disease- 
germ, but a neoplasm, properly speaking a zoophyte, whose com- 







External appearances, magnified 250 
diameters, from a shred of a polypus. 




Microscopical appearances, 
magnified 250 diameters, 
from the interior of a poly- 
poid growth. 



ponent parts or elements form a hybrid, a transition between the 
animal and vegetable kingdoms. This is true, whether the 
mass be gelatinous, or fibroid, pale or fleshy. 



BACTERICIDES. 



809 



Polypoid growths, mixed in their microbial constituents, be- 
long really to that class of tumors which we have designated 
papilloma, in which the 
living germs, bacterium (^ 

porri, tubercle bacillus, ^^^ 

with minute vegetable 
organisms, form the neo- 
plasm. This conglomer- 
ated or mixed organism 
i<s pathogenic of all poly- 
poid growths, bears cul- 
ture, and if eaten by or in- 
jected into animals will 
reproduce the disease. 

They are completely 
annihilated in the presence 
of peroxide of hydrogen, 
ozone et chlorine, naph- 
thaline, nitrate of sangui- 
naria, and other bacteri- 
cides. 

The prevention or 
eradication of the polypoid diathesis requires the same treatment 
as for tuberculosis, and the careful maintenance of a high state 
of vital force. 




Microscopical appearance of a perfect polypoid pro- 
tuberance. 



Polypi are found growing from the tympanum, 
Polypus, more especially its posterior wall, from the meatus, 
[Aura/.) and from the tympanic membrane. 
Pathology, — They are either mucous, fibrous, or myxomatous. 
The first named is composed mainly of a homogenous stroma, 
in which are round cells enclosed in a fibrous framework (Politzer.) 
In their interior may be found cystic spaces lined with epithe- 
lium. They are rich in vessels. The density of the growth 
depends on its gradual conversion of the round cells into fibrous 
elements. The fibrillar nature of the fibrous polypus distin- 
guishes it, and it is not so vascular as the mucous. True myxo- 
matous polypi are exceedingly rare. 

Those polypi which grow from the membrane and tympanic 
cavities are very vascular. They occur as the result of otitis 
media and chronic suppurative states of the middle ear. Polypi 
vary in size from that of a large mass which completely fills the 
meatus, and protrudes from it to a small growth, which it is diffi- 
cult to seize with the forceps. 



8lO DISEASE GERMS. 

Polypi may be multiple, severalexisting in one ear, and we may 
find them in both ears. There is often a considerable discharge 
of pus, which obscures the polypus, on the removal of which 
with a syringe the polypus comes into view. There is not neces- 
sarily pain during their formation, and the characteristic symp- 
toms are deafness with a discharge, which is occasionally mingled 
with blood. Those springing from the deeper portion of the 
meatus, or just in front of the membrane, frequently conceal a 
perforation of the latter. The dangers arising from the neglect 
of aural polypus are elsewhere referred to. 

Treatment. — If the polypus is of larger size, globular or pyri- 
form in shape, of the fibrous or fibro-gelatinous kind, we must 
resort to other means of removing the mass. It is well in these 
cases to determine as carefully as possible before operating, the 
size, mobility and seat of attachment of the polypus. This, as a 
rule, can be readily done with a probe. Most of the globular 
polypi which fill up the meatus are easily removed, with the 
ordinary small curved polypus forceps ; but the best instru- 
ment is the polypus snare of Wilde — the only difficulty which we 
meet with is the careful noosing of the polypus close to its at- 
tatchment. This, however, is seldom a matter of difficulty, and 
will be found less so if wire strong enough for the removal of 
the polypus, at the same time that it can be easily moulded so as 
to encircle the mass, is used. 

I have tried various wires for the removal of polypi. I prefer 
thin copper or iron wire if the growth is large and hard. Thin 
wire or fishing gimp can be used in ordinary cases. 

For operating on small vascular growths, either the rectangular 
ring forceps or the lever ring forceps is the best to use. This 
latter instrument is admirably adapted for this purpose. 

Free syringing will bring away any loose portions of polypus 
not removed by the forceps.- I have never had any hemorrhage 
to speak of after removal of any kind of polypus. I generally 
use a little very hot water if the bleeding is severe, and this is, as 
a rule, sufficient to control it. Occasionally it is not possible to 
remove the entire of one of these vascular polypi at one time, 
and we have to operate three or four times before the growth is 
cleanly extirpated. But the mere removal of these troublesome 
growths is only the first step in the process of cure. It requires 
often considerable forbearance on the part both of the patient and 
surgeon to follow up the treatment. Periodical touching of the 
exposed surface with some caustic is required, as well as the 
thorough cleansing out of the canal. Having wiped the raw- 
surface with cotton-wool, used with the armed aural probe, then 
the site of the polypus must be lightly touched with a fine pencil' 



BACTERICIDES. 



8ll 



of wool rolled on the point of the probe, and moistened with 
chloro-acetic acid. The crystallized acid is readily converted 
into a fluid state by the addition of a little water. We may also 
use the mullein oil with great success ; it entirely gets away with 
the root or pedicle, prevents the growth ; or perchloride of iron. 
But after a fair trial of many agents, I prefer the chloro-acetic 
acid to any for this purpose. One rule should be adopted in 
every case ; no one should be satisfied as 
to the cure of the disease until all dis- 
charge has ceased, and the surface from 
which the polypus has sprung presents a 
healthy appearance. 

Illustration of the cases of aural polypi 
which had been erroneously diagnosed 
as otorrhosa, otitis media, ulceration of 
membrana tympani, etc. 

All springing or growing from the 
membrana tympani; all were crude, 
polypi withered, died and disappeared 
by dropping ozonized mullein oil into 
the ear. 




A crescentic gelatinous, with central fibroid. 

Conglomerated mass, fibroid in centre, with gelatinous terminations. 

Small red gelatinous polypi growing firom the membrana tympani. 

Entire membrana tympani covered with a gelatinous membrane of some thick- 
ness. 

Four distinct nodules ; tubercle contents, with mucous covering. 

Three distmct growths, two large and one small pale fibroid. 

Three fibroid spring from the same source. 

Large mixed polypus, central elevation, firm, fibroid, with fibres running into gela- 
tinous edges. 

This and No. i6 are alike, single fibroid, with mucous covering. 

One distinct fibroid could be distinctly visible sprouting towards external meatus. 

Soft slate-colored excrescence covering the entire membrane. 

Two large lateral polypi ; three small central ; total deafness, which was com- 
pletely restored when they were removed. 

One large gelatinous mass, covering the membrane — perfectly deaf — hearing re- 
stored when it disappeared. 

Crescentic fibroid. 

One distinct irregularly shaped fibroid. 



The neglect of polypi may lead to the most serious conse- 
quences. On two occasions I have seen death with brain com- 
plications following on aural disease that was associated with the 
presence of a large polypus in the meatus. In both cases the 
symptoms of cerebral abscess were present. I saw the cases 
when the removal of the polypus was too late to avert the mis- 
chief. Such cases should act as a warning to practitioners not 
to simply pull away a polypus with a forceps or snare, and then 



gl2 DISEASE GERMS. 

send the patient home with the idea that he is cured, only giving 
him some simple lotion to keep the ear clean with. The polypus 
re-grows, perhaps the patient has the growth again torn away, or 
partially torn, as happens in many cases, and he now thinks it 
useless to apply for relief for that which is certain to return. 
And so he is satisfied to let things as they are until some formid- 
able symptoms are induced by the growth and the discharge. 
All this is the result of want of subsequent attention to the re- 
mains of the pedicle of the polypus or the granulations that re- 
main after its removal. 

Whenever a polypus is removed the patient should have im- 
pressed on him the necessity of a prolonged attendance or an 
occasional inspection of the ear subsequently, in order to prevent 
its re-growth, and also to get the meatus or other seat of the dis- 
ease into a healthy condition. 



These neoplasms in the nasal fossa are 
Polypus in either benign or malignant, they are met with 

Nasal Fossa, as mucous, gelatinous slate-colored or red; 
fibroid, pale, or red ; and either form may 
liave the microbe of cancer interspersed through it. 

They are all of mycomatous structure, pedunculated. 

The causes of these pear-shaped growths, or nasal polypi are 
confessedly obscure, evidently identified with tuberculae and 
hereditary syphilis. They are much more common among men 
than women. They may be of traumatic origin, but are also 
probably often due to any causes which induce or maintain in- 
flammation of the pituitary mucous membrane. From this point 
of view they may be a pathological derivative of hypertrophic 
rhinitis. But mere chronic inflammation can scarcely be alone 
sufficient to produce them, seeing that children, who are more 
subject to persistent catarrh than adults, are yet not nearly so 
liable to polypi. 

Pathology. — Mucous polypi are composed in part of the ele- 
ments of the mucous membrane, from which they spring. They 
are invested with ciliated epithelium, contain a few small blood- 
vessels, and are destitute of nerves. They consist chiefly of em- 
bryonic connective tissue. According to recent authorities, the 
cells composing their mass are first rounded, but subsequently 
become fusiform and stellate. The intercellular tissue is formed 
of stout and fine fibres, among which either connective or glan- 
dular tissue may predominate. In the former case, the polypi 
will appear as soft fibromata, in the latter as adenomata. They 
may occasionally be cystic and contain glands, but the cysts, if 



BACTERICIDES. 



813; 



such, have no true walls. The contents of the cavities are, as a 
rule, serous, but may become colloid, fatty, or mucous. Polypi 
in most cases exist as globular ovoid tumors, gray, semi-trans- 
lucent and jelly-like. They vary in size from that of a mustard 
seed to a walnut. The smaller ones are pear-shaped, but the 
larger take the form of the cavity in which they have been 
developed. They are attached to the mucous membrane by a 
pedicle of varying size and consistency, which is often pearly 
and fibrous in appearance. They may, however, have a broader 
base and even become sessile and immovable. 

The number of polypi present may be variable. They are 
seldom single and are often very numerous. I have frequently 
removed from thirty to forty from the nostrils of patients, but 
this number has in some recorded instances been much sur- 
passed. Thus, cases are mentioned in which sixty-five and even 
eighty have been removed. Generally, both nostrils are affected 
simultaneously, and may be completely obstructed from front to 
back. 

Polypi, on a cursory examination, appear to spring from the 
middle turbinated body, but it has been shown that they often 
have a deeper origin, viz., from the superior meatus or superior 
turbinated body. They may occasionally grow from the septum, 
or from the inferior turbinated body, or from the nasal roof, or 
from the outer wall, or from the floor of the nose ; but such 
positions are unusual. 

Symptoms. — The earliest symptoms of polypus are increased 
secretion from the nose, together with a sense of fulness and 
stuffiness and pain over the brow. As the neoplasm increases in. 
size, interference with respiration becomes more marked. There 
is a constant desire to blow the nose, but though this may be 
done frequently, and even violently, it gives no relief. It feels like 
a constant cold in the head, with a sensation of something mov- 
ing up and down in the nose. In proportion as the nasal fossa 
becomes blocked up the symptoms increase in severity, espe- 
cially in cold or damp weather. Later on breathing is carried 
on entirely by the mouth. If they are large and numerous they 
often cause atrophy of the bones of the nose by pressure, the 
septum being displaced, aspect of nose altered occasionally, they 
protrude externally. Naso-pharyngeal polypi give rise to an 
alteration in the voice and the sensation of a foreign body in the 
pharynx. Smell, taste are completely abolished. The lachry meal 
duct is blocked. If the polypi occupy only one nostril, or do 
not completely fill both, many of the above symptoms may be 
absent altogether or present in a minor degree. 

In most cases of polypus there is a remarkable train of symp- 



8 14 DISEASE GERMS. 

toms referable directly to the nervous system. These are head- 
ache, giddiness, failure of memory, migraine, neuralgia, asthma 
and even epilepsy. They may not all be present in any given 
case, and will, of course, vary in degree in each. It is probable 
that the presence of these symptoms depends in a great measure 
on deficient aeration of the blood, owing to the absence of nasal 
respiration. Carbonic acid poisoning is in fact taking place 
slowly but surely, and causing a condition of vital depression 
and mal-nutrition. It has been observed that asthma occurs 
more frequently in cases where polypi only partially obstruct the 
nostrils. The occurrence of the attacks during sleep, and their 
absence in complete obstruction, when patients necessarily sleep 
with their mouths open, is- an argument in favor of insufficient 
oxygenation. 

External examination may in many cases suggest the presence 
of a polypus. The alae of the nose may be dilated, and the nasal 
bones forced outwards. On examining the nostrils with a good 
light, one or more tumors will be seen occupying the nasal fossae, 
and having a gray gelatinous appearance. During forcible expi- 
ration and inspiration the tumors will be displaced. The probe 
will show their mobility, elongated form and pedunculated attach- 
ment. 

The progress of nasal polypi is slow but progressive, and they 
gradually fill up the nose, displacing the septum and forcing the 
nasal bones outwards. They may also protrude beyond the 
nostrils, and extend posteriorly into the pharynx. Rare cases 
have occurred in which the pedicle has been ruptured by some 
sudden effort of sneezing or blowing the nose, and a polypus has 
been expelled. But as these tumors are almost always multiple, 
no real alleviation is obtained from the removal of a single one. 
When of long standing- cystic cavities may form, and these as 
they rupture from time to time give some little relief to the 
patient. 

Diagnosis. — When polypi are sufficiently large to fill one or 
both nasal fossse the diagnosis is easy ; indeed, it is sufficient to 
see the tumors in order to recognize them. But the case is dif- 
ferent when the neoplasm is only partially developed. Care is 
then required in order not to confound polypus with hypertrophy 
of the mucous membrane, with deviations of the septum, with 
foreign bodies in the nasal fossae, and more particularly with 
thickening of the membrane covering the inferior turbinated 
bodies. This latter error is by far the most common, and is not 
unfrequently made. Attention to the following points are there- 
fore important. Polypi though often bilateral are seldom sym- 
metrical. The turbinated bodies form only one or two promi- 



BACTERICIDES. 



5 



nences, and are situated anteriorly and laterally. Again, the 
mucous membrane pits under pressure with a probe, while a 
polypus moves as one solid mass. If any doubts still remain, 
they may be set at rest by the application of a ten-per-cent. solu- 
tion of cocaine. This will not affect the polypus, but relieve all 
the congestion, and admit of seeing the polypus. 

The prognosis is good for a cure in all cases with bactericides. 
The treatment is quite elaborate, consisting either of interstitial 
injections, or perchloride ferri, or by snuffs of bayberry, blood 
root and sulphate of zinc, or better still, by injecting each one 
with a few drops of ozone et chlorine or peroxide of hydrogen, 
by inserting the nozzle of the hypodermic syringe well into the 
centre of the polypus and depositing the remedy. This at once 
■causes it to wither and die, without pain, hemorrhage, or any 
constitutional disturbance whatever. No force is necessary, sim- 
ply inserting the syringe with a rotary motion. 

Otherwise, excision, ligation, torsion may be tried. Each 
method has its advocates, its advantages and disadvantages. 
The disadvantages of the excision are, that they are painful to 
the patient, that they cause bleeding, and so obscure the field of 
operation, that they seldom remove the polypus as a whole, and 
that if used Injudiciously they may inflict irreparable damages on 
the nasal tissues. It is, however, but fair to add, that many 
operators of large clinical experience and undoubted skill prefer 
excision to any other method. In my own practice I reserve 
excision for two classes of cases, the first where the polypi are 
situated very anteriorly and are easily grasped, and where the 
movements of the instrument can be kept in sight ; the second, 
where the polypi are very large, and situated so far back that 
they cannot be snared. But generally in these latter cases ope- 
ration through the mouth, with the retro-nasal forceps is pre- 
ferable. 

For ordinary cases of polypi I do not hesitate to say that the 
wire snare, either cold or heated by electricity, offers the best 
means of removal. I generally operate in the following manner : 
The patient being seated on a low chair, the nostrils are dilated 
with the speculum and well illuminated by means of a frontal 
mirror. The polypi are then carefully examined with a probe 
and an estimate formed of their number and connections. A 
ten-per-cent. solution of cocaine is next applied by means of a 
fine nasal spray. By this not only is a better view of the 
growths obtained, but all pain to the patient is completely 
guarded against. The wire snare is then very carefully intro- 
duced into the nose in a vertical direction, and made to grasp 
the most anterior and perhaps smallest of the polypi. Traction 



gl(5 DISEASE GERMS. 

is made and the polypus removed slowly and gently, the same 
process being repeated until either the nostril has been cleared 
or until hemorrhage so far obscures the view that a little delay 
is advisable. But very often, with care, only slight bleeding will 
take place. It thus becomes possible to work backwards, re- 
moving small polypi, until a large one is met with. This latter,. 
when removed, will often give immediate relief, and restore the 
patency of the nostril. It is sometimes advisable after the re- 
moval of several polypi from one nostril to syringe it with an 
astringent solution, and to operate on the other side, returning 
to the former when the bleeding has ceased. A good deal may 
thus be done at one sitting. If the pedicle is narrow bleeding is 
slight, but more considerable when the attachment is extensive. 
Several operations will generally be necessary. The longer the 
time over which they are spread, the less trying will it be for the 
patient, and the less chance will there be of recurrence. 



Etiology. — Sex and age have an im- 
Polypus, portant influence on the grov.th of these 

Naso-Pharyngeal. neoplasms. They are almost, if not ab- 
solutely unknown in women, or beyond 
the age of thirty. They are met with chiefly in growing lads, 
between the ages of fifteen and twenty-five, and are fortunately 
excessively rare. 

Symptoms. — The earliest symptom is a sensation of fulness in 
the nose, with perhaps slight bleeding, and more or less interfer- 
ence with respiration. The constitutional symptoms are a dull 
headache, localized in one spot, and marked drowsiness, with an 
overpowering desire for sleep. Later on there is a mucous dis- 
charge, an alteration in the voice, deafness with partial or com- 
plete loss of smell, and difficulty of swallowing. At this period 
the tumor may be felt in the pharynx, or seen with the rhinoscope. 
The third and last stage is that of deformity, which is pathogenic 
of this terrible malady. As the neoplasm grows, it may, like a 
wedge, open up the bones of the face and base of the skull, the 
eye may be projected outwards, the palatine arch depressed into 
the mouth, the soft palate thrown forward, the temporal and 
zygomatic fossae filled, and the whole countenance assume the 
hideous deformity known as "" frog face." The cranial cavities 
may gradually be invaded, and the brain itself compressed 
or forced out in the form of a hernia. There may be profuse 
hemorrhages, endangering the life of the patient. When death 
occurs it arises from exhaustion, or from compression of the 
brain. 



BACTERICIDES. 



817 



The point of implantation of these tumors is still uncertain, 
but they probably spring from the basilar arch or pterygoid 
process. Attached to the mucous membrane by a broad base, 
are usually solitary, with rough, uneven surfaces, often attain a 
considerable size, and are very vascular. 

If a very large polypus occupy the whole of the posterior nasal 
fossae, it may be impossible to grasp it through the anterior nares. 
I have met with a similar difficulty in a case where, together with 
the polypus, there was also a bony growth in a nasal passage. 
In such cases it is best to pass the finger into the naso-pharynx, 
behind the soft palate, and endeavor to hitch the wire round the 
tumor, a procedure of some difficulty, or the polypus may be 
grasped by a forceps introduced post-nasally, or again by a snare 
of wire rendered incandescent by the galvanic current Such 
cases are among the most difficult to deal with. No strict rules 
can be laid down for operating, as so much must be left to the 
necessities of each case, and the inventive skill and dexterity of 
the surgeon. 

The galvanic cautery has much to recommend it, and will 
probably, in the hands of specialists, at any rate, gradually super- 
sede all other methods. It requires, however, not only con- 
siderable skill to use, but also special apparatus, and this will 
prevent its becoming popular in general surgery. With the elec- 
tric wire the operation is conducted much as with the cold snare. 
Cocaine should be used freely before operation, and the wire not 
heated till it has grasped the polypus. The current must then 
be passed slowly, so as to sever the tumor at a dull red heat. 
In this way bleeding v/ill be prevented. A platinum wire, which 
is always expensive and troublesome to procure, is not ab- 
solutely necessary, the ordinary iron or steel wire answering all 
purposes. 

Polypus, a peculiar pear-shaped growth. 
Polypus of the either gelatinous, fibroid or malignant, corn- 
Rectum, mon in the various orifices of the body in 
those of a tubercular diathesis, who suffer 
trom local irritation. When met with in the rectum, it is usually 
attached to the mucous membrane by a tendinous cord, smaller 
than the body of the tumor, but of the same substance as the 
main mass. We say that it is pear-shaped, but as those growths 
are usually inside the internal sphincter, and even very high up, 
their shape is apt to be elongated by pressure. But there is no 
other name that can be applied to them, they seldom, if ever 
have the same jelly-like consistence which belongs to those of 
the nose, but growths of a firmer nature are by no means uncom- 

52 



8i8 



DISEASE GERMS. 



mon. Rectal polypi are unyielding under pressure with the 
finger, commonly pale red in color, and fibrous, or fibro-cellular 
in texture. 

In size they are very variable, as small as a pea, prominent on 
the surface of the bowel, and in length from one-half to two 
inches or more, nearly cylindrical, of the thickness of a quill. 
Those little sessile bodies often detected when the bowel is ex- 
amined for other diseases, often give no trouble, but some reflex 
irritation. 

Polypi and polypoid growths of the rectum., whatever their 
texture may be, soft or firm, spongy or vascular, when they are 
not protruded from the bowel, and not attended with hemorrhage, 
produce very little inconvenience, unless they attain a large size, 
but if it is prolapsed it becomes the source of much annoyance, 
even of pain, and the alarming intensity of the reflex symptoms 
call for its immediate removal. 






wim ' 









Villous polypus in rectum, 
a very common form. 



Section of rectal polypus. 




The general symptoms are frequent desire to go to stool, and 
violent straining in the act of defecation ; protrusion of a fleshy mass 
frequently takes place with a discharge of blood and mucus. 
No symptom to be depended on unless it can be seen. 

The reflex symptoms, as aching in the back, numbness of the 
hips and posterior portion of the thighs, vertigo, pain in the 
back of the head, coated tongue, general derangement of' the 
nervous system. 

The favorite methods of removal are by the knife, ligature, 
ecraseur, torsion and by caustics. 

More recently, papoid, trypsin, etc., have been introduced 
into bougies and inserted, with most remarkable success. 

Polypus and stricture of the rectum intensify the predisposition 
to cancer, so does an exudation or exfoliation of the papillae and 
all other morbid states. 

Pockets, fringes, punples of the mucous membrane of the rec- 
tum, or thickened elongations or prolongations of mucous mem- 



BACTERICIDES. 



819 



branes, cone shaped, very pointed and sensitive at the apex, 
which is free ; very broad and thick at the attached base. These 
papillae vary in number from one to five or six, and in length 
from one line to half an inch, are not unlike in appearance the 
broken relics of a hymen. These papillae are always sources 
of irritation and should be at once removed. Transfix them one 
by one with a tenaculum and snip them off with the scissors. 
They are not found in every rectum, but are common. We also 
find pockets from one-eighth to an inch in depth, and their num- 
ber varies from one to eight. Their direction is always to the 
anus. The bottom of the pockets are usually very sensitive and 
contain an ulcer. You enter the pocket with a probe bent in the 




A polypoid excrescence attached by its 
pedicle to the rectal walls; often met 
with in tubercular subjects. 







Section of a rectal polypus. 



shape of a fish-hook, raise it up slightly and snip it off with the 
scissors. The operation is simple and does not need ether, ex- 
cept in very nervous patients. Now anoint your fingers with soap 
and water and introduce two of each hand into the rectum and 
stretch it for one or two minutes, or until the sphincter is par- 
tially paralyzed. 

Any one can guess as to the cause ot these pockets, papillae 
and fringes. They are not a normal condition, as is proved by 
their absence in a healthy rectum. They provoke irritation by 
reflex action in various portions of the body. By their re- 
removal you can cure a chronically-coated tongue in a short 
time. Their removal rapidly and permanently cures acne of the 
lips and tip of the nose, restores color to pallid lips and face, and 
it will relieve obstinate constipation, cure headache, spas- 
modic urethral stricture, cough, uterine congestion and other 



820 



DISEASE GERMS. 



troubles too numerous to mention. Rectal conditions influence 
waste and repair more than any other single point of the system. 
If not attended to cancer, is the inevitable result. 



Polypus, 
Umbilical. 



Polypus originating from the navel are very 
rare, but once in a great while we meet with one. 
The drawing below gives a very faithful ap- 
pearance of the microscopical characters of the 
growth in the case we have described. 

The section is taken transeversely to the long axis of the 
growth, and shows that the surface is covered with columnar 
epithelial cells of one-cell thickness. Opening out on this are 
the orifices of many glands. These glands are of the tubular 
variety, and reach towards the nucleus of the growth to the ex- 
tent perhaps, of one-third 
the diameter of the poly- 
pus or less. Many are seen 
in transverse or oblique 
sections, others are cut in 
the direction of their long 
axis. They end blindly, 
are not branched at their 
extremities, and are lined 

^i^-^^M^^^^^^^^M^^^ throughout with a single 
.^w**y ^,«*.-.A^x i. . v^ . ..v;.,.v layer of columnar epithelial 

cells, many of which are 
beautifully goblet-shaped. 

Supporting these is a fine 
and very bountifully nucle- 
Lying under the investing layer of 
columnar epithelium, and supported by the connective-tissue 
growth just mentioned, are many vessels, chiefly cut longitudi- 
nally, which are intensely gorged with blood, and during life 
gave the scarlet hue characteristic of the tumor. 

The centre of the growth consists in large measure of bundles 
of involuntary muscle-fibre, here seen for the most part in longi- 
tudinal sections, but some of them are cut transversely to their 
lon^ axis. A few muscle filaments appear to entwine in the con- 
nective tissue round the glands at their central terminations. In 
addition, in the central area, many vessels of large size are seen 
cut in various directions. 

Umbilical polypus with a large base may be obliterated or re- 
moved by electrolysis ; if the pedicle is small, ligation, torsion, 
excision may be resorted to, according to the ideas of the surgeon. 




Umbilical polypus. 



ated connective tissue. 



. BACTERICIDES. 



821 



We find those pear-shaped excrescences 

Polypus of the growing from all parts of the mucous mem- 
Uterus, brane of the uterus, such as the cavity, 
neck, OS, or in any part of the vagina, by a 
root, pedicle, or stem. 

Three varieties are common: (i.) gelatinous, or mucous; 
(2.) fibroid, pale, covered with mucous membrane; (3.) fibroid, 
fleshy or placental. 

The predisposing cause is the tubercular diathesis ; the excit- 
ing causes, any kind of irritation, such as sexual incompatibility, 
frequent abortions, masturbation. 

Symptoms. — Either profuse menstruation or irregular attacks 
of uterine hemorrhage, or a dribbling all the time, or often ex- 
cessive bleeding; profuse leucorrhoea. It must be borne in mind 
that hemorrhage or flooding, may result from an alteration of 
the structure of the uterus, and an examination in all cases 
should be made, so as to determine the cause. Profuse dis- 
charges from the 
uterus are the pre- 
cursors of abortion ; 
some arise from 
scirrhus ; others 
from polypi. 

If a hemorrhage 
comes on suddenly, 
with pain in the 
back, abdomen, 
thighs, bearing 
down, it resembles an abortion. But if the discharge of blood 
has continued for weeks, giving rise to cerebral anaemia, pasty 
complexion, lancinating pain in the uterus, with a fetid discharge, 
the cancer germ has probably localized itself But if there are 
recurrent hemorrhages, unattended with pain, anterior and pos- 
terior, it would be well to examine for polypus; if this hypo- 
thesis is correct, instead of finding an empty vagina, there will 
probably be found a tumor, varying in size from that of a walnut, 
apple, or child's head. 

As a general rule, the polypus, if present, is easily detected in 
the uterus by the sound, or if on the neck or vagina, by the 
speculum and finger. 

Treatment. — If the polypus is in vagina, or on the neck, or os, 
any of the following methods of treatment can be resorted to : 
It can be excised, and bleeding arrested with a sponge, proper 
size, saturated with perchloride of iron ; it can be ligatcd, and 
allowed to slough off; torsion can be used, that is, it can be 




Gelatinous polypus, hanging from the fundus of the uterus, pro- 
truding a little beyond the plane of the orifice — hemor- 
rhages very threatening. 



822 



DISEASE GERMS. 



turned a little every day, thus impeding its circulation, strangu- 
lating it, and allowing it to slough off; or the chain of the 
ecraseur can be applied round it, and crushed ; or, if it can be 
brought into a speculum handy, the ozonized chloride of chro- 
mium can be applied, and cause its in- 
stant death without a particle of pain. 

If in the cavity of the uterus, the os 
uteri must be dilated, and it may then 
either be snipped off or ligated. 

If in the cavity of the uterus, gelatin- 
ized bougies, prepared with papoid or 
trypsin, introduced daily into the cavity 
of the uterus, causes those excrescences 
to wither and die. To those in the 
vagina, touching them with lactic or 
chromic acid, has a marked effect in 
their destruction. 

This cut illustrates a case of polypus 
of the uterus, with an infiltration of the 
neck and body with the cancer microbe ; 
the polypus hanging from the os uteri ; 
with a cancerous nodule on the posterior 
vaginal wall. The cachexia well marked, 
pain anterior and posterior, diurnal hem- 
orrhages, followed by fetid discharges. 
The vagina was first packed with boroglyceride paste for 
twenty-four hours, which produced a marked withering of the 
polypus, so much so that it admitted of an easy exploration, 
permitting the pedicle 
of the polypus being 
freely painted with >^ ^-- , ^ ^' 

a strong lactic acid. 
The packing of the 
vagina with borogly- 
ceride was performed 
every night for four 
consecutive times, 
wnen the polypus was 
expelled and the hem- 
orrhages in a great 
measure ceased. The 
vagina and neck of the uterus were syringed three times daily, 
after each a boroglyceride pastile was inserted up against the 
neck of the uterus and permitted to dissolve. 

This diagram represents the dual microbe of polypus and can- 




Diagram of polypus. 




Polypus, with infiltration of the neck with cancer germ. 



BACTERICIDES. 



823 



cer on the cervix uteri ; a nodular growth just rupturing, with a 
most offensive discharge, tinged with blood. Occasionally 
hemorrhagres. In this case there was the diathesis, anterior and 




Internal polj'pus, with epithelium of the neck, encroaching upon the cavity. 

posterior pain, infiltration of the lymphatic glands of the groin; 
the body of the uterus was considerably infiltrated. A micro- 
scopical examination of the vaginal discharge revealed the fact 
that it consisted almost entirely of liv- 
ing and dead germs. The local appli- 
cation in this case was the application 
of the contents of half a dozen jequi- 
rity wafers to the ulcerated surface, 
which caused a large mass to exfoliate, 
then following with the boroglyceride 
injections and pastiles. Twice a week 
painted the germ-laden parts as far as 
it was possible to reach with lactic 
acid. 

This illustration shows an internal 
polypus of the uterus, with epithelium 
of the neck ; the internal polypus was 
first diagnosed and neglected ; the 
daily hemorrhages became exhaust- 
ing, and latterly carcinoma appeared. 
This latter commenced as an indura- 
tion. 

The local treatment consisted in painting the parts affected 
with lactic acid, using the boroglyceride injections and pastiles. 

As the cancer microbe has a remarkable tenacity of life, and 




A large mixed polypus, fibroid and 
red, gelatinous, growing from the 
neck of uterus, cured by injecting 
with peroxide of hydrogen. 



324 DISEASE GERMS. 

as the Chian turpentine mistura is antagonistic to its existence, 
nearly all cases may be readily cured with this remedy. 

The Chian turpentine mistura is composed of the best selected 
Chian turpentine, ethereal peroxide of hydrogen, resorcin, thal- 
lin and other germicides, which, when they enter the blood, 
come like an avalanche upon the germ, and destroy it. 



Urethral polypi, usually of the fibroid 

Polypus of the variety, are occasionally found protruding 

Urethra. from the male urethra, causing occlusion of 

the canal. 

Pathological products are sometimes met with in the fossa 

navicularis, which present a structure absolutely analogous to 

that of the vegetations seen on the surface of the prepuce and 

glands. They are slowly developed in the interior of the canal, 

where they preserve an elongated shape, but spread as soon 

as they have passed outside of the meatus. 

Polypoid growths in the urethra being of the character of 
papilloma (bacterium porri), are readily got rid of by the inter- 
nal and local use of thuja, filling the urethra, or inserting a gela- 
tinized bougie of the same. By the use of this remedy, all irrita- 
tion is avoided ; the oil is the best form. 



In all deviations from health, all 
Poison of Subjects, states of vital depression, bacteria 
(Cadaveric Alkaloids^ evolved from the normal living matter, 

and the microbes of disease from 
without are present and play an important part in the transition 
from life to death. 

When life, or the soul element, leaves our bodies, the corpo- 
real part enters a new sphere of existence in the form of micro- 
bial life. All forms of micrococci, streptococcus, bacterium and 
bacilli are evolved, they eat up all the pabulum obtainable for 
their growth and development and either die or are converted 
into other living organisms, dual, triple or quadruple germs, and 
this process continues until our bodies are reduced to their 
original constituents, water, carbonic acid gas, ammonia, and 
earthy salts. 

During this stage of microbial existence, of chemical change, 
of prodigious growth, we have every known micro-organism 
with its deadly alkaloid (ptomaine), present. If, at any stage of 
bacterial existence, the most minute particle be introduce into 
the living blood of man, it will breed with most extraordinary 
rapidity ; the germs indeed have their vitality augmented and 



BACTERICIDES. 



825 



produce in the living organism precisely the identical state of 
decomposition, which they were pushing forward in the dead. 

The olfactory nerve also, of an educated physician, recognizes 
^in the odors of the cadaver the various micro-organisms present, 
•even the one which caused the death of the subject. The micro- 
organisms of the dead are keenly active in the subject, so much 
so that in the atmosphere for one hundred feet around it they 
can be detected, and within that radius they can also be found in 
mouth, eyes, hair and clothing of the attendants. 

With an open mouth, they enter the salivary glands of the 
oral cavity and descend to the stomach, giving rise to gastro- 
intestinal irritation. 

With regard to dissection wounds, we must bear in mind the 
following facts : that all subjects are but one mass of disease- 
germs, being more or less virulent according to the disease, or 
species of bacteria which induced the separation between soul 
and body. Injecting the subject with either chloride of zinc or 
arseniate of -soda solutions, or even the oil of cloves, or peroxide 
of hydrogen, does not destroy the germs and its spores, they 
simply for the time being induce a latency. There is no bacteri- 
cide which will destroy the comma-bacillus of epidemic cholera, 
or the streptococcus of diphtheria, or erysipelas, etc. 

It is also well to bear in mind that the more highly developed 
the dissector, the more finely organized the brain and muscle, 
the greater is his affinity or inhibitory power to take in germs. 
This is true of all animal matter. 

Inoculation, through a scratch, abrasion, indentation of or 
^from the microbial mass, a subject will produce in the living 
the same growth of micro-organisms ; but if the subject has slid 
off his immortal through the agency of the microbe of phlebitis, 
erysipelas, typhoid fever, pneumonia, etc., then the case is bad, 
and an inoculation is followed by grave results. 

In the management of such wounds or inoculations, the per- 
oxide of hydrogen stands first among all remedies — applied 
locally, administered internally. No well-conducted dissecting 
room can afford to be without this bactericide. 

Its use supersedes all our old remedies ; students, nurses, 
washerwomen, should have it handy, C. P., and medicinally pure. 



Polyuria always indicates some affection of the 
Polyuria, parts of the brain situated in or near the posterior 
fossae, the cerebellum, pons, and medulla oblon- 
gata, but that the material on hand does not permit a more ex- 
act localization. 

It is a symptom showing an irritation of the cerebral parts 



826 DISEASE GERMS. 

concerned, but it is never only a functional disturbance. Poly- 
uria, especially if not permanent, might, therefore, indicate a pass- 
ing hypera^mia, or an otherwise transiently irritated state of the 
portions of brain-tissue mentioned, but if continuous and not 
amenable to treatment, the same symptom would be an evidence 
of some organic lesion of the same cerebral parts. This theory 
is confirmed by the empirical observation, that ergot is the only 
remedy which has thus far resulted in a cure of polyuria. This 
drug has been tried in cases of that kind, where it has been suc- 
cessful. Ergot, as well known, causes a contraction of the 
capillaries and, therefore, a diminished blood supply mainly in 
regions specially rich in capillaries, as the brain and spinal cord. 
A transient hyperaemia will thus be relieved, and the polyuria, 
when due to the latter, disappear under the influence of ergot. 
But when the prolonged administration of this remedy does not 
diminish the flow of urine, the suspicion is warranted of an or- 
ganic change in the parts mentioned of the brain being respon- 
sible for polyuria. In such cases the symptom is of grave import, 
and usually predicts the fatal issue of the case. The fact that 
polyuria, if of long duration, occasionally ends in diabetes, also 
is explained by the statements above made. 



This is normal in old age and is 

Porrigo Decalvans. usually preceded and accompanied by 
{Baldness.) grayness {canities). Premature bald- 

ness may occur from failure of general 
health, as a consequence of eczema, seborrhoea or other disease of 
the hairy scalp, or without apparent cause. It often seems to be 
hereditary and is most common in males. It generally begins at 
the top of the head and tends to spread from thence. The hair 
gets thin before any patch becomes completely bald. 

Treatment. — Senile baldness is not very amenable to treatment. 
Premature baldness may be treated with more hope of benefit. 
Any disorder of the general health should be attended to, and 
any cutaneous disease present on the hairy scalp should be 
treated. When any obvious general or local affection has been 
attended to, local stimulants may to some extent promote 
the growth of hair. Various preparations of cantharides are 
often employed, and lotions containing ammonia have been 
recommended. 

The following formula may prove useful : 

Bay rum, one pint; tincture of lobelia; tincture of cantharides, 
of each one ounce ; boroglyceride, two ounces. Mix. 



BACTERICIDES 



827 



Wash scalp with castile soap, dry well. Use the above for a hair 
dressing-. 

Alopecia ar. differs from the ordinary form in several important 
particulars. As implied by the name it occurs in isolated patches, 
not as a general thinning and falling of hair. Rest of hair often 
grows with great vigor. It is not preceded by grayness. The 
patches attacked get perfectly bald and as smooth as the surface 
of a billiard-ball. It may attack the beard and whiskers as well 
as the scalp ; also the eyebrows and other hairy parts. The dis- 
ease is not one of old age, but of early life. Children are more often 
attacked than adults, and women more commonly than men. 
(Ordinary alopecia is more common in men.) Distinguished 
from ringworm by the absolute baldness and smoothness of the 
patches which present a marked contrast to the broken stumps 
seen in ringworm. A characteristic feature is the presence of 
short clubbed hairs at the margin of the patches. Recovery in 
in some cases spontaneous, but disease is apt to recur. It often 
tends to run in families. Often found associated with excessive 
brain-work (school children) and worry. Has hence been re- 
garded as a neurosis. Also been considered a vaso-motor, or 
trophic lesion,' but a microscopical observation shows a parasite. 

Treatment. — The general health should be attended to and 
tonics given if needful. Glycerite of kephaline and tincture of 
oats internally often gives good results if persevered in for some 
time. Local stimulation may do some good. The patches may 
be painted at intervals with jaborandi fluid extract, or equal parts 
of the liniment and tincture of iodine. An ointment or lotion 
containing cantharides may also be of service. 

Canities, or Acquired Whiteness of the Hair. — Grayness of the 
hair is a common precursor and accompaniment of baldness as 
already mentioned. It is due to deficiency of pigment. In 
those rare cases in which sudden blanching of the hair has fol- 
lowed great emotion it is said to be due to the formation of air- 
bubbles in the shaft of the air. 

Treatment. — Not very effectual. Tonics (especially oats) may 
be given and local stimulants used, such as cantharides. Kaposi 
recommends the use of fatty oils, as those of mace, walnut, or 
cassia. Persons wishing to conceal it very generally consult 
their hair-dresser and use some form of hair dye, which he finds 
it profitable to sell to them. Lead is a frequent ingredient in the 
popular nostrums sold and darkens the hair by chemically com- 
bining with the sulphur in it to form a sulphide. A lead comb is 
often used. 



828 DISEASE GERMS. 

Conception consists in the fertilization of 

Pregnancy and the ovum or egg of the female, by the sper- 

Parturition. matozoa of the male in the ovaria ; then 

fecundation takes takes place. There must 

be a union of the two materials furnished by both sexes ; that is, 

the spermatozoa must unite with the egg in the ovary and fertilize 




Side view of viscera, female pelvis : r, vagina; 2, bladder; 3, Interior of rectum; 4, uterus ; 
a, fundus ; d. cervix : ,c,c, os uteri ; d, posterior portion ; g, anterior portion ; 5, rectum, 
here cov red by peritoneuiti ; 6, 6, 6, sacrum; 7, coccyx; 8, labia minora; 9,labia majora; 
10, urethra; 11, symphysis punis ; 12, clitoris ; 13, mons veneris ; 14, urachus ; 15, section 
of peritoneum ; 16, last lumbar vertebra ; 17, broad ligament; 18, ovary. 

it ; and the embryo results from this union. The spermatozoa is 
ejaculated into the vagina ; the uterus, by inhibitory action and 
vermicular movements, takes it into its cavity, and passes it along 
the fallopian tubes to the ovaries. It may occur without the 
patient being conscious of its occurrence, or against her will. 



BACTERICIDES. 



829 



The most favorable period for conception to take place is either 
before or after a menstruation. After the ovum is impregnated, it 
increases in size and becomes prominent on the ovarium ; then 
absorption of the peritoneal coat takes place ; and when free, is 
seized by the fimbriated extremities of the fallopian tube, and 
carried into the cavity of the uterus. 

The ovum, as a general rule, is found in the uterus twenty days 
after impregnation, sooner or later. 

After the exfoliation of the ovum from the ovary, an effusion 
of blood takes place into the cavity in which the egg was em- 
bedded, and this is followed by a corpus luteum. 

The human impregnated egg is very small, about the size of 
a dwarf pea. When impregnation takes place, the internal os 
uteri becomes closed by a soft, gelatinous substance, and the 
internal lining membrane of the uterus throws out a flocculent 





A fair standard specimen of a 
virgin ureius ; 2^ inches in 
lenjth, 1% inches in width, 
and 2j^ ounces in weight. 



Interior view of the same 
uterus. 




enne cavity. 



or downy substance, which fills its cavity entirely. This is 
called the membrana decidua, and into this downy bed the 
ovum drops when it makes its exit from the fallopian tube, and, 
if not disturbed, will form its attachment near the point of 
ingress, and cause a growth of that part with which it comes 
in contact, and is called the decidua reflexa. So that the decidua 
is now divided into that portion lining and in contact with the 
uterus, called the decidua vera, and the other portion called the 
decidua reflexa. 

The embryo then becomes covered with two membranes — 
the chorion and amnion. The amnion is an internal lining of the 
serous membrane, which furnishes a fluid for the protection ot 
the embryo ; allows space, facilitates motion and development 
of the foetus, and wards off shocks, jars, concussions. The 
chorion, or outside covering, furnishes a means of communication 
with the uterus 



830 



DISEASE GERMS. 



The ovum, after its establishment within the uterus, consists of 
the decidua, decidua reflexa, chorion, amnion, hquor amnii, foetus, 
and umbilical chord, with one extremity attached to the child, 
the other to the membranes at the point of attachment in the 
after-birth. The after-birth, or placenta, is a plexus of vessels by 
which the circulation is maintained between mother and child, 
and by which the latter is nourished. When of full size, it is 
from six to eight inches in diameter, and in thickness varies 
from a line to one inch, or more, at its centre. It has two 
surfaces: one attached to the uterus, which is rough, spongy, 
traversed by ditches ; and the foetal side, which is lined by the 
amnion, which is smooth. 

For the first three months of intra-uterine existence, this twig 
of humanity is termed an embryo; the latter six, a foetus. 
As soon as impregnation takes place, the walls of the uterus 
become greatly infiltrated with blood, which increases the size of 
the vessels from being very small and convoluted, to that of large 
and straight ; the muscular fibres grow with perfect regularity. 
This increase of growth and development for the first three 
months is very great, .«o much so that the specific gravity of the 
uterus is such that its broad ligaments are unable to hold it 
up, and it descends very low into the cavity of the pelvis, often 
nearly protruding. After the fourth or fifth month this difficulty 
is entirely obviated, by the uterus floating above the pubes ; and 
at six months it is still higher. After the fifth month there 
is a gradual distension of the body of the uterus, which en- 
croaches upon the neck, distending it, merging it into the 
body, and causing it to become shorter and shorter, until, 
from the eighth to the ninth month, it is entirely obliterated ; that 
is merged into the body. 

Signs and symptoms of pregnancy are divided into rational and 
sensible signs. The rational signs embrace : 

First and Second Months, — A stoppage of the menses, nausea, 
vomiting, flatness of the abdomen, depression of the umbilical 
ring, tumefaction and tenderness of the breasts. 

Third and Fourth Months. — In addition to the above, there is 
now a slight fulness of the abdomen, augmented swelling of the 
breasts, prominence of the nipple, and discoloration around 
areolae. 

Fifth and Sixth Months. — The disturbance of the digestive 
organs usually disappears ; abdomen becomes well rounded and 
full, and the uterus can be detected above the pubes ; fluctuation 
can be detected; and the color around the nipples becomes 
brown. 

Seventh and Eighth Months. — Abdominal tumor large ; dis- 



BACTERICIDES. 



83 



coloration of the skin of the abdomen common ; often varicose 
veins of the leg, labia, vulva ; vaginal granulations ; leucorrhoea, 
pruritus, and real copper-color around nipple ; and suppression 
of the menses through the entire nine months. 

First Half of the Ninth Month. — Vomitings liable to re-appear ; 
the abdominal swelling is so great that the skin of the abdomen 
is stretched, tense ; there is difficulty of breathing ; oedema of 
feet. 

Last Half of Ninth Month. — Vomiting ceases ; abdomen re- 
laxes ; uterus descends ; there is less difficulty in breathing, but 
more in walking ; often difficulty of urinating — sometimes sup- 
pression, in other cases an inability to hold it ; often piles ; vari- 
cose veins of the leg ; pains in the loins ; cramps in the legs ; 
colic, etc. 

The sensible signs embrace : 

First and Second Months. — Augmentation in the size and 
weight of the uterus causes that organ to descend low down in 
the pelvis ; it cannot be moved easily ; its walls touch the neck, 
which is directed downwards ; the orifice or mouth is rounded, 
swollen, and a slight softening of the lips. 

Third and Fourth Mo7iths. — The fundus of the uterus rises 
above the pubes, and a rounded swelling can be detected by palpa- 
tion. Making the patient stand up, and putting the finger on the 
OS uteri, and lifting it up, it drops suddenly down on the finger. 

Fifth aud Sixth Months, — The fundus can now be detected 
below the umbilicus ; there are active movements of the foetus ; 
foetal heart can be detected distinctly, indeed, it is very percep- 
tible. The uterus can be mapped out, fluctuating, rounded ; and 
the lower half of the neck of the uterus is softened, and the neck 
now begins to lose itself in the distension of the. body. 

Seventh and Eighth Months. — The increased size of the uterus 
and abdomen ; the fundus of the uterus is three finger-breadths 
above the umbilicus at the seventh month, four or five at the 
eighth; movements of foetus stronger; foetal heart very clear; 
neck disappearing in the body. 

First Two Weeks of Ninth Month. — The fundus of the uterus 
reaches the borders of the false ribs, clear up to the stomach ; 
foetal heart very strong ; neck of the uterus gone entirely into 
the body ; the mouth of the uterus open. 

Last Fortnight. — Fundus sunk low down ; movements active ; 
mouth of uterus open, soft, dilatable ; the whole cavity of the 
neck becomes confounded with that of the body. 

The entire period of pregnancy occupies nine calendar months, 
or forty weeks. Time varies somewhat, as to whether concep- 
tion took place immediately before or after menstruation. 



832 



DISEASE GERMS. 



Pregnancy may be protracted in some rare cases ; that isy 
carried out beyond two hundred and seventy-eight days, the 
interval between the last day of the menstruation and the ex- 
pected confinement, and at least a fortnight more than this. 
There is no very exact time, or number of days, to which preg- 
nancy may be protracted ; still, it would be safe to maintain that 
in no case can it be prolonged over three weeks beyond the 
natural period. 

Development of the Foetus. — Fifteen days after the ovum or ^^^ 
appears in the uterus, it is a gelatinous, semi-transparent, floccu- 
lent, grayish mess ; at thirty days, the size of a large ant, and 
from three to five lines in length ; at six weeks, ten lines in 
length, about the size of a. bee, but some of the organs, in a very 
rudimentary state, visible ; at two months, two inches long^ 
weighs two ounces, and ossification has commenced at some 
points; at three months, three and-a-half inches long, weighs 
three ounces ; umbilical cord well formed, and genital organs 





Ovum and embryo at the sixth week, A foetus at fort' -five days and at 

two months. 

distinct ; at four months, five or six inches long, weighs from 
four to five ounces; at four and-a half months, c\mckQn'mg, or 
motion, is felt by the mother, or by placing the cold hand on the 
abdomen, and it is now from seven to nine inches in length, and 
weighs from nine to ten ounces ; at six montJis, parts pretty fully 
developed, and weigh from one to two pounds, and its length 
from nine to twelve inches ; at seven months, all parts are per- 
fectly developed; weighs from two to three pounds, and in 
length from twelve to fourteen inches, or more, and perfectly de- 
veloped ; at nine months, usually twenty inches long and average 
weight seven pounds ; bones of head firm ; ossification more 
complete, and all the organs capable of performing their natural 
function. 

Some variations in the above, but it gives the general average. 

There may be several eggs fertilized, so that there may be 
twins, triplets, or quartlets. Pregnancy may occur outside of 
the uterus, extra-uterine ; it may take place in the ovary, and the 
embryo develop there ; or it may be developed in the fallopian 



BACTERICIDES. 



833 



tube, or in the abdomen, or the ovum may find its way into 
the muscular coat of the uterus and be developed. The conse- 
quences of such are usually serious, causing inflammation, 
ulceration, suppuration, internal hemorrhage, and death to the 
mother. 

When pregnancy takes place, and the woman knows she is in 
that state, she should eat the best of food, take moderate exer- 
cise, but avoid hard work or any strain, and above all, keep her 
bowels regular by eating sufficient fruit, or using enemata of milk 
and water. She should make a regular habit of either sponging 
or bathing the entire body once a day. All gloomy or idle fears 
should be banished ; no tales of woe or sorrow told in her pres- 
ence ; her surroundings should be of the most agreeable kind, 
and she should ^lace her trust in the benevolence, mercy, and 
wisdom of her Creator. Her clothing should be flannel, next 
the skin, at all seasons ; she should have abundance of sleep, and 
all symptoms in this state should be managed with as few drugs 




Diagram of the fcEtus and membranes about the sixth week : a, chorion ; h, the larger absorbent 
extremities, the site of the placenta ; c, allantois ; d, amnion ; e, urachus ; e. bladder ; f, vesi- 
cular unibihcalis ; ^. communicating canal between the ^vesicular umbilicalis and intestine; 
h. Vena um^Jilicali^; t, i, ar erise umbilicalis; k, arteria omphalj-meseraica; /, vena omph<ilo- 
meseraica; n, heart; o, rudiment of superior extremity; p, rudiment of lower extremity. 

as possible. The sickness of the stomach is one of the earliest 
of all symptoms, and should be treated with the plainest bitter 
tonics. 

General symptoms of pregnancy are reflex; that is, they are de- 
pendent in a great measure upon some loss of tone, or weakness 
of the reflex centres, the medulla oblongata and spinal cord ; so 
that when pregnancy or any condition of molecular activity of 
the uterus takes place, the excitement or hyperaemia is trans- 
mitted to the cord and bulb ; directly from the uterus to those 
centres, and thence along any weakened nerve, hence we have 
{d,<z\?\neiLroses, toothache, salivation, if the nerves supplying those 
nerves are weak ; nausea, vomiting, headache, heartburn, water- 
brash, constipation, diarrhea, if the nerves of the stomach have 
suffered a partial loss of vitality ; or there rnay be syncope, 
aphonia, difficulty of breathing, insomnia, hypochondriasis, con- 
53 



834 



DISEASE GERMS. 



vulsions, abnormal states of sensation, sight, and hearing ; vari- 
ous neuroses, even chorea, epilepsy, catalepsy. 

Now with reference to these and numerous other symptoms, 
we would say : palliate them in the best manner possible, and 
above all things avoid medication during pregnancy. 

It is well to forbid the use of all malt or alcoholic drinks, as 
they dwarf and whittle down the elements of humanity ; predis- 
pose to fatty degeneration of the uterine fibres, and hemorrhage, 
give rise to miscarriage and brain failure in the infant ; forbid 
all impressive sights ; and the inhalation of all anesthetics, espe- 
cially nitrous oxide gas for the painless extraction of teeth, be- 
cause the nitrate of ammonia, of which it is composed, increases 
the alkaline constituents of the blood, and is very liable to cause 
an exfoliation of the uterine contents. The pain of toothache is 
due to the microbe of dental caries eating the nerve of the tooth. 
Kill it with resorcin paste, or concentrated ozone, and relief is 
afforded. 

Symptoms of indigestion can be relieved with papoid ; ozon- 
ized pepsine, and bitter tonics ; diarrhea arrested with opium 
and tannin pill ; constipation relieved by fruit ; loss of voice 
by inhaling the nascent chloride of ammonia and a glass 
of coca wine ; fainting or difficulty of breathing relieved by some 
diffusible stimulant ; insomnia or hypochondriasis by extract of 
of hop, or coca et celerina ; and neuralgic pains in the breast by 
heat. 

With regard to chorea, epileptic fits, or other nervous states, 
they must, if possible, be suspended, as their continuance is most 
disastrous ; so extract of sumbul should be tried first, in the 
event of a failure, bromide of potass, blue cohosh, and simulo 
next. 

Morning Sickness of Pregnancy. — Many theories have been 
adduced regarding the cause of morning sickness during preg- 
nancy. All, however, appear to have been too speculative, and 
no one has met with anything like a universal opinion. Evolu- 
tion may aid us in arriving at a just and feasible interpretation. 
From the earliest period of existence every organism has been 
endowed with two distinct qualifications : i , tnat of maintaining 
self; 2, that of perpetuating its species. At first the double 
function was performed by a uniform mass, free from any sem- 
blance of structural differentiation. Habitual localization of 
function, however, produces eventually a specialization of struc- 
ture, and with it the evolution of a nerve tract whereby the inter- 
dependence is maintained. It is therefore feasible to suppose 
that the nerve centre which regulates the process of assimilation 
is either in opposition or at least in direct communication with 



BACTERICIDES. 



835 



that which presides over the organs of generation. All the 
visceral functions are now performed automatically, and are regu- 
lated by nerve centres located in the medulla oblongata ; the 
uterine, by inference, being no exception. Considering the close 
relationship that exists throughout life between the two processes 
of assimilation and reproduction, there can be no doubt that the 
representative nerve centres act and react upon each other. When 
the uterus becomes the nidus for a developing germinal mass, 
the molecular disturbances radiated therefrom to the reproduc- 
tive centre are liable to be transmitted to the pneumogastric as 
well, and induce either a feeling of nausea or actual emesis. 
Usually, however, in the course of a few months, through habit, 
the pneumogastric centre becomes tolerant, and the symptom 
evidencing disturbance at the same time disappears. It is diffi- 
cult to understand why the sickness should be experienced more 
especially in the morning, unless it be that the change from the 
recumbent to the erect position after sleep renders the whole 
nervous system more liable to explosive disturbances. Fre- 
quently we find patients who only suffer from disturbances asso- 
ciated with epilepsy on assuming the erect position after sleep. 
The more highly unstable the nervous system is generally, the 
more likely is a woman who becomes pregnant to suffer markedly 
and for a lengthened time from sickness, whether matutinal or 
more or less constant. It is well, however, to remember that the 
molecular radiations from the uterus itself may, for some reason 
or other, be materially augmented ; and such, acting on a nerv- 
ous system otherwise apparently healthy, may induce an aggra- 
vated train of events. 

The neurasthenic are most liable to it, whether it be due to a 
morbid innervation or a reflex condition. The sickness is often 
bad, even fatal, but in the large proportion of cases ceases at four 
and a half months, but may continue ail the time. It is 
arrested if the foetus dies, or if miscarriage, abortion, occurs, or 
when the patient is delivered at full time. 

Some cases can be directly traced to a general catarrhal state 
of the salivary glands of the mouth, with great salivation, catarrh 
of the stomach and bowels, with liver irritation. Other cases are 
due to a degeneration of the liver, spleen, kidneys — a sort of 
passive usurpation of their proper structure with fatty granules, 
a common condition in both pregnancy and lactation. Such 
conditions induce persistent anaemia, often jaundice, and uraemia. 
These symptoms are very dangerous, as there is apt to exist a 
structural granular lesion. Even slight vomiting, when accom- 
panied with jaundice and albuminuria, is unfavorable. 

Decided yellow atrophy of the liver is only present once in 



836 



DISEASE GERMS. 



lOOO cases of pregnancy, whereas uraemia is common one in 500 
cases. Still it is well to look upon nearly all cases with suspi- 
cion. The theory of pressure is untenable, for the worse cases 
are in the early months long before the gravid uterus could either 
affect the kidneys, or liver, or spleen. 

No definite line of treatment could be laid down for any one 
case. Remedies must be tried, and if found successful, persevered 
with. 

A few of the best remedies for the purpose of trial are the 
following : 

Confine the patient to bed for one or two hours after the 
morning meal. Bowels to be kept well regulated. 

A cup of good strong mocha coffee, without milk or sugar ; 
or citrate of caffeine ; or guarana could be tried ; when either 
operates beneficially, usually from the first dose. 

Liquor cerii ozonized is a splendid gastric sedative, tried in 
teaspoonful doses repeated ; the oxalate in five-grain doses; ipecac 
in one-eighth or one-quarter of a grain dose. Dioxide of hydro- 
gen worthy of a trial. 

Carbonic acid gas operates as a sedative upon the base of the 
brain, and medulla oblongata, it could be tried in the form of a 
glass of champagne, vichy, apoUinaris, and other effervescing 
drinks. 

Papoid, pepsin, ingluvin and other digestive agents, as pan- 
creatine, maltine, before or after meals, are often of great utility 
in arresting the vomiting. They should have a fair trial, as they 
often operate like a charm. 

Milk and lime water. Peppermint water, bitter tonics, camo- 
mile, columbo. 

Ozone tablets are excellent. 

Tablets of nitro-glycerine. 

Cocaine suppositories, one at bedtime, of great efficacy in nu- 
merous cases. 

Hot applications over the abdomen. 

Menstruation during pregnancy and lactation should not take 
place ; indeed the presence of ovulation during these states is to 
be regarded in a most serious light, calculated to impair the 
vitality of both child and mother, causing both to acquire a 
tubercular diathesis. 

The causes which have brought about this uterine, ovarian, 
and spinal neurosis, are obscure, some attribute it to a high state 
of nerve-strain, worry, struggle incidental to civilization; others 
assert that our modern, sexually exciting literature has much to 
do with it in producing this special neurosis, and wrecking the 
female organism ; another class attribute it to the sewing ma- 



BACTERICIDES. 



837 



chine ; while others claim that sexual excesses and over- stimu- 
lating diet are the cause. 

Whatever the cause may be, one thing is very certain, that it 
did not exist thirty years ago. 

Occurring during pregnancy, it is to be carefully distinguished 
from those cases where the after-birth" is over the mouth of the 
womb, when after the fifth or sixth month of pregnancy there is 
a dribbling from the uterus daily. 

The appearance of the menses during pregnancy and nursing 
is to be looked upon as a weakness, or neurosis of the sexual 
appetite, brain cord, ovaries, uterus ; and every possible means 
seould be taken to arrest it by strengthening the whole system, 
and parts implicated. 

There must, in the management of such cases, be an entire 
avoidance of all excitement; no use of the sewing-machine ; an 
avoidance of shows, theatres, balls ; no light or fictitious read- 
ing ; a perfect freedom from care, worry, taking life easy with a 
good deal of rest. 

The best remedies are hip-baths, wine of aleteris farinosa ; and 
erythroxylon coca ; comp. syrup partridge berry and fi. ext, of 
stylosanthus. Two of these remedies should be used one week; 
next week the other two, and so on for a period of some months, 
as each one has a most remarkable vitalizing action on the 
uterus. Avena sativa might be administered occasionally. 

A morbid appetite, a perverted or depraved longing, or craving, 
or insatiable desire for peculiar substances, as sand, chalk, clay, 
sponge, and other articles. 

We have often the same state existing in uterine irritation, 
chlorosis, masturbation, ascarides, an abnormal hyperaemia or 
neurosis transmitted to the co-ordinating chemical centre in the 
brain ; the same state is induced during the first four and-a-half 
months of pregnancy. To correct this state, and appease the 
craving or hungering, rest in the recumbent posture, and a per- 
sistent use of coca wine are most effective. 

The coca wine is also the best remedy for the pallor, anaemia, 
mental depression, colicky pains, diarrhea, debility and other 
symptoms of nerve tire. 

To increase the efficiency of the coca wine, it could be alter- 
nated with kephaline or avena with advantage. 

An irritable bladder is present as a symptom of pregnancy, 
chiefly among neurotic females, in quite a number of cases. 

Some few cases are due to the presence of an excess of uric 
acid ; if such be the case, a change of diet, more fresh air, will 
probably overcome it without resorting to drugs. 

Still, if no improvement takes place, it might be well to look 



838 DISEASE GERMS. 

for some adjacent irritation, as some caruncle, or vascular excres- 
cence, lupoid, or other ulcer on a follicle of the vagina ; sym- 
pathy from a rectal abrasion or pocket, or fissure, or neurosis. 

If the irritability of the bladder is great, ordinary treatment 
must be resorted to, irresj^ective of the condition of pregnancy. 

Passive chronic interstitial nephritis is quite a common condi- 
tion during pregnancy, especially after the fourth month. 

The peculiar protoplasmic changes in the blood-forming and 
blood-raising glands ; the intimate nervous connection of the 
uterus and kidneys; possibly pressure; albuminuria during 
pregnancy is to be looked upon as a most grave affection, often 
involving the death of the foetus by a peculiar degeneration of 
the placenta, and later on the mother succumbs to the inevitable. 

The same course of treatment should be pursued as in chronic 
interstitial nephritis. Our two best remedies are nitro-gly- 
cerine and benzoic acid, which, when carefully administered, 
cause a rapid disappearance of both albuminuria and dropsy. 

Mellituria^ the sugar fungus in the blood, is becoming more and 
more common as a symptom of pregnancy. 

No doubt this is due to a neurosis of the sympathetic system, 
as it occurs most frequently among ladies of high culture, with 
excessive mental development. 

The peculiar change in the hepatic structure, or else in the 
eighth pair of nerves which supply the liver, or in the brain, inci- 
dental to this condition, is probably the cause. Few of the essen- 
tial symptoms of diabetes are present, there is usually no exces- 
sive appetite for either food or drink ; no chloroform breath, and 
although the urine is loaded with the sugar fungus, it is neither 
excessive in quantity nor of a high specific gravity. 

It is this saccharine fungus-laden urine, coming in contact with 
the fine sensitive mucous membrane of the vulva, which excites a 
neurosis, a pruritus, with its intolerable itching. 

The best remedies are : administer five grains of jambul after 
each meal till pregnancy is completed, when the fungus at once 
disappears. 

Solutions of boroglyceride, either in an infusion of elder 
flowers or poppies, are most effective in relieving the intolerable 
itching. 

Pure cocaine, dissolved in coca butter, is also most efficacious. 

Eruptions and excoriations are also quite common around the 
labia, entrance to the vulva, also on the perinaeum extending back 
to and around the rectum ; often partaking of the nature of an 
eczema. 

As a creneral rule it orig-inates from some local irritant, as sac- 
charine urine ; in other cases from neglect of diurnal ablutions 



BACTERICIDES. 



839 



with castile soap and tepid water, followed by boroglyceride 
solutions. 

The best treatment is great cleanliness, followed with ozone 
or resorcin ointment. Cracks, abrasions, ulcers, apply resorcin 
ointment. 

A serous, or watery discharge front the vagina, loaded with 
cocci, best relieved by the boroglyceride wash locally, and inter- 
nally by the use of the aleteris farinosa. 

Piles are often present, and usually the result of the passive 
changes in the liver, incidental to pregnancy, all that can be done 
is to palliate the condition by keeping the bowels regular by 
taking fruit, use of baths, bathing the anus with distillation of 
witch hazel and boroglyceride. 

Swelling of the labia, best relieved with rest, bathing the parts 
with distillation of witch hazel. 

Varicose veins of the limbs should be palliated by first bathing 
the limb with castile soap and tepid water, drying well, then 
bathing with distillation of hamamelis, and either wearing an 
elastic stocking or bandage during the day. 

Cramps in the limbs, best relieved with rest, rubbing. 

Inability to hold the urine or retention of urine, best relieved by 
rest, change of diet, and a persistent use of the aleteris cordial 
in alternation with the compound syrup of partridge berry. 

Undue tightness of the abdomen is best relieved by rubbing 
warm olive oil into the abdomen before retiring. 

General Rides to be Observed. — Daily tepid sponge bathing to 
be observed, so as to permit free aeration of blood by the skin ; 
no drugging, but what is absolutely necessary ; a good deal of 
rest, with a fair amount of open-air exercise ; change very salu- 
tary ; abundance of good food ; tea and coffee restricted ; she 
should never feel exhausted by any labor, nor be fretted or wor- 
ried by care ; mental and physical vigor of the highest , calibre ; 
the higher and holier attributes of her being should be brought 
permanently forward; she must positively avoid Hterary pursuits, 
as they arrest brain evolution in the foetus. 

Deformities and mutilations are becoming more common as 
the nervous system is being developed at the expense of the 
physical. There are some causes which are known, others 
which are latent. A child begotten by a father in a state of alco- 
holic intoxication, either suffers from idiocy, or brain shrinkage, 
feebe-mindedness, imbecility or epilepsy; some brain disease of 
the insane group. 

All children born with deformities, such as hair-lip, cleft 
palate, club-foot, imperforate anus, are the result of incompati- 
bility of temperament, close consanguinity, or in-and-in breeding ; 



840 



DISEASE GERMS. 



whereas, mutilations, monstrosities, are due to shocks, frights, 
impressions made upon the mother during the first two or three 
months of embryonic life. 

Probably amputations of the limbs come later. 

The prevention of brain disease and deformities is in the 
hands of the parents, and should be regulated by the most 
stringent laws ; whereas, the prevention of mutilations is in the 
hands of the mother alone; she should avoid reading all dime 
novels, fictitious literature, or attending theatres, or excursions, 
or the killing of animals or poultry, or seeing, hearing, or feeling 
any strange or abnormal thing that would be likely to vividly 
impress her. 

All physicians deprecate. the practice of the administration of 
drugs during pregnancy, still there are exceptions to the rule in 
our present conditions of civilization. The use of the wine of 





Showing the vessels of the gravid uterus at The appearance of the uterus and child 

the beginning of labor. at full period of pregnancy, weight 

from seven pounds upwards. 

the aleteris farinosa, comp. syrup of partridge, fl. ext. stylosan- 
thus, either one alternately, should be recommended in, and dur- 
ing all pregnant states, as they are most invaluable remedies for 
strengthening the uterus and its appendages, and rendering labor 
easy and natural. These remedies have a most salutary action 
in obviating all complications, as false pains, hemorrhages, etc. 

The bowels must be kept regular by the use of fruit and 
vegetables, and once a week, for eight weeks prior to the eveat, 
the coming mother should take a dose of castor oil, in order to 
favor a secretion of milk. 

Parturition or labor may be defined to be the expulsive efforts 
of the uterus and mother to evacuate the contents of the womb, 
the foetus being a mere passive body. 

Violent passion, mental excitement or impressions may excite 
or suspend labor, but cannot prevent it. 

Symptoms of labor may be briefly enumerated : When the 



BACTERICIDES. 84I 

fortieth week has expired, there is likely to be some nervous de- 
pression, which is manifested by a rigor or chili of more or less 
intensity ; a frequent inclination to make water, or else a sup- 
pression of it, bearing-down ; subsidence of the abdominal tumor ; 
secretion of mucus, often streaked with blood, called the show ; 
aching in the hips or thighs ; sometimes cramps, and a dilatable 
condition of the mouth of the womb, with alternate contractions, 
accompanied with pain. In some cases the pains are false or 
spurious. They are said to be such when the mouth of the 
uterus remains unaffected by them. These pains in some ladies 
are apt to come on several days before the genuine, and are apt 
to worry or annoy the patient ; and in all cases in which you are 
satisfied that they are false, they should be stopped by an injec- 
tion of starch and laudanum into the rectum. 

The following are the measurements of a foetal head, of ordi- 
nary dimensions, at the full period of utero-gestation : 

The longitudinal diameter of its head is from 4 to 4j^ inches. 

The transverse, 3j^ to 4 " 

The occipito-mental or obhque, 5 " 

The cervico bregmatic, 4 to 4^ " 

The trachelo-bregmatic, 3^ to 4 " 

The inter-auricular, . 3 " 

The fronto- mental, 3^ " 

The transverse diameter of the shoulders, . 4^ to 5^ " 

" *' " hips, ... 4 to 5 

True pains are produced by contraction and drawing up of the 
womb, which first expels the slimy matter, mixed with blood, 
called a " show." As soon as this appears, the mouth of the 
womb at each pain begins to open and widen itself, so as to per- 
mit the contents of the womb to pass. 

When labor begins, the mouth of the 
womb is opened by the longitudinal fibres 
which are opposed to the circular. 

Labor is very correctly divided into three 
stages : the first is the period of dilating of 
the mouth of womb sufficient to let the 
head of the child pass, and occupies more 
than two-thirds of the time of a labor ; the 
second is the expulsion of the child from the 
uterus, and occupies much less than a third ; y^^^^j exammaUon. 
and the third stage is a complete expulsion 
of the membranes and placenta. 

The first pains are short, come on at long intervals ; the patient 
is restless under them, first hot, then cold, and not infrequently 
sick at the stomach. She may be griped, belches wind, or passes 
it from the bowels, which should not be restrained by false deli- 




842 DISEASE GERMS. 

cacy. By and by pain passes to the back and then to the bottom 
of the belly, and there is usually a desire to urinate or to go to 
stools, calls that are to be obeyed, never neglected. Just at this 
time she is likely to become fretful, uneasy, and may ask for 
something to hurry up pains ; but be patient, wait a little, don't 
force nature to premature efforts; let her rest while nature rallies^ 
and the womb gradually opens. 

The duties of the nurse, midwife, or physician, if the presenta- 
tion is all right, consists in aiding, if needed, giving consola- 
tion and encouragement; warm drinks ; watching the case care- 
fully and closely, and rendering assistance when necessary. 

During the First Stage. — At this stage it is unnecessary for 
the patient to go to bed, only once in a while, for examination. 
She is better during the greater part of the 
first stage, moving gently about the bed- 
room, and when a pain comes on, be in a 
vV ^^'^^^^T^ i position to get hold of something. During 
such pains a doubled-up position, either 
sitting on a low stool, or kneeling, answers 
Avell. When this first stage is nearly over — 
that is, dilating the neck of the womb com- 
pleted, the patient must go to bed. The best 
position for American women is the left side. 

Head at the lower outlet. ^^^^ ^^^ ^^^^ ^^ ^^^ ^^^^ ^^ ^^^^ ^^^ ^^^ ^^ 

her feet firmly against the bed-post; her hips from ten to twenty- 
four inches from the edge of the bed. 

If attendants are few she could have a sheet attached to the 
bed-post, so she could hold on to something from below ; her legs 
bent, a pillow between her knees, and her head also supported 
by a pillow. The bed for about a yard and-a-half square should 
be protected with a gum or oil-cloth spread, and two or three 
quilts doubled up over the same, so as to take up the discharge. 
Irish or German women, with straight sacrums, do fully as well 
on their backs, or even on their knees, in the bed, or on the floor^ 
until they are well over and into the second stage. Once it is 
ascertained that the presentation is a good one, it is unnecessary 
to annoy her by repeated examinations. 

All examinations should be made during a pain, and continued 
when a pain is off. If the pains are good, efficient, and the mouth 
of the womb well dilated, parts well lubricated and the mem- 
branes 'seem to act as a retarding element, they can be ruptured 
by roughening the nail of the index finger ; but if they do not 
seem to retard the labor, they may be let alone, until they almost 
protrude externally, as they act as a good dilator. 

The bag of waters differs in size in different cases, according 




BACTERICIDES. 



843 



to the amount of water present, and is, always, large or small, a 
good dilating body, continuing to force open and widen the 
mouth of the womb, until it is open sufficiently to permit 
the head of the child to pass. It also distends or dilates the 
vagina. 

In some cases, ladies, by excessive or violent movements, 
cause a rupture of the membranes, a week or more before labor; 
then labor is dry, and is not nearly so easy ; in other cases of 
sudden or hurried labor, the membranes, water, child and after- 
birth are expelled in a mass, then the child is said to be born 
with a caul: When they burst at the proper time the pains con- 
tinue, and the child gradually enters the world. If the mouth of 
womb is dry and rigid, so that the pains are inefficient and the 
first stage prolonged, this rigidity must be overcome in various 
ways ; enemata of tepid water and lobelia into the rectum, steam- 
ing the vulva, perinseum, and anus, by causing the patient to sit 
on a chamber partially filled with boiling water in which a plug 
of tobacco has been cut up ; or by smearing the rigid mouth 
with belladonna ointment, or introducing a pastile of belladonna 
and opium into the vagina; and if it does not yield, these means 
may be repeated, or they can all be used. 
A decided nausea has an excellent effect. 

When the head is emerging under the 
arch of the pubes, the perinseum should 
be supported with the palm of the left 
hand, and retained there till the head is 
free from the vulva. 

If the perinseum is tough, rigid, not 
easily distended, and thus obstructs the 
exit of the head, it may be well oiled, and Forehead ui^the arch of 
hot towels — as hot as can be borne — ap- thepeivis. 

plied, one after the other, so as to relax it. If this is unavailing, 
wring the towels out of hot lobelia or tobacco water. 

When the head has made its exit, do not pull or drag it, but 
simply hold it in the hand until the next pain, and, when it 
occurs, have the patient hold her breath well and bear down, 
when the body will be expelled. Indeed, all through the case 
the patient must exercise great fortitude, patience, and forT 
bearance; be quiet and docile, and on no account must she 
throw up her arms, stretch herself, or let go her breath in the 
middle of a good bearing-down pain or effort. Some ladies are 
remarkably sensitive, and the greatest delicacy and kindness 
should be observed towards her in all things. Her person must 
not be exposed. 

Cool, firm determination, a cheerful disposition, with the use 




844 DISEASE GERMS. 

of warm stimulating drinks, are of more utility than a lot of 
humbug. We must guard against too sudden a delivery, with 
membranes, water, and after-birth altogether, as that is very apt 
to be followed by hemorrhage. After the delivery of the child, 
lay It on the right side, remove any mucus from its mouth, and 
give it a very gentle beat on the back with the open hand. 
Usually this is sufficient to establish respiration ; if not, artificial 
respiration, or otherwise, should be resorted to. (See Asphyxia^ 
Respiration may be suspended for over forty minutes, and resus- 
citation may take place ; so our efforts should continue as long. 
As soon as the child cries lustily, and there is evidence of a 
proper supply of arterial blood, that is the time to ligate the 
cord, applying the first ligature from three-fourths to one inch 
from the belly, the other one two inches further on, and then 
dividing or cutting it between the two. As soon as this is 
done, wrap or roll up the child in a blanket, and hand it to the 
nurse ; then attend to the mother, and the removal of the after- 
birth. On placing your hand over the abdomen, you will find 
the uterus either contracted or relaxed. If contracted, the after- 
birth may be in the vagina, and a cough, or sneeze, or blowing 
with some force into the palms of both hands, or a gentle bear- 
ing-down effort, or slight traction on the cord, may cause it to 
come away. As soon as it approaches the vulva, it should be 
grasped and twisted round several times, so as to twist the mem- 
branes, and have them come easily and entirely away. 

If the uterus is relaxed, and after-birth attached, resort to fric- 
tions with oil over the abdomen, so as to cause contraction; 
allow a little rest till the vital forces rally. Administer a little 
capsicum in warm sweet milk, or a little quinine, or a little hot 
punch, so as to establish permanent tonic contraction of the 
uterus. If there is retention of the after-birth after tonic con- 
tractions have taken place, use friction, sham- 
pooing, dry heat to the abdomen, enemata of 
tepid water into the rectum, and administer 
stimulants. These means failing, after waiting 
perhaps one or two hours, introduce the hand 
in the form of a cone — the back of it well 
Extraction of a re- ollcd — into the cavity of the uterus, and gently 
tained.piacenta. ^^^^^ ^^^ placeuta, or aftcr-birth. It is very 

probable that the presence of the hand will cause such violent con- 
tractions, with expulsive pains, as to cause it to be thrown off If 
not, detach it carefully, and leave no portion behind ; wait until 
a pain comes, when withdraw the hand in harmony with the 
bearing-down effort. This is best effected with the patient on 
her back, knees drawn up, and I will repeat, let it be done with 




BACTERICIDES. 



845 



great kindness and gentleness. After it is removed, the patient 
should be carefully bandaged, from the middle of the thighs to 
the bottom of the sternum, with a thin compress over the uterus. 
In applying this bandage, it should be pinned from below up ; a 
pin every inch, and free from all wrinkles. Then a dry, warm 
diaper should be pressed against the vulva. This, or a similar 
bandage, should be applied daily, and seen to by the physician 
or nurse for ten days, and it should be worn for at least two or 
three months. On the re-application of the bandage, it is well 
to sponge the abdomen with a little hartshorn and tepid water; 
dry off well, and then use either bay rum or cologne-water. By 
this means all the cracks, fissures, crevices, of the abdomen are 
avoided ; also enlarged or pendulous abdomen. A woman can 
be well preserved if due care is taken of her, even after she has 
had a dozen children. 

After the bandage is applied, the patient should be moved up 
to her proper place in bed, and a doubled quilt placed underneath 
her. The use of the bandage after delivery has many advan- 
tages. Besides maintaining the natural condition of the abdo- 
men, it stimulates the uterus to contraction, and thus prevents 
hemorrhage; it rests the broad ligaments, and gives support, and 
prevents falling of the womb ; it is, besides, a great safeguard 
and comfort to the woman, and on no account can it be dispensed 
with. Always pin from below up, firm at first, but always easier 
as you progress upwards. 

If there is any disposition to hemorrhage, in addition to the 
roller put the child to the breast at once, or as soon as possible 
after the mother has rested. The first cathartic should be given 
after the mother has had a sleep ; and it should be oil, on account 
of its influence in secreting milk. All through, during and after 
labor, the bladder should be carefully watched, especially if there 
is any retention of urine. 

The diet of the mother, if not very feeble, should, for about 
nine days, consist of plain oatmeal gruel, sago, arrowroot, rice, 
tea and toast, beef-tea. As a rule, beef, mutton, chicken, game, 
or highly-seasoned food, or stimulants, should be avoided ; but 
after the ninth day, a generous and nutritious diet may be 
allowed, even as liberal as the patient may desire, avoiding all 
indigestible articles, as veal, pork, salt meat and fish, pie-paste, 
cabbage, etc. 

The discharge that comes, or takes place from the uterus after 
delivery, is called the lochia, or cleansing, and should continue 
from two to three weeks ; If longer than three or four, means 
should be taken to tone up the uterus by port wine and Peru- 
vian bark, mother's cordial. If it should suddenly cease inside 



846 DISEASE GERMS. 

of the first two weeks, measures should be taken to re-estab- 
Hsh it. 

The most common causes that are likely to cause its arrest, 
are cold, cold drinks, ice ; sudden mental emotion, or excitement, 
or worry, or passion. 

To cause its re-appearance, try heat to the vulva, over the 
uterus, and to the feet, with infusion of catnip, and a few drops 
of the tincture of aconite. If that fail, try serpentaria compound, 
in half-teaspoonful doses, in some warm tea, and administer 
enemata of flaxseed tea, with laudanum. If that fails let patient 
drink linseed tea, warm, with tincture of snake-root. If the 
stoppage, or arrest of the lochia takes place inside of the first ten 
days, we may entertain apprehension of its absorption into the 
blood, and puerperal fever; later than that it is not likely to be 
attended with such grave results. The prevention of its disap- 
pearance, by keeping the patient quiet, free from all care or anx- 
iety, by a strict avoidance of all cold drinks, and inculcating 
other elements of comfort, which are of great consequence, will 
almost infallibly ward off this complication. 

The early and often indiscreet use of ergot is most disastrous 
in parturition, by energetically stimulating the lumbar portion of 
the cord, and often causing rapid contraction of the entire uterus, 
neck and all. This is most liable to occur if the drug has been 
administered freely early on the expulsion of the child, causing 
a retention of the placenta. 

If this should occur, opium should be administered in small 
but repeated doses, to relax the neck of the uterus ; inject hot 
water copiously into both rectum and vagina, following with one 
or two obstetric cones into each ; apply scorching hot pillows to 
loins and over uterus. If not successful, in a short time in get- 
ting the fingers and hand into the uterus, after it, inhalation of a 
few drops of chloroform on the towel, never enough to produce 
anaesthesia, because the blood is embolized and heart feeble. If 
this fails, try enemata of lobelia, and administer the same inter- 
nally in small doses, just enough to nauseate well, but not to 
cause emesis. In connection with the lobelia, insert a cocaine 
suppository into both rectum and vagina every three hours. 
These means failing, insert a Ng. 12 cat-gut bougie, well up 
to the fundus of the uterus, and leave it there for a few hours to 
try and excite or originate pains or contractions. 

If all these means fail, then inject the uterus thrice daily with 
either tepid solutions of creolin,or boroglyceride and being care- 
ful that it all escapes, keeping the patient under the influence of 
opium and the uterus under bactericides. 

Retention of the placenta must invariably be regarded as a 



BACTERICIDES. 



847 



most grave compligation, there being great danger of metria, 
septicsemia. 

Owing to the nervous, impressible condition of the reflex nerve 
centres in American ladies, they do not bear uterine injections 
well, and they in themselves are dangerous from the fluids 
finding their way into the uterine sinuses, thence into the 
circulation. 

The emerging of the foetus from the uterine cavity in some one 
of its six vertex positions, head downwards, a position the 
necessary and ultimate consequence of its own specific gravity ; 
extension and impaction of the child's lower limbs against the 
resisting parts of the uterine cavity, is the normal state. 

The breach, or the feet, knees, buttocks, are regarded as 
natural, and are next in frequency to the head, but they are not 
such good points for dilatation ; consequently, the labor is very 
slow or prolonged, and even when the feet, knees, buttocks and 
body are expelled there is danger to the child, if the head is not 
delivered, by pressure upon the cord. 

If hemorrhage should occur during natural labor, enjoin rest, 
recumbent position and a plug. This latter is uncomfortable, 
and really does not hasten evacuation much, and scarcely pre- 
vents hemorrhage. 

If these means fail, endeavor to excite uterine contractions 
with quinine, capsicum, corn-smut, mistletoe. If still persistent, 
and the os uteri dilatable, rupture the membranes and introduce 
the hand into the cavity of the uterus, seize the feet and bring 
them down with their toes pointing to either thigh of the mother, 
so as to bring the long diameter of the head into the long diame- 
ter of the pelvis. 

In convulsions during natural labor, if the mouth of the 
womb is rigid, administer opium and lobelia, by the mouth and 
by enemata ; if they recur, inhalation of chloroform ; and as soon 
as the mouth is dilated sufficiently to admit the hand, insert it, 
seize the feet, and bring down, with the toes pointing to either 
thigh ; and deliver under chloroform and hypodermic injection 
of morphia. 

If fainting fits should occur, and they are due to debility, or 
some peculiarity of the nervous system, diffusible stimulants 
should be given ; but if they are due to internal hemorrhage 
(concealed), turn and deliver. 

If there is a rupture, and danger of strangulation, and the 
mouth of the womb is dilatable, turn and deliver. 

In case of presentation at the shoulder-joint, it is easily recog- 
nized by the child lying crossways in the abdomen, head at one 
side, buttocks at the other, by the sharp point of the shoulder 



848 



DISEASE GERMS. 



or the descent of the arm. In cases of this kind, delivery can- 
not take place, and it is necessary in all cases to turn. So wait 
until the mouth is sufficiently dilated to admit the hand ; then 
rupture the membranes, if still entire, and proceed to turn. In 
doing this, the patient should be placed upon her back, knees 
drawn up ; the back of the hand of the operator well oiled ; 
hand in the form of a cone, gently introduced into the cavity of 





Arm presentation, first position. Compound presentation, head, feet and cord, 

the womb ; seize the feet and bring down, with the toes pointing 
to either thigh of the mother. If the hand of the child has de- 
scended, the palm will cither point to the front or the back ; this 
forms an excellent guide to where the feet are to be found. If it 
points to the front, insert the hand up in front, and there the feet 
are to be found ; if to the back, then in that direction. This 
saves groping round after the feet. In all cases of turning, or 
when it is necessary to introduce the hand into the uterus, it 
should be done during the at^sence of a pain ; and if a contrac- 
tion or pain comes on when it is so introduced, Jet it lie flat until 
the pain subsides, and then proceed and bring down the feet. 

After- Pains. — After the first confinement there is usually no 
after-pains, as the uterus does its work well and with energy ; 
that is, effects a perfect evacuation of its contents, leaves nothing 
behind, but in all subsequent deliveries, there is liable to 
be a slight inertia, or sluggishness, and there is apt to be 
an imperfect closure of the uterine vessels, an oozing, or 
clot, or shred of the secundaries, a something which the uterus 
tries to expel. It is simply due to a want of tone, and it is 
greater with each subsequent delivery. The pains are due to 
contraction of the uterus upon something, which if large, the 
pains are severe ; if small, less annoying. 

Ladies affected with neurasthenia of the spinal cord, after labor, 
often have the recently emptied uterus brought into a most vio- 
lent and painful contraction, without any discernible object in 
view ; and a severe case of this kind is bad ; much more painful 



BACTERICIDES. 



849 



than ordinary after-pains, that come on to expel a clot or piece 
of membrane. 

In all cases of after-pains, whether mild or severe, the roller 
should be kept applied, but not too tight, as it acts as a stimu- 
lant to contraction. A solution of sulphate of morphia, thus : 
sulphate of morphia, four grains; bicarbonate potass, twenty- 
grains ; cinnamon water, four ounces. Mix. Dose, one teaspoon- 
ful, as indicated, relaxes the neck of the uterus, and by adminis- 
tering gradually just enough to permit the egress of the clots, 
discharge or cleansing, and discontinuing as soon as relief is 
afforded. If in spite of this, pains persist, evacuate the bowels 
' with a dose of castor oil, and insert one, two or more obstetric cones. 

Ftom extensive observations of the bacteriology of the genital 
canal in the non-puerperal condition, it has been found that the 
uterus, its tubes and crevices, upper part of vagina, when in a 
normal condition contain no micro-organisms, but all below the 
external os, in the cervix and lower portion of vagina, organisms 
are numerous. They consist of cocci, pathogenic in appearance 
and behavior, but in an attenuated condition, incapable of culture. 

The lochial discharge is simply a myriad of disease germs, 
but they contain no power of inoculating till they reach the 
vagina, when patients are affected by their own secretions. The 
lochial organisms are intimately associated with the microbes of 
suppuration and septicaemia, hence the indispensable necessity of 
obtaining aseptis in obstetrical practice. 

The hands of the physician, all instruments, cloths, as well as « 
those of the nurse, should be carefully disinfected by solutions 
of boroglyceride, resorcin, creolin, iodine. A closure of all 
lacerations at the earliest possible moment after delivery, to 
render them impervious to the entrance of germs. 

Boroglyceride, acetic acid, creolin, resorcin, iodine, 
etc., are excellent disinfectants, styptics, non-poison- 
ous, prodace no unpleasant effects, and are fatal to 
all micro-organisms in the puerperal state ; the bo- 
roglyceride and creolin in solution are superb, 
leave the mucous membrane smooth and healthy. 

Hour-glass contraction of the uterus and retention 0, : ^^ 

of the placenta or after-birth, is not at all uncom- Hourglass con- 
mon, and most cases noted can be traced to the traction ot the 

... _ uterus. 

early and persistent use 01 ergot. Hour-glass con- 
traction is a condition in which some nerve that supplies the 
centre of the uterus is weak, which receives an undue amount of 
stimulation from the cordf irritated by the ergot, which causes it 
to contract in the middle, with the after-birth in the upper half. 
This is not nearly so grave an affection as contraction of the 

54 




850 



DISEASE GERMS. 



neck, for when some degree of relaxation is induced by either 
chloroform or lobelia, it usually yields readily to gentle manipu- 
lation, first one finger being inserted then another, and so on, 
latterly the whole hand gets through the obstruction, seizing the 
after-birth, gently withdrawing it. 

Placenta prcevia, a condition in which, instead of the after- 
birth being adherent to the fundus, it is implanted over the mouth 
of the uterus. 

This is usually recognized sometime between the fourth and 
sixth month, by an almost daily dribbling or oozing of blood, 

which increases in quan- 
tity and frequency as the 
neck merges into the 
body, and durmg the 
later months the loss is 
quite considerable. 

On making a digital 
examination, a soft, 
spongy mass can be de- 
tected over the mouth of 
the womb. 

In all such cases it is 
well to have another 
physician in attendance 
besides the regular one, 
not for aid, but to share 
the grave responsibilities 
of such a case. Wait 
until labor sets in ; if 
there should happen to 
be hemorrhage, use the 
plug made of several 
fine sponges until the mouth of the womb is sufficiently dilated 
to admit the hand ; then push away the after-birth on one side, 
whichever yields most readily ; then insert the hand, rupture 
membranes, and bring the feet down, toes to the thigh of 
the mother. Before resorting to this, either brandy or capsicum 
should be given, with infusion of good, fresh ergot ; the abdomen 
rubbed with warm oil ; and every means taken to 
livery. Promptness of action and a clear head are 
this crisis, in order to save either mother or child, 
ing- is once consummated, there is little of further 
because the head of the child effectually blocks the mouths of 
the bleeding vessels. If no physician is near, the nurse or mid- 
wife must pursue the above course, without aid, for if she waits, 
death will inevitably take place. There should be no inter- 




Placenta praevia 



the child's head firmly imbedded 
the after-birth. 



facilitate de- 
necessary in 
When turn- 
hemorrhage. 



BACTERICIDES. 



851 



ference until the mouth is dilated to admit the hand, only by the 
plug, but everything be in readiness. 

Inducing, exciting, stimulating uterine contractions during labor 
is often necessary, and we have many valuable agents for effect- 
ing this purpose. The drug in common use is frgot^ which, 
when administered freely, produces continuous contraction of 
the uterus, and embolism of the blood. In all cases, every possible 
means of increasing the vital action of the uterus should be tried 
before risking the hfe of both mother and child upon this drug. 

Ustilago maidis, corn smut, is rapidly taking the place of ergot. 
It is a uterine excitant of the highest order; when administered in 
parturition, it gives rise to intermittent contractions and does not 
create embolism. 

Sulphate qidnine is an efficient parturient, stimulates contrac- 
tions, cleanses the uterus of retained clots, membranes and pla- 
cental debris. Its action as an oxytocic has long been known ; 
it acts upon the body of the uterus alone, leaving the cervix un- 
touched, thus being superior to ergot, which acts upon both body 
and neck and occasionally occludes pieces of membrane. 

Painless labor is the great desideratum of ladies of the present 
age, and is effected in a variety of ways ; anesthetics are not to 
be recommended, except in some rare cases. Smearing the loins 
and entire abdomen with the following acts well : Concentrated 
ozone, four ounces ; chloroform, two ounces ; sulphate of mor- 
phia, ten grains. Mix. Before applying the above, insert two 
obstetric cones up the rectum and the same number up the 
vagina. These cones being composed of cocai/cC, peroxide of 
hydrogen and boroglyceride, render all parts to which they are 
applied aseptic and completely blunt the sensory nerves, aid 
dilatation, facilitate a speedy, painless delivery. 

If, from any cause, labor be prolonged, their administration 
can be repeated, as the attending accoucheur may direct. 

Various complications or accidents vtay arise, as extravasatiojz of 
blood into the labia; this is usually either caused by the presence 
of the head or instruments. 

After the labor is over, apply cloths saturated with either dis- 
tillation of witch hazel or arnica or marigold ; these failing to 
excite absorption, use tincture of iodine in lime-water. 

Convulsions appearing during the progress of labor, belong to 
a state characterized by anaemia or congestion. 

In both forms, turn, and deliver with all speed, if the mouth 
of the womb is dilatable. 

If due to ancemia, hypodermic injections of morphia ; lobelia 
enemata, and very nourishing drinks ; or use inhalations of 
chloroform or chloral hydrate, with the hypodermic injections. 

If due to congestion, enemata of lobelia, active purgation, hy- 



852 



DISEASE GERMS. 



oscyamus, bromide of potass ; heat to feet, stimulants to nape of 
neck, cups ; all failing, administer either by mouth or rectum the 
antispasmodic mixture, which is a safe and always efficacious 
remedy. A division of the class thus enables you to meet them 
with great promptness. 

Rupture of the uterus is very apt to take place if there is any 
obstruction, hardened faeces, an exostosis of the promonotory of 
the sacrum, deformed pelvis, a bad presentation, turning during 
a pain, or the use of ergot during the first stage, and such like 
causes. Some think fatty degeneration of the muscular fibres of 
the uterus has much to do with it, and thinning of its walls. It 
is easily recognized by the sudden cessation of pain, fainting, 
pallor, death-like coldness, and, on placing the hand over the 
abdomen, the child can be detected in the cavity of the abdomen 
out of the uterus. 

If such an event should take place, the abdomen should be 
slit up, its cavity exposed, the child, after-birth, blood, clots and 
water carefully sponged out, the cavity of the uterus cleansed, 
the whole stitched up and bandaged. An effort should be made 
to rouse up the patient by administering diffusible stimulants; 
and if she rallies, treat for peritonitis. 

Unnatural Labor, — Unnatural labor may arise from defective 
uterine power, and abnormal states of the pelvis, and by some 






Face presentation, 
I si position. 



Face presentation, 
2d position. 



Passage of the head ihrough 
the external parts in face 
presentation. 



peculiarity on the part of the child. Of this latter the most 
common malposition is presentation of the face. 

The face usually presents in two positions — the first is when 
the forehead is to the left ilium, and the chin toward the right 
ilium. This is the most common. 

Treatment. — If the pelvis be not smaller than usual, assistance 
will rarely be necessary, but if the delays be great, interference 
is justifiable. If there is an impediment, we must decide whether 
there is room for the application of the forceps, or whether 
craniotomy is the only alternative. The time for operating must 
be determined by the symptoms. 



BACTERICIDES. 



853 



Malpresentations. — The head is the type of natural labor, so 
that any presentation of any other part of the body may be 
classed under the head of malpresentations. 

Presentation of the breech. — This presentation in the statistics 
of my practice occurred about one in sixty. The breech may 






Breech presentation, 
ist position. 



Breech presentation, 
1st position. 



Breech presentation, 
2d position. 



present at the brim in different positions, 
but as it enters it usually arranges itself, so 
that, either first, the back of the child shall 
be turned anteriorly toward the abdomen of 
the mother; or, second, the back of the 
child shall look posteriorly toward the back 
of the mother, not directly anterior or pos- 
terior, but obliquely, the transverse diameters 
of the child's hips corresponding to one or 






Breech presentation, 
extraction of the head. 



Presentation of the inferior extremities 



other of the oblique di- 
ameters of the brim. 

In the first and most 
frequent position the left 
ischium corresponds to 
the left acetabulum, and, 
being anterior, it is de- 
pressed, and presents at 
the OS uteri, so that the finger impinges upon it if it be passed 
into the centre of the os uteri. In this oblique position the 
breech descends into the cavity. On examination, we discover 
the absence of the head, blocking up the passages. 

Presentation of the inferior extremities. — In my practice, I have 
met with this position but once in one hundred and ten cases. 
By this presentation I include both of the knees and feet. There 



854 



DISEASE GERMS. 



are but two forms of malpresentation. When the toes are di- 
rected backward, and when they are directed forward, they 
correspond exactly to breech presentations. The first thing that 
excites our suspicion of its* being unnatural is very often the 
early rupture of the membranes and the large quantity of liquor 
amnii that escapes. 

Presentation of the superior extremities. — I have met with this 
presentation once on an average in every 230 cases. In almost 
all cases, it is the shoulder with primarily presents, and after- 





Arm presentation '. position for 
turning ; ist position. 



Arm presentation, 
2d position. 



wards the arm prolapses, but sometimes we find the arm, or 
hand, or elbow, at the beginning of labor, at the os utea. 

In all cases the back of the child either looks toward the abdo- 
men of the mother, or backward toward her spine. 





Version, or turning; seizing the feet. 

The delivery of a child 



Turning; bringing down the feet. 



SO placed is impracticable, unless 
assisted by art. Although cases of spontaneous evolution have 
been met with, yet they are very rare. 

Symptoms. — Labor with this presentation is extremely danger- 
ous to the mother, being about one lost in every ten, and of chil- 
dren more than one-half After the membranes have burst, and 
discharged more liquor amnii than in general, when the head or 
nates present, the uterus contracts tighter around the child, and 



BACTERICIDES. 



855 



the shoulder is gradually pressed deeper in the pelvis, while the 
pains increase considerably in violence from the child being 
unable, from its faulty position, to yield to the expulsive efforts 
of nature. Drained of its liquor amnii, the uterus remains in a 
state of contraction even during the intervals of the pain ; the 
consequence of this general and continued pressure is, that the 
child is destroyed from the circulation in the placenta being 
interrupted, the mother becomes exhausted ; inflammation or 
rupture of the uterus or vagina are unavoidable results. 

Ireatment. — The labor is impracticable ; there is nothing to 
expect from natural efforts, except an increase of the difficulty, 
so that it is our duty to interfere in every case with promptness 
and energy. If the malpresentation is detected before the rup- 
ture of the membranes, and the liquor amnii has not escaped, 
there is seldom any difficulty, but, after its escape, the uterus 
contracts firmly upon the child, and, in proportion to this con- 
traction, is the difficulty. If the uterine action be very intense, 
the operation may be impossible; if so, give opium in solution, 
alternately with lobelia, to perfectly and thoroughly suspend 
uterine contraction. 

After suspension, turn the child ; if the front of the head 
points anteriorly, slip the hand up in front, seize the feet gently 
and firmly, and bring down the feet in such a manner as to have 
the great toe pointing to the inner part of the left thigh ; if the 
anterior portion of the arm points to the coccyx, insert the hand 
behind and bring down the feet, with the great toe pointing to 
the inner portion of the right thigh. Then the management of 
the labor will be the same as breech presentation. 



Prolapse of the umbilical cord. — Natural 
Complex Labor, labor, we have seen, is where the agents 
or elements of parturition are equally bal- 
anced. Unnatural labor, where some abnormal deviation has 
occurred from some deficiency or irregularity in the power, in 
the passage of the child. 

We have now to consider another element in parturition ; an 
accidental complication, which renders a labor complex. The 
labor may be natural or unnatural, but this complication renders 
it complex. 

Prolapse of the cord. — The first and most common complica- 
tion is, prolapse of the umbilical cord, either above or with the 
presenting part of the child ; and it may occur at the beginning 
of labor or during its course. The accident, or complication, 
has no bearing upon the progress of labor, but a most disastrous 



856 



DISEASE GERMS. 




Prolapse of ihe cord. 



effect upon the child, and any interference that the physician re- 
sorts to should have this one object in view. More than half 
the children are lost, which gives us a 
large mortality indeed. 

Causes. — This accident occurs about 
once in 230 cases, and is caused by various 
circumstances, as the malposition of the 
child ; a small child with a large quantity 
of the liquor amnii ; the sudden rupture 
of the membranes ; the forcible rush of 
a large quantity of the liquor amnii ; pre- 
sentation by the feet or knees ; irregular 
shape or irregular action of the uterus ; where the placenta 
was situated low down, near the cervix uteri, etc. The child is 
in the greatest possible danger in all cases of dropping of the 
cord. 

Treatment. — The means to be adopted will depend entirely 
upon the state of the prolapsed cord. If it exhibits marks of 
putrefaction, or is flaccid, without pulsation, it is useless to inter- 
fere, because hopeless, as regards the life of the child ; but if 
pulsation be good, there are various modes 
of management. 

Push up the cord, beyond the brim of 
the pelvis, and there retain it with one or 
two fingers, until the upper outlet is filled 
by the descending liead. 

Labor may be obstructed by mechanical 
impediments in the passages, which are 
numerous, and varied in their character. 
One, formerly rare, but now becoming 
common, is tumor of the ovary. 

The enlargement is sometimes solid, more frequently fluid, or 
containing a substance of the consistence of honey. If the dis- 
ease progresses slowly, the uterus, with the ovaries by its side, 
will have emerged from the pelvic cavity in time to remove the 
obstacle, which will then be in the abdominal cavity; but, in 
some cases, either from the situation or rapid increase of the 
ovarian tumor, or by adhesions between it and the neighboring 
parts, it is retained in the pelvis, and may offer a serious obstruc- 
tion to labor in the second stage. There are several forms of 
ovarian tumors which thus obstruct the passage of the child. It 
may be a cyst or a real enlargement of the ovarium ; but, gener- 
ally, an ovarian tumor is much more likely to be moved out of 
the way of the child at the time of labor than any other form of 
tumor. 




Ovarian tumor. 



BACTERICIDES. 



857 



The diagnosis is usually difficult. If the tumor within the 
recto-vaginal septum be movable, elastic, and communicates to 
the finger a sense of fluctuation, it is probably ovarian, but it is 
not always so ; it may be hard, not fluctuating, and, to the touch, 
solid. The only practical test is puncture. 

Treatment. — Give ample tinie to see whether the tumor be not 
displaced by an effort of nature ; carefully estimate the effects of 
pressure upon it before bad symptoms supervene. If it be insur- 
mountable by the natural powers, if it cannot be raised above the 
brim of the pelvis by the hand, then we must puncture the cyst 
through the vagina ; nor are we to be deterred by the apparent 
solidity of the tumor, as they mostly all contain fluid. A long 
trocar and canula should be used, and plunged quite through the 
parietes of the tumor. If fluid be freely evacuated we shall have 
no further trouble with the labor ; if it be 
viscid, and does not pass freely through the 
canula, enlarge the opening. 

Vaginal cystocele. — The necessity of keep- 
ing the bladder empty during labor is clearly 
pointed out, as, if it is distended, it is apt to 
be caught by the head of the child in its 
descent and pushed before it into the cavity. 
The patient complains of fulness, tension, 
pressing down and dragging, a desire to Vaginai cystocele. 

evacuate frequently, and inability to do so. 

On examination, we detect a tuT>or in front of the pelvis, par- 
tially covering the head and containing fluid. The fiuger passes 
easily posterior to the tumor, but not anteriorly, and the catheter 
cannot be passed in the usual direction, clearly indicating its 
nature. This, if it exists, occasions delay in the second stage, 
and danger to the mother from rupture of the organ. 

We should be active here, whenever we are aware of the im- 
pediment. A gum bougie should be at once introduced, the 
point directed backwards, and we shall very probably be suc- 
cessful in emptying the bladder; if necessary, raise the head a 
little with the finger, during an interval, to facilitate the intro* 
duction. 

We usually succeed, but, if we fail, the labor will be arrested 
by the obstacle, or pressure threaten a rupture. I have always 
been able to draw it off, therefore, I cannot, from experience, 
recommend tapping the bladder with a trocar, through the vagina, 
which is often done. If the quantity of urine be moderate, pres- 
sure not excessive, the head of the child not large, we may leave 
the case to nature. But, after the labor is over, we must imme- 
diately evacuate the bladder, and watch the patient. 





858 DISEASE GERMS. 

Various minor operative procedures are in use for the purpose 
of aiding^ parturition. 

The vectis or lever. — The great variety of levers in use have 
only led to confusion and misunderstanding. 

The nature of the aid afforded by this in- 
strument is threefold : 

First. — To correct malpositions, or aid the 
natural rotations of the head at the brim, or 
in the cavity of the pelvis. 

Second. — As a lever, making a fulcrum 
of the pelvis, or the left hand of the opera- 
tor, external to the pelvis. Its employ- 
ment in making a fulcrum of the soft parts 
of the pelvis is extremely dangerous, besides 
the chance of injuring the soft parts, or the 
^, . ,. , child's head. 

1 he vectis applied. • 1 a • 1 1 

Third. — As a tractor, it should not be em- 
ployed to wrench, but to hook or draw down. 

The cases in which the use of this instrument is indicated are: 

Those in which the head, having descended into the pelvic 
cavity, is arrested in its progress by the inefficiency of the pains, 
when the patient is beginning to exhibit symptoms of constitu- 
tional or local disturbance. 

This does not take place until the second stage of labor has 
advanced some hours. There is supposed to be space enough, 
but pains feeble, and a slight additional force will often succeed 
in bringing the infant into the world ; and as there is nothing in 
the nature of the operation to add to the danger, and more par- 
ticularly since the tractile force will be sufficient, it seems pecu- 
liarly adapted to these cases. 

In cases of convulsions, resulting from the head pressing upon 
the sacral nerves, the use of the vectis is specially indicated ; 
provided the pains continue, the aid of the lever may consum- 
mate the labor. 

Respecting the time when the instrument ought to be used» 
This is regulated somewhat by the object sought to be attained. 
If to assist the head in passing through the upper outlet, or to 
change its position there, then operate whenever the os uteri is 
dilated or dilatable ; but never use this extractive power during 
the interval of contraction, but during its continuance; and it is 
only as the result of considerable experience that the practitioner 
can, nearly always perceive whether or not a woman still retains 
the power of assisting her labor. 

Of course, in cases where serious constitutional disturbance 
exists, the vectis ought to be applied as early as possible. 



BACTERICIDES. 



859 




The forceps are invaluable in cases of inertia of the uterus, 
powerless labor. 

The object of the operation with the forceps is to facilitate 
delivery when its progress is arrested by certain malpositions of 
the head at the brim, or in the cavity of the pelvis. 

To supply the want of uterine action, or to render it effective 
for the expulsion of the child. 

To save the mother from the evil results of too long a labor. 

To save the child, or at least afford it a chance of escape from 
certain destruction. 

These objects are attainable by the nature of the aid afforded 
by the forceps, and that they have attained 
most brilliant results, experience has 
proved. 

TJie forceps possesses a twofold power : 

First. — It grasps and compresses the 
head of the child. 

Second. — It acts as a lever of the first 
kind and as an extractor. 

The compression exercised by it must 
be limited within the degree the head 
can bear without injury. 

The extracting force will be in propor- Application of the forcepT 
tion to the firmness of the grasp, limited 

by the resistance, by the danger of injury to the mother. If 
there be sufficient space, we may so grasp the child's head, 
without injury to it, as to enable us to extract it, and the ex- 
tracting force is not sufficient to injure the mother. 

Numerous cases occur where the transverse diameter of the 
child's head is rather larger than the antero-posterior diameter 
of the brim, or the transverse diameter of the lower outlet; but, 
if this does not exceed the amount of compression that the head 
will safely bear, and the force required safe to the mother, such 
extracting force maybe supplied by the forceps, which will likely 
render the uterine action effectiv^e. In inexperienced hands this 
might fail, but with ordinary care no mischief will be done. 

A sufficient grasp will almost always be obtained, where the 
head is not impacted, to enable us to alter the position of the 
child. 

There can be no doubt of the propriety of using these valuable 
instruments, as compressors within natural limits, if early used 
and properly applied. They are extremely valuable in tedious 
labors, for abnormal or diseased action of the uterus. In these 
cases they should be freely used, and the best period for their 
use is early in labor — as soon as the os permits — before the 
maternal system suffers. 



86o 



DISEASE GERMS. 



It is a well recognized rule in obstetrics, that the forceps are 
not to be applied until we are satisfied that the obstacle cannot 
be overcome by the natural powers with safety to mother and 
child. 

In craniotomy our object is to secure the safety of the mother, 
by the destruction of the child, where both would be lost were 
no interference attempted. Cases of rickets, deformity, a dispro- 
portion between the foetal head and the pelvis, whereby a living 
child cannot be expelled by the natural powers ; distortion so 
great as to prevent its extraction. 

In distortion of the pelvis, when the antero-posterior of the 
brim is less than three inches, where we have no chance of 
delivery by other means ;. also, if the transverse diameter of the 
lower outlet is diminished to three inches. No approximation 
of the tuber ischii, if the forceps are applied antero-posteriorly, 






Use of the perforator. 



Application of the crotchet. 



Application of the crotchet 



is sufficient to move the head. We must have recourse to 
craniotomy. 

If the calibre of the pelvis is diminished to a certain degree 
by a fixed obstacle, as a fibrous tumor, exostosis, etc., it is neces- 
sary to diminish the head. It is also necessary, in certain cases 
of ovarian disease, where the tumor has formed adhesions within 
the pelvis, so as to prevent its being pushed above the brim, it 
has been found necessary to lessen the head before the child 
could be extracted ; but we must first ascertain whether the con- 
tents of the tumor may not be drawn off, in order to save the 
child. If the child be hydrocephalic to such an extent as to 
prevent its entering or passing through the pelvis, whether dis- 
torted or of the natural size, there can be no doubt about the 
propriety of opening the head. 

Mode of operating. — It is not necessary for the operation that 
the OS uteri should be fully dilated, though it is an advantage, 



BACTERICIDES. 85, 

for greater care is necessary when it has not taken place. The 
rectum and bladder are first to be evacuated; then place the pa- 
tient upon her left side, with the hips over the edge of the bed, 
and an assistant to keep his hand expanded over the abdomen. 
Then make an examination, and find the part of the head for 
perforation, which is best at the sutures, for the bones will col- 
lapse more readily. ^ Having decided upon the part or position, 
take the perforator, passing it along close to the palm of the 
hand, and inside of the fingers, so as to avoid injury to the soft 
parts of the mother. 

Once arrived at the point of insertion into the skull, carefully 
guided and guarded by the fingers, the perforator is to be pressed 
firmly forward, in a semi-rotating manner, until it pierces the 
bone ; it is then to be passed in, the handles opened, the brain 
thoroughly broken up, the medulla oblongata thoroughly cut 
across. The perinaeum should be carefully guarded, and the 
greatest care exercised that the soft parts be not injured. 



Phantom tumors are among medical curiosi- 
Pregnancy, ties. They commonly occur in females, who, 
{Black}) examined one day, might seem to have a large 
abdominal tumor, examined next day, nothing 
is felt. The size of these tumors varies much ; in some it 
amounts only to the size of a fist, in another it may amount to 
that of a fully distended uterus, near the full term of pregnancy. 
These tumors have not unfrequently been mistaken for a true 
pregnancy, and everything been prepared for the birth of a child. 
Nay, the woman herself has been apparently in labor, and yet there 
have been neither conception nor even enlargement of the v/omb. 
The shape of the tumor may remain long unchanged, or may 
vary from day to day. Sometimes the patient complains of acute 
pain on examination, at other times, she is completely insensible. 
Again, and perhaps most frequently, these tumors seem to disap- 
pear under prolonged and gentle pressure, but they return next 
day or the day after. ^ 

Now as to the cause of such tumors, or rather perhaps we 
ought to say their natures. In a goodly number of instances, 
they consist of flatus, limited to one particular portion of the 
bowel by contraction of the gut above and below. In other 
cases it is said that the muscular wall o£ the abdomen is concerned 
in their product'on, but the cases we have seen, have been of the 
former kind, especially if the walls of the abdomen and the 
omentum were loaded with fat. 

The diagnosis of these tumors is more a curious problem to 



862 DISEASE GERMS. 

the physicians than of practical interest to the pubh'c. Their ex- 
istence is a fact, which, however, should never be forgotten. 
The same treatment as for neurasthenia. 



Constant and distressing erection of the penis, 

Priapism, may be caused by shocks, concussions, blows, 
fractures, injuries of the lower portion of the 
spinal cord, occurring at the lower portion of the lower dorsal 
or upper lumbar of vertebrae : or at the origin of the nerves sup- 
plying the sexual organs in the brain. 

The gonococcus in the urethra often penetrates deeply into the 
corpus cavernosa, breeds rapidly, excites an inflammatory process, 
with effusion of lym*ph or blood into that structure. 

The damaging effects of masturbation and of abnormal and 
excessive coition, upon the same parts, the reflected irritation to 
the spinal cord and brain, is productive of this difficulty. 

The treatment of such cases will depend entirely upon the 
cause. In all cases of shocks, concussions, injuries of the spinal 
cord, general principles must guide. 

When due to sexual excesses, or masturbation, our chief de- 
pendence must be placed upon the frequent administration of large 
doses of tincture of the green root of gelsemium in alternation with 
as large doses of the bromide of potassa as the patient can bear. 
From thirty to sixty drops of the gelsemium every three hours, 
in small, but often-repeated doses, watching it carefully, with 
from thirty to sixty grains of the bromide of potass, to which a 
little bicarbonate potassa is added every three hours. 

Enemata of a solution of boroglyceride, to which a few drops 
of the tincture of belladonna is added. 

Persistently repeat, and repeat the gelsemium and bromide until 
the erections are overcome. 

If the case is one dependent upon the microbe of gonorrhea, 
the same plan of treatment should be pursued, with the addition 
of belladonna suppositories. 



The various affections which are associated 

Prolapse of the with prolapse of the mesentery are a clue 

Mesentery. to its pathology. Given in the order of 

their^ frequency, they are prolapse of the 

transverse mesocolon, prolapse of the hepatic flexure of the 

colon, and prolapse of the right kidney, prolapse of the splenic 

flexure of the colon, and prolapse of the left kidney. The pylorus 

and duodenum are at times also prolapsed, with elongation of the 



BACTERICIDES. 



863 



lesser omentum ; but a mobile pylorus is such an ordinary oc- 
currence that it hardly deserves to be enumerated amongst the 
other complications. The co-existence of these affections has 
just been adduced as an argument to prove that when acquired 
hernia is associated with prolapse of the mesentery the prolapse 
is a cause of the hernia, and not an effect ; and now it may be 
argued that their co-existence proves that, with rare exceptions, 
prolapse of the mesentery is not due to a local and accidental 
condition, but that there is, except, perhaps, in simple prolapse, 
a more general deterioration, in which the suspensory apparatus 
of the mesentery merely participates. The nature of the lesion 
which permits the displacement of the kidneys is pointed out by 
Landau, in his excellent work on movable kidney. In my 
opinion that author clearly establishes that the prolapse of those 
organs is due to elongation of the fascia which descends from 
the diaphragm for their support. The cases in which I have seen 
prolapse of the kidneys, either with or without hernia, show that 
the displacement of the kidney is nearly always associated with 
descent of the hepatic or splenic flexure of the colon. 

Analogy would lead us to infer that prolapse of the mesentery 
was of the same nature as prolapse of the kidney, and was due 
to a failure in the suspensory apparatus. The question, how- 
ever, can be placed upon a surer basis, because there is no diffi- 
culty in ascertaining that when the mesentery is prolapsed its 
root becomes excessively movable and capable of being pulled 
downwards with significant ease ; and moreover, dissection shows 
that under these circumstances the tissues which compose its root 
are thin and scattered and inadequate to resist displacement. The 
suspensory muscle is one of the chief constituents of the root of 
the mesentery, and is, I think, mainly at fault. But there are 
other circumstances, which suggest that the peritonaeum ought not 
to be ignored ; for instance, I am not aware that either the hepatic 
or splenic flexures or the colon, or the transverse mesocolon, 
have other support than the serous membrane, and yet, as we have 
seen, prolapse of one or more of those structures is a common 
accompaniment of prolapse of the mesentery ; also when the 
pylorus is displaced the elongation of the gastro- hepatic ligament 
is very obvious. All of these circumstances point to the import- 
ance of the peritonaeum as a factor in these displacements, in- 
cluding that of the mesentery. With regard to the other struc- 
tures which are involved in this affection, namely, the mesenteric 
artery, vein, nerves and lacteals, we can only infer that they play 
a minor part, although, as in prolapse of the kidney, they are 
noticeably elongated. The causes of the deterioration of the 
suspensory apparatuses and peritonaeum which permits these 



864 



DISEASE GERMS. 



various displacements are not clearly indicated by rny investiga- 
tions, but age has without doubt an important influence, and it 
seems quite safe to add other debilitating influences, such as 
poverty, wasting diseases, certain occupations, and the like. 



Prolapsus of the rectum, or falling of the- 
Prolapse of tlie fundament, or a protrusion of the lower 
Rectum. bowel, may exist in various degrees ; it may 

be simply a protrusion of the mucous mem- 
brane near the anus, or the various coats of the bowel, or the 
bowel itself may be protruded several inches. 

The chief causes of these displacements in children are : in- 
herent weakness ot the parts, diarrhea, straining at stool, worms 
and any irritating disease of the rectum, or genito-urinary organs. 
The same causes may produce like results in adults, also chronic 
diarrhea, catarrh, dysentery, internal hemorrhoids, polypus, 

impacted faeces, diseases of 
the urinary organs, as irrit- 
able prostate and bladder, 
ca.culi, ulcer. 

Symptoms. — Usual ly in 
the early stages the prolapse 
takes place after the bowel 
acts. Insidiously, and pro- 
gressively the descent of 
the bowel or its coats follow 
any exertion, as running, 
jumping, coughing, strain- 
ing, laughing, crying, etc. 
A fold of the mucous coat at first, by and by the inverted bowel 
may be protruded to the extent of four or five inches. This 
usually follows defecation, and is easily returned ; but if not cured 
speedily, the sphincter ani becomes relaxed, and the pro- 
lapsus becomes permanent ; the intestinal mucous membrane 
being exposed to the air and subjected to various forms of irrita- 
tion, becomes thickened, indurated, often ulcerated; discharge 
of mucus tinged with blood; general distress, about the hips, 
back, with severe pain in defecating. The reflex symptoms are 
numerous, headache, mal-assimilation, nervous twitching, convul- 
sions, general impairment of the vital force. 

Treatment. — In the prolapsus of both children and adults, 
much good can be effected by improvin-g the general health in 
every possible manner. Daily bathing, massage, flannel clothing 
and the very best of diet, abundance of fresh air. The patient 




Prolapse of rectum, with its mucous membrane. 



BACTERICIDES. 



865 



should in all cases pursue an alterative and tonic course of treat- 
ment for some months. The best remedies for internal exhibition 
are Virginia stone-crop, collinsonia, bayberry, aromatic sulphuric 
acid and quinine; compound tincture of cinchona and nitro-mu- 
riatic acid, and for an alterative compound, saxifraga. 

The bowel, if possible, should never be permitted to remain 
protruded, if it can be returned ; if this is difficult, make a hot poul- 
tice of pulverized slippery elm, in which are incorporated some 
powdered lobelia and belladonna leaves. After this has remained 
a short time the bowel is usually very easily replaced by oiling 
the back of the hand and pressing it gently, but firmly, against 
the bowel, and replacing it. In some obstinate cases, it may be 
necessary to administer an anesthetic 
or place the patient under the influ- 
ence of a relaxant, as the compound 
lobelia. 

When the bowel is returned every 
precaution must be taken to prevent 
a recurrence or even a slight pro- 
trusion by applying a pad of lint 
firmly against the anus and a T- 
bandage. 

The bowels should be moved by a 
mixture of castor oil and glycerine ; 
a sufficient quantity administered to 
cause one evacuation of the bowels ; 
or fluid extract of butternut, or cas- 
cara sagrada lozenges might be tried 
for the same purpose. 

The patient for a few weeks should defecate in the recumbent 
posture so as to avoid straining. Immediately after the bowels 
have moved, a cold water hip bath should be used, parts well 
dried, and a teaspoonful of either the fluid extract of Virginia 
stone-crop, or collinsonia, or oak bark, or matico, or bayberry, 
added to one or two tablespoonfuls of water injected into the 
bowel, or if a mineral acid is deemed best, the following is of 
great efficacy : aromatic sulphuric acid, one ounce ; water, six- 
teen ounces. Mix. Inject one ounce. 

The best suppository to use instead of the enemata is one 
made of the Virginia stone-crop, pulverized opium and butter of 
coca. 

If these means fail, after a fair and prolonged trial, administer 
a large dose of castor oil before retiring to bed ; next morning, 
after the bowels are thoroughly emptied of their contents, the 
protruded portion should be well cleansed with warm water and 

55 




Prolapsus of three folds of the rectum 
with posterior tubercular ulcer — a 
most c«mmon condition in the diar- 
rhea of phthisis. 



366 DISEASE GERMS. 

castile soap, and returned, then an ordinary anal speculum with 
a window its entire length, well warmed and oiled should be in- 
inserted its entire length, the vertical portion of the bowel ex- 
posed in the window of the speculum should be wiped dry, 
then C. P. nitric acid should be painted down its entire length. 
This should be repeated thrice, so as to be effectual. Then the 
speculum should be turned about three-quarters of an inch and 
another vertical streak made with the nitric acid, and this should 
be repeated so as either to make five or seven vertical streaks 
around the bowel. An interval of time should elapse between 
each turn of the speculum so as to permit the nitric acid to 
penetrate to the erectile fibres. 

Following this, one grain of pulverized opium should be ad- 
ministered every three or four hours to allay peristaltic action ; 
patient confined in the recumbent posture for about seven or nine 
days. 

Underneath each of the vertical streaks of nitric acid, a species 
of plastic inflammation is set up, lymph is effused, thickening 
takes place and vertical pillars, usually strong enough to keep the 
bowel erect, are established. 

Food must be taken in a concentrated form, as it is not desira- 
ble to have the bowels move for over a week. At which time they 
should be acted on with castor oil. 

This is the most effective method of affording a radical cure. 



The uterus may be displaced in various ways. 

Prolapse, the most common forms being simple displace- 

i^Uterus) ment in which it descends down and protrudes 

beyond the vulva ; anteflexion, where the fundus 

of the uterus is bent over on the bladder ; and retroversion, in 

which the fundus is bent over on the rectum ; besides it may be 

displaced laterally. 

The predisposing causes are inherent wealcness of organization, 
or debility. 

The exciting causes are a relaxed state of the vaginal walls, 
debility of the broad ligaments, added to which there is either 
tight lacing, Hfting, jumping, strains, fall, standing occupations, 
constipation, indefinite retention of urine, congestion, tumors. 

Prolapsus and procidentia are two terms employed to designate 
a descent or falling of the womb, as * it exists in two different 
degrees, or grades. Prolapsus means that condition in which 
the uterus falls below its natural level in the pelvic cavity. The 
term procidentia is used when the uterus slides down and pro- 
trudes beyond the vulva. It is simply prolapse or falling, ex- 
tended in degree, both conditions being the same. 



BACTERICIDES. 



mr 



Symptoms. — Leucorrhoea, pain in the back, sense of weight or 
fulness about pelvis, bearing-down pains. Usually no impedi- 
ment to menstruation, or conception, as uterus is generally re- 
placed when in the recumbent posture in bed ; irritation of blad- 
der and rectum. In prolapsus, uterus found depressed, resting 
on upper floor of perinseum ; in procidentia, a round or pear- 
shaped tumor, with os uteri visible at its centre, is seen project- 
ing beyond the vulva. Labia of os uteri, from exposure to air 
and clothing, often becomes excoriated; vaginal walls dry, 
harsh, cracked or ulcerated. 

Treatment, — As far as possible remove all predisposing and 
exciting causes, as debility, tight lacing, coughing, constipation, 
standing occupation, congestion ; carefully regulate bowels with 
either cascara sagrada or kola nut, so that the stools will be soft, 
and easy ; place the patient upon the best of food and a tonic 
course of remedies, embracing such medicines as wine of aleteris 
farinosa ; and coca erythroxylon, in alternation with comp. syrup 
of partridge berry and comp. tincture 
cinchona. A two-quart fountain syringe 
is an essential requisite of every lady's 
toilet. This must be used morning and 
night. The first thing in the morning, 
before getting up, it should be used in 
conjunction with a bed-pan, so as to keep 
patient strictly in recumbent posture. A 

selection from some of the following 

agents should be made for the purpose Proiapse of uterus (procidentia). 
of injecting : boroylyceride, resorcin, 

creolin, lime water and tincture of iodine, matico, oak bark , dis- 
tillation of witch hazel. 

A full quart or more be permitted to pass through — of a 
strength adapted to each particular case. 

Before the patient is permitted to get up, some form of mechani- 
cal support should be applied. 

This may consist of a silver, or gutta-percha cup, or it may be 
a fine silk sponge, cut in the shape of a small pear, with a silk 
cord fastened to it, which saturate with the last wash used, and 
then insert up the vagina, the broad baipe upwards and point or 
pedicle downwards, from which the cord hangs. Then patient 
to get up. The size of this pear-shaped sponge will depend on 
the capacity of the vagina ; it must be large enough to prop the 
uterus up in its proper place. This process of injection is to be 
repeated at noon and at bedtime. The patient can easily draw 
the sponge out herself, which should be thoroughly washed 
every time. After the night injection the sponge need not be 




868 DISEASE GERMS. 

inserted, but should be laid to steep in a solution of boroglyce- 
ride. This is to be repeated every day, changing remedies 
every three or four days, and keeping the patient lying down as 
much as possible. Cold water hip-bath, morning and night, to 
give tone to the pelvis and its organs, especially the broad liga- 
ment. All treatment, except the tonics, to be discontinued 
during menstruation. 

If the case is an aggravated one of procidentia, the uterus 
must be returned, and the same plan pursued. 

Now, if this fails in eight or ten weeks, which is seldom the 
case if patient is faithful, and the injections cold and of proper 
strength, return the uterus, and resort to the radical operation of 
painting seven vertical streaks on the vaginal walls, as described 
under Vaginal Prolapsus. This is better than humbugging with 
belts, supporters, plates, pessaries, rings, and other trash that 
irretrievably ruin a woman. Any lady, with a very little in- 
struction, may cure herself in a short space of time. It will aid 
matters much if she is freed from all domestic care, or toil, or 
worry, so that when about she can either walk gently, or ride, 
for the improvement of general health. 

A most excellent plan in old chronic cases, with considerable 
irritation and thickening of the neck of the uterus, is to pack 
the vagina with boroglyceride every night on retiring to bed. 
This exercises a most beneficial effect, as it stimulates absorp- 
tion of the effused lymph, and exercises a highly vitalizing action 
upon the parts; it gets rid of the induration, drains off the super- 
fluous products of inflammation. 

If this does not operate speedily, or efficiently enough, the in- 
sertion of two or three jequirity capsules, say about once a week, 
will cause a complete exfoliation of dead tissue to take place, 
and lighten to a considerable extent the specific gravity of the 
uterus. 

The body or fundus of the uterus may be thrown forward on 
the bladder, or backward on the rectum, constituting anteflexion, 
or retroflexion. 

If the displacement backward or forward is not very great, 
there may be very few symptoms present. If the flexion is quite 
considerable, there is much suffering ; the uterine ligaments are 
unduly stretched, the circulation through the body of the uterus 
is interfered with, impeded, and the fundus immovably fixed on 
either the bladder or rectum. 

The leading features of those cases are great languor, lassitude, 
debility ; dull, wearing, aching pain in back; tenderness about the 
groin and inside of the thighs ; sense of fulness or obstruction in 
either rectum or bladder; pain in coition; fecundation prevented; 



BACTERICIDES. 



869 



severe dysmenorrhoea ; nausea, gastric irritation, loss of appetite. 
Great mental depression, reflex irritation, etc. 

The displacement is readily made out in all cases by the uterus 
sound. 

Antiflexion of the uterus gives rise, in addition to pressure on 
the bladder, to sterility, dysuria, dysmenorrhaea, dyspermasia. 
The kink produced in the cervical canal by the flexion of the 
cervix prevents the ingress of the seminal fluid into the uterine 
cavity. Until this obstruction is removed by straightening the 
canal, the sterility will persist. To effect this the introduction of 
an intra-uterine stem is the only certain remedy. Slight flexions 
may be relieved by the occasional passage of the uterine sound. 

Backivard displacement^ and uterus freely movable, the bladder 
should be emptied and the uterus fully replaced by bimanual 
manipulation in a position of complete anteversion, the fundus 
being directed to the pubes and the cervix to the sacrum. A 
Hodge pessary of sufficient size is to be now inserted to keep the 
cervix in this position. The use of the pessary in the posterior 
cul-de-sac is not to support the body of the uterus, but to sling 
the cervix upwards and backwards. 

When adhesions prevent reposition, and no activ^e disease 
exists, stretching and loosening the adhesions is to be recom- 
mended. 

Cases of this kind are not by any means 
Prolapsus rare. It is met with in women who have 

of the Vagina, practiced masturbation, or borne many 
children, or had numerous miscarriages. 
Tight-lacing, strains, lifts, coughing may produce it. 

When the front part alone is affected it draws down the back 
portion of the bladder and is called vaginal cystocele ; if the back 
wall of the vaginal falls down it is called vaginal rectocele. In 
the former case, urine is apt to accumulate tn a pouch formed by 
the bladder; in the latter, a pocket forms in which hardened 
faeces are retained, causing a sense of weight and irritation. 

In the treatment of prolapsus of the walls of the vagina there 
should be an avoidance of coughing, straining, lifting, and above 
all things, tight-lacing. The patient should be placed upon a 
general tonic and alterative course of treatment : the wine of 
the aleteris farinosa and coca erythroxylon in alternation with 
compound partridge berry, compound tincture of cinchona, avena 
sativa. 

Vaginal injections, with fountain syringe thrice daily, very 
copious, consisting of boroglyceride, matico, oak bark, glucozone, 
distillation of witch hazel. 

Pastiles are also of great utility. 



870 



DISEASE GERMS. 



An effort of cure should be tried by these and like means. All 
failing, then a radical cure should be tried, as follows : 

In diminishing the calibre of the canal, in exciting seven pillars 
of plastic inflammation, or effused lymph to prop it up. It is 
performed as follows : Bladder to be evacuated, rectum 
thoroughly syringed ; the vagina to be washed out with a 
quart of soapsuds ; the protrusion returned ; then introduce 
a proper-sized speculum, with a window ; wipe dry the part 
of the vaginal walls opposite window ; then take chemically 
pure nitric acid and paint a vertical streak one-quarter of an 
inch wide and two and a half inches long ; paint it neatly and 
carefully seven or eight times ; when finished, turn speculum half 
an inch and repeat the same process by making another, 
and another, until seven good streaks are made. Before re- 
moving speculum, fill it with a piece of lint, saturated with olive 
oil, which, hold firmly with a ramrod ; then withdraw the specu- 
lum, leaving the oiled lint in vagina. Administer one grain of 
opium every three hours, to lock up the bowels ; keep patient in 
bed ten days, with a catheter in bladder ; permit no straining, 
laughing, or lifting for some time ; bowels to be opened with 
enemata or cascara'sagrada. This is the most effectual method, 
if well performed. The oiled lint need not be disturbed for a 
week, unless there is some uterine difficulty above ; if there is, 
it may be necessary to remove it inside of twenty-four hours. 
On the removal of lint, injections of cold linseed tea or slippery- 
elm-water ; all through, pushing tonics and good diet. 

A more recent method is contraction of the calibre of the 
vagina by the use of the jequirity wafers, and occasionally pack- 
ing the vagina with boroglyceride. 



One of the most common of all maladies, a 
Prostatorrhoea. hyper-secretion of the tubular glands of the 
prostate, due to any irritation, such as mas- 
turbation, extension of the gonorrheal germ, to marital sexual 
excesses, sedentary habits; bicycle riding, etc., morbid sensibility 
of the prostate, aggravated by stricture, riding, alcoholic and 
malt liquors, with contraction of the perineal and other muscles 
during the micturition and defecation. 

Such an irritation, with sufficient discharge to barely cause a 
gluing of the lips up to several drachms, invariably depreciates 
the quantity and quality of the semen, so that under the micro- 
scope, the discharge is found to consist of cylindrical epithelial 
cells, countless refractory and colorless granules of lecithen, and 
minute, yellowish concentric, amyloid concretions, phosphate of 



BACTERICIDES. 



871 



magnesium, watery and colloid semen. When the secretion de- 
pends upon chronic inflammation of the glands of the prostate, it 
thickens, and contains in addition, pus, mucus, corpuscles, muco- 
purulent casts of the follicles and ducts. 

' In addition, the local signs, urgent desire to relieve the blad- 
der, scalding in urinating, a sense of weight, fulness, even dull 
pain in the perinaeum. Aching, with darting pain in the hips, ex- 
tending down to the knees ; unsteadiness of gait ; and reflexly the 
irritation is carried to the medulla oblongata ; brain suffers, as we 
see by the vertigo, tinnitus aurium, haziness of vision and unbal- 
anced state of the sufferer. In all cases, it is an obstinate affection 
to treat. All causes that tend to produce or aggravate the trouble 
must be interdicted, and attention to the diet and secretions duly 
attended to. 

The oozing or leakage is owing to a 
swollen and irritable state of the pros- 
tate gland and a debilitated condition 
of the seminal vessels allowing that 
fluid to escape; consequently a general 
alterative and tonic course is indicated. 
This enlarged prostate is exceedingly 
common, and the older methods of treat- 
ment are of no utility whatever. 
, .^. . ^ ^, ^j The introduction of a seven-inch bougie, 

A Diagram of the Bladder, , . , , . , . , , ,*=» . ' 

showing the prostrate gland prepared from the glucoside 01 the black 
enlarged. willow, Stimulates absorption in the gland, 

reduces its size, and restores it to a healthy condition. The pro- 
cedure possesses many advantages over all other methods. In 
old chronic cases experience has satisfied me of the utility of this 
remedy in this form ; it has very many advantages, it does its 
work well, its use is not attended with pain, it does not require 
the patient to leave off his usual avocation, it has a peculiar and 
astringent action on the parts. Among the medicaments lately 
brought into very general use for restoring, the integrity of the 
sexual organs, none can excel the fluid extract of black willow ; 
it is a drug which is both sedative, tonic and astringent to the 
nerves and vascular structure. 

When the reproductive organs of both sexes are damaged in 
any way, it is the drug from which the most decided tonic action 
is to be obtained. 

By its use all leakages, great or small, are effectually checked. 
Its introduction at the present time may stem the current which 
is dwarfing humanity in its very essence. 

Every man or woman who has practiced self-abuse ; every one 




8;72 DISEASE GERMS. 

who has had a gonorrhea, or suffered from sexual perversion, or 
ridden a bicycle, needs the vivifying influence of the salix 
niger. 

For a more elaborate descriptive article, the reader is referred 
to article Hypertrophy of the Prostate, page 475, of present 
volume. 

The most prevailing affection of American males, in all 
ages. 



A condition of heightened sensibility, with 

Pruritus, altered nutrition, with microbe evolution, in which 
the main symptom is an indescribable itching, 
affecting the whole or a portion of the body. Generally local, 
not infrequently a most troublesome, obstinate malady. 

Pruritus of the vulva frequently depends on uterine disease, 
and all remedies prove useless till that is removed. 

After vaginal injections of either lotions of boroglyceride or 
resorcin, try some of the following remedies : Carbolate of 
sodium in equal parts of cologne spirits and glycerine ; or the 
sozoiodol of mercury ; or strong peppermint water and borogly- 
ceride. 

Pruritus ani, lime water and fluid extract of belladonna, or 
ozone ointment with atropia ; salicylate of soda, with creosote 
and camphor, is most efficacious ; tincture benzoin, peroxide ot 
hydrogen, oil of rue, etc., painted on the part are of immense 
utility. 

A selection of one of the following formulae may be tried in 
pruritus: Saponis viridis; oil cadini ; alcohol, of each one 
ounce ; resorcin, two drachms. Mix. 

Sodae borate, two drachms ; chloride of morphia, sixteen 
grains ; dilute hydrocyanic acid, half an ounce ; glycerine, two 
ounces ; water, eight ounces. Mix. 

Add one ounce concentrated ozone to two ounces of ozone 
ointment. Mix. 

Muriate of cocaine, fifteen grains ; muriate of morphia, ten 
grains ; carbolic acid crystals, twenty grains ; tincture of aconite 
rad., three drachms ; rub the whole up in one ounce of ozone 
ointment. Apply lightly over the affected surface. 

Menthol, thymol, of each one drachm ; oil of sweet almonds, 
one ounce ; benzoated zinc ointment, half an ounce ; muriate 
cocaine, ten grains. Mix. 

Conium cerate, one ounce ; resorcin and salicylic acid, of each 
two drachms. Mix and apply. The local treatment should be 



BACTERICIDES. 



873 



commenced by the institution of the most perfect cleanliness. 
The patient should be instructed to wash his anus well with a 
cloth and cold water after each action of the bowels, and then to 
bathe his anus with the following wash : 

Hyposulphite of soda, half an ounce; carbolic acid, two 
scruples ; aqua destil., four ounces ; glycerine, two drachms. 
Mix. Sig. — Shake the wash well, and use freely after first 
thoroughly washing the anus with cold water. 

In addition to this treatment, the patient must every night or 
two, after undressing for bed and washing and drying his anus, 
lie upon his face, and with his hands behind him separate his 
nates as widely as possible, and be instructed to strain as at 
stool, and while thus straining the anus will protrude, and while 
the anus is protruding in consequence of the strong effort, five 
or ten grains of pulv. iodoform must be sprinkled upon the anus 
from a knife or spatula by an assistant. The minute eruption 
which causes this most distressing itching will be found most 
abundant at the junction of the mucous membrane of the rec- 
tum and the skin of the anus, and it is at this situation that the 
application does the most good. The patient should allow the 
iodoform to remain in the position of its application during the 
night, repeating- during the day his ablutions of the anus after 
each action. The probability is that after two or three nightly 
applications of the iodoform all pruritus will disappear ; but the 
patient should be directed to have the application of the iodoform 
continued three or four times a week until he is entirely relieved. 

Frequently we have occasion to try many medicaments in 
succession before we hit the right one suited to the case. The 
disease is always stubborn in pregnant women. External appli- 
cations are not always of permanent utility, constitutional treat- 
ment is often required, even then we have our hands full, for 
medicaments soon lose their effect. 

Gelsemium in full doses has done best for us of any single 
remedy. Skull-cap is often of eminent benefit in some cases. A 
combination of chloral and bromide of soda occasionally does 
wonders. In some cases euonymus and helonius act well. In 
one severe case, lady-slipper tea, made from the recent root, one 
ounce to a pint of boiling water, a wineglassful every two hours, 
worked like magic. 

Among local agents, balsam of peru stands first in our ex- 
perience, apply it full strength. Some cases will require it di- 
luted, then use vaseline as the diluent. When it fails, try an 
ointment made of balsam peru, two drachms ; quinine sulphate, 
one drachm ; extract belladonna solid, one drachm. Rub on 
the parts. Borax, two drachms, water, eight ounces ; oil of 



874 



DISEASE GERMS. 



peppermint, ten drops. Apply often to the parts. Nitric acid, 
ten drops ; water, eight ounces Apply to the parts. Bismuth 
subnit, apply dry to the parts. Iodoform, bismuth subnit, boric 
acid, equal parts. Apply dry to the parts. Boroglyceride and 
resorcin a most excellent application. 

In some cases, local applications to the os uteri will be needed 
to effect a cure. But few things are equal to carbolic acid di- 
luted with glycerine, applied at first moderately strong, then 
stronger. You may add solid extract belladonna with good re- 
sults. In one case we made a strong solution of salicylic acid 
in glycerine, applied to the os and cervix with a small swab. A 
second application was needed a week after, after which no more 
trouble was experienced. A medical friend says he has the best 
results from dry sulphur, rubbed on the parts and small doses 
taken internally twice a day. Keep the bowels soluble with mild 
cholagogues. 

There is often an intimate relation between pruritus in preg- 
nant women and liver inactivity, hence the benefit of such reme- 
dies as chionanthus, 

The causes of general pruritus is obscure, it is met with chiefly 
in elderly people, and is but very little amenable to treatment. 
When present in the middle-aged, it is generally associated with 
some other malady, especially jaundice, glycosuria, and albumi- 
nuria. In women, pregnancy and disturbance of the menstrual 
functions may also give rise to it. The disease, however, is more 
commonly met with as a senile change of an obscure kind, and 
as such is incurable. 

Treatment. — When the neurosis arises from, or is associated 
with, some other malady, such as jaundice, glycosuria, or dis- 
turbed menstrual functions, a rational and often successful mode 
of treatment is at once suggested. The cause of the disease 
should as far as possible be removed, and in addition, local reme- 
dies of a soothing kind may be used to give a little temporary 
relief from the intolerable itching. Amongst these, tepid gela- 
tine, and bran and alkaline baths are the most generally useful, 
some soothing ointment being always applied to the skin after 
the bath, to prevent it from becoming too dry and cracked. In 
senile pruritus the same plan of local treatment may be adopted, 
but the relief at best is only temporary. 

In all cases of pruritus, whether local or general, the microbe 
of neurasthenia is ever present, and all cases are greatly benefited, 
nay, cured by glycerite of kephaline and tincture of oats. 

Great cleanliness is essential. Stimulating food, hot, fiery 
drinks avoided. 



BACTERICIDES. * 8/5 

A peculiar form of skin disease, characterized by 

Prurigo, itching especially when the body is heated, due to 

an altered state of nutrition of the skin. Generally 

no eruption visible. There are numerous varieties, depending 

upon the cause. 

Any remedy which will promote nutrition of the skin is the 
one to administer, as quinine, iron, sulphur, arsenic, oxygen. 
Locally, sulphur baths, naphthaline. 



A term applied to a condition, in which the 

Psilosis. leading features are bareness or rawness of the 
tongue and entire intestinal mucous membrane. 

The most prominent symptoms are remitting inflammation of 
the mucous membrane of the mouth and alimentary canal; diar- 
rhea, irregular action of the bowels, anaemia, general atrophy. 
During the exacerbation, tongue swells, papillae become elevated 
and red, shallow ulcers appear on the cheeks, tongue, lips, accom- 
panied with salivation, swelling and tenderness, with a tendency 
to bleed ; articulation is difficult. The acute stage passes off, 
and the tongue becomes small, glazed or shining, looks as if it 
was denuded of its epithelium. Taste and smell usually in abey- 
ance. 

The evacuations from the bowels are usually a gray pultaceous 
mass deficient in bile ; albumen, excessive debility. 

The pathology of the disease is obscure. 

What few cases have been seen have been amenable to an in- 
fusion of the Japanese persimmon with resorcin, and arrow root 
and beef tea for diet. 



This is a dry scaly disease of the skin ; it is 
Psoriasis, chronic in its course and characterized by 
slightly raised red patches covered by white, 
shining, opaque scales ; these scales often come off in great 
numbers, so that on waking iu a morning, the patient finds his 
bed full of little branny particles. Sometimes the spots are cir- 
cular, small and numerous, and scattered over the skin ; some- 
times they are ring-shaped and the centre is healthy, while the 
disease spreads at the circumference ; sometimes large patches 
of irregular shape occur, and most often they are seen at the 
knees and elbows ; at other times the patches assume a figure- 
of-eight form. The edges are always well defined and with a 
tendency to be circular ; when the scales are rubbed off, a dry 
and red surface is left. The name lepra was formerly given to 



^76 



DISEASE GERMS. 



the ring-shaped variety of psoriasis, but the term has now fallen 
into disuse. Psoriasis in all its forms runs a very chronic course, 
lasting not unfrequently for many years. When cured it is 
prone to come back again. Some persons have an attack of 
psoriasis every year ; spring and autumn are the seasons when it 
most frequently appears. The red patches of psoriasis are due 
to inflammation of the skin ; the scales are due to excessive for- 
mation of epithelium on the inflamed surface. The rash is often 
accompanied by much itching ; it occurs on the coarse and dry 
parts of the skin, and not where the sweat-glands are abundant. 
The disease is never communicated from one person to another, 
although a tendency to it is certainly hereditary ; it may come 
on as a consequence of syphilis. On the palms of the hands and 
soles of the feet it may be mistaken for eczema. 

The peculiar defect which gives rise to this form of skin dis- 
ease, is to be found in the presence of the bacillus of tubercle, 
syphilis, rheumatism, gout ; in the surroundings and general 
health of the patient ; in states or conditions of depressed vitality, 
overwork, relaxing climate, sexual excesses, or any excessive 
drain upon the system. 

In the treatment, the essential points are to build up the gen- 
eral health by every possible means, by a most nutritious diet, 
daily hot alkaline baths ; flannel clothing. 

General alteratives and tonics, as saxifraga, phytolacca ; alter- 
nated with avena sativa, kephaline. 

A selection of some of the following remedies are worthy of a 
trial. Large doses of Fowler's solution might be tried, and in 
order to facilitate its toleration. 

Oil of cadi is a most efficacious remedy as in the following 
formula. Glycerite ; starch ; oil of cadi, and green soap. This 
in suitable strength, is applied over the eruption. 

An ointment of thymol, or salicylate soda, or chrysarobin. 



Red, circumscribed, hyperaemic 
Psoriasis Linguae, patches on the tongue, and inner sur- 
{Leucoplacia) face of the lips and cheeks, may exist 

for a few days, weeks, or months, and 
then spontaneously subside, or become developed into circum- 
scribed grayish or white discolorations. 

There are many micro-organisms present, the oidium albicans 
usually taking the lead. Irritation has much to do with its pro- 
duction, especially smoking, which favors the development of 
epithelioma. 

The numerous micro-organisms are met with in nests, which 



BACTERICIDES. 



877 



bore their way into the epithelium, and deeper tissue, giving a 
thickened and fissured aspect to the patches. The whole pro- 
cess is characterized by infiltration and cell-proliferation of the 
corium, which explains the obstinate persistence of the patches 
and the readiness with which they undergo conversion into 
other processes. The early or hyperaemic stage of leucoplacia, 
as described by Professor Schwimmer, is not often seen ; the 
disease usually presents the appearance of milky white patches 
on the dorsum of the tongue ; sometimes these patches are 
slightly raised and rough, and have a sodden appearance ; in 
other cases they are quite smooth. I.eucoplacia is not confined 
to the dorsum of the tongue ; it is occasionally met with on the 
mucous membrane of the cheek and lower lip. 

Diagnosis. — Leucoplacia should be distinguished from a some- 
what similar condition produced by syphilis, and also from 
superficial scars of the tongue, which sometimes have a white 
appearance ; and, if I am right, it should also be distinguished 
from psoriasis of the tongue, which, like the syphilitic affection, 
is more amenable to treatment than ordinary leucoplacia ; but 
on this point I should be very unwilling to dogmatize. 

In the treatment, all irritation, including smoking, should be 
removed. The most favorable local treatment is the application 
of a saturated solution of boroglyceride. 

Many kinds of stomatitis have been described, but it is only 
necessary to refer to three : 

1. Aphthous stomatitis, which is the commonest of all forms, 
begins as little yellowish spots of exudation; these subsequently 
form into small, very superficial ulcers with a red areola. When 
these ulcers are of larger size than usual, and the attendant in- 
flammation considerable, the disease becomes both very painful 
and troublesome, and the ulceration difficult to cure ; but under 
ordinary circumstances, when it does not assume this severe 
form, it yields readily to local and general treatment with boro- 
glyceride. The affection is very apt to recur. In all severe 
forms of ulcerating stomatitis the internal administration of 
opium is all-important. 

2. Parasitic stomatitis, or thrush, is chiefly met with in un- 
healthy children, and in those suffering from exhaustive diseases. 
It is due to the micro-organism oidium albicans. The white 
patches seen on the buccal mucous membrane are found to con- 
sist of epithelium permeated by the spores and mycelium of the 
parasite. A weak resorcin lotion is useful as a wash for the 
mouth, and in addition the spots may be painted with glyceri- 
num boracis, applied with a small camel's-hair brush. 

Wandering rash on the tongue. It is usually seen as small 



8/8 



DISEASE GERMS. 



rings and fine serpiginous lines of a bright red eruption. The 
peculiar character of the rash is the quickness wito which it 
spreads centrifugally, so that it is appropriately described as 
wandering over the dorsum of the tongue ; the rings will some- 
times disappear and new ones appear in the course of a few 
hours. Subjective sensations of itching are always present. It 
has been compared in appearance to ringworm, but has no re- 
lationship to that disease. 



A varicose condition of the vessels of the inner 
Pterygium, canthus of the eye, giving rise to a triangular 

excrescence, usually the result of inflammation. 
The generally accepted theory of all authors is that pterygium 
has its origin in a marginal corneal ulcer, to which a tag of con- 
j unctiva has become attached ; it is thought to be untenable, because 
if this were its usual mode of origin, pterygium would be found 
approaching the cornea from every possible direction, since 
marginal corneal ulcers are not apparently more frequent in one 
position than in another. It is known, however, that such is not 
the case, but that pterygium is almost always situated directly 
over the recti muscles, and that in a very large proportion of 
cases it is over the rectus internus. The more recently proposed 
theory of Poncet, that pterygium is due to the presence of mi- 
crobia, which tunnel their way under the corneal epithelium, is 
open to the same objection, for this also assumes the existence 
of a precedent corneal ulcer. The view long held, that con- 
ditions which tend to induce chronic hyperaemia of the conjunc- 
tiva favor the formation of pterygium, is thought to be well es- 
tablished. 

Assuming that this view is correct, are there reasons why a 
localized hyperaemia of the conjunctiva should be of frequent 
occurrence where pterygium usually forms to the nasal side of 
the cornea? This is answered as follows: The close connec- 
tion between the vessels of the recti muscles and those of the 
anterior portion of the conjunctiva, were referred to, and it was 
pointed out that the determination of blood to these muscles 
might influence the blood-supply of the overlying conjunctiva, 
and that this would be the case especially with the recti interni, 
since they were the largest of the straight muscles and in close 
relationship with the conjunctiva, because attached to the scle- 
rotic nearer to the corneal border than any of the others. Ab- 
normality in the distribution of the blood-supply of the internal 
recti muscles, and of the overlying conjunctiva, and, more fre- 
quently still, disturbance in tihe normal relationship between 



BACTERICIDES. 



879 



convergence and accommodation, such as insufficiency of the 
of the internal recti muscles, the different varieties of ametropia ; 
these were regarded as the usual causes of pterygium through 
the localized hypersemia of the conjunctiva, to which they give 
rise. 

Brushing it over with a solution of nitrate of silver, thirty 
grains to the ounce of water, repeating a few times with proper 
intervals apart, is usually successful in effacing it ; if not, then it 
must be hooked up and snipped off. 



All chemical compounds, basic in character, 

Ptomaines, formed during the putrefaction of organic mat- 
ter. They bear the closest possible resemblance 
to vegetable alkaloids, but they are not all poisonous. 

All putrefaction is due to the action of bacteria; ptomaines are 
the result of the growth and activity of disease germs. 

The poisonous or non-poisonous character of ptomaines de- 
pends a great deal upon the individual bacteria engaged in their 
production, upon the temperature, amount of oxygen present, 
electrical states, etc. 

Each disease germ excretes or generates its own ptomaine. 
The bacillus of typhoid produces the ptomaine ty photo xine ; 
tetanus, tetanine ; which if injected into animals gives rise to 
tetanic convulsions ; the bacillus amylobacta, by its action on 
carbohydrates, gives rise to butyric. 

Bacteria are either aerobic or anaerobic ; the one thrives by the 
presence of air, the other by its exclusion. This quality in itself 
causes a difference in the chemical character of a ptomaine, 
besides there is a decided difference in the various stages of 
putrefaction. 

Ptomaines are transition products in the progress of putrefac- 
tion — temporary forms through which matter passes in its change 
from the organic into the inorganic state — complex organic sub- 
stances, as brain, gland, muscle, etc., are broken up into less 
complicated molecules — their original elements. 

Countless myriads of minute organisms are thus constantly 
engaged in transforming matter from the organic to the inorganic 
state. 

Besides being abundant in all putrefactive states, ptomaines, 
abound in all forms of shell-fish, in decaying sausages ; in im- 
perfectly cured ham ; in all canned meats ; in a large amount of 
imperfectly cured cheese ; tyroxicon is found in all milk partially 
frozen, then thawed, and re-frozen and used ; in ice cream ; in the 
mould of meal, flour or bread, ptomaines are found like in ap- 
pearance to the crystals of uVea. 



38o DISEASE GERMS. 

Specific micro-organism are the cause of special disease. Each 
must be pathogenic of that disease and conform to definite rules. 

In order to be able to state definitely that any disease is due to 
the action of a microbe it is necessary to fiilfil certain conditions 
as formulated thus : 

1. The microbe must be found in the body of the man or 
animal suffering from or dead of the disease. 

2. The microbe must be isolated and cultivated in suitable 
media outside the body of the animal. The cultivations should 
be carried on through successive generations of the organism in 
order to insure its purity. 

3. A pure cultivation when introduced- into the body of a 
suitable healthy animal, must produce the disease in question. 

4. In the inoculated animal the same microbe must again be 
found. 

The cultivation of microbes. — In the examination of air, water, 
and the fluids and tissues of the body many kinds of microbes 
may be seen under the microscope, but it is possible to distin- 
guish them from one another only by comparing their reactions 
to staining fluids and their appearance and mode of growth in 
certain media. The media which are used are both solid and 
fluid; potatoes, peptone-gelatine, agar-agar (Japan isinglass), 
bread-paste, chicken-broth, milk, blood serum, urine, various 
chemical solutions, most of which contain sugar and phosphates. 
These media, as well as all apparatus with which either the mi- 
crobes or the media come in contact, must be thoroughly 
sterilized. 

It is found that some organisms grow better in one kind of 
soil, others in another, thus pathogenic germs grow best in an 
alkaline medium, putrefactive in an acid one : and at least twelve 
pathogenic forms will not grow in nutrient animal jelly. It is 
not every acid, however, which interferes with the growth of 
pathogenic germs, as the acid surface of a potato affords a favor- 
able nidus. Besides these points, their growth is influenced by 
temperature, by the presence of mineral matter (amount and 
kind), and by the presence or absence of oxygen (aerobic or 
anaerobic). 

Germs grow in nutrient jellies in a manner varying with the 
way in which they are planted, the usual methods in tubes are 
surface, depth, and streak cultivations. Gelatine jelly is used 
when the required temperature at which the tubes have to be 
kept is under 25° C., at which point it liquefies; agar-agar 
liquefies at 35° C. When microbes are cultivated in this man- 
ner, under favorable circumstances, they rapidly grow and mul- 
tiply ; this is done by simply dividing in two (fission), or by the 



BACTERICIDES. g^I 

production of spores, or by both means. The vitahty of many 
of the spores is so great that if circumstances favorable for im- 
mediate growth are not present, they will survive for very long 
periods ; outbreaks of diseases which seem spontaneous in their 
origin may be thus explained. 

The special bacterium must be present in all forms of the disease ; 
special micro-organisms freed from all extraneous matter. 

The micro-organisms themselves may be poisonous, or the 
poison may be an integral part of them, or the germ may pro- 
duce a poison, by splitting up pre-existing compounds in the 
body, or it may be intimately associated with or produce a solu- 
ble, chemical ferment. 

Ptomaines excreted from the microbes of anthrax, cholera, 
puerperal and typhoid fevers, often kill before the germ enters the 
blood. 

Ptomaines resemble, in all essentials, the vegetable alkaloids, 
poisons, Conine, nicotine, strychnine, morphia, atropia, digitaline, 
veratrine, delphine, colchicum, curare, aconitine. 

Besides the presence of disease-germs, with their alkaloids, 
ptomaines, there are another class of basic substances which are 
found in the living, either as the product of fermentative changes 
or of retrograde metamorphosis, alkaloidal products of physiologi- 
cal change found in the animal tissues during life, termed leuco- 
maines, in contradistinction to the ptomaine, a basic product of 
putrefaction. The leucomaines are derived from the urea and 
creatine group, and are called autogenous. 

The excretion of all living things, plants and animals are 
poisonous to the organism which excrete them. An individual 
may drink only pure water; eat food of the best; free from all 
adulteration, breathe the purest atmosphere, and yet his excretions 
will contain the most deadly alkaloid poisons, which are formed 
in the body, originate in the metabolic changes by which com- 
plex molecules are split up into simpler compounds. 

These woe-be-gone states of languor, lassitude, debility ; states 
in which there are headache, brown-coated tongue, termed 
biliousness, are due to the formation of alkaloids, shocks to the 
system from cold or wet or otherwise, retain effete matter, which 
poison the nervous system, which is speedily relieved by a 
Turkish bath, opening the bowels with a bactericide. 

Some febrile states are autogenous, due to the retention in the 
body of products which should be eliminated. 

Urine excreted during the hoursof activity is much more toxic 
than during the hours of repose. Physical and mental work 
give rise to the formation of numerous poisonous substances ; 
lengthen the hours of labor, shorten those of rest, and we have 

56 



882 



DISEASE GERMS. 



toxical agents formed, which give rise to insomnia and fretfulness ; 
brain excited and refused to rest. Fever from fatigue, from pro- 
longed excretion due to like causes, often mistaken for malaria. 

The following is a list of ptomaines discovered, with their 
formula, up to the date of publication of this work : 



Name. 



Methylamine, .... 
Dimethylamine, . . . 
Trimethylamine, . . 
Ethylamine, . . . . 
Diethylamine, . . . 
Trietbylamine, . . . 
Propylamine, .... 
Amylamine, .... 
Hexylamine, .... 
Tetanotoxine, .... 
Collidine (?), .... 
Hydrocollidine (?), . 
Parvoline (?), . . . . 

Unnamed, 

Ethylidenediamine (?), 
Trimethylenediamine, 

Putrescine, 

Cadaverine, .... 

Neuridine, 

Saprine, 

Unnamed 

Methyl-guanidine, . . 
Unnamed, 



My dine, . . 
Neurine, . . 
Unnamed, . 
Choline, . . 
Betaine, . . 
Muscarine, . 
Mydatoxine, 
Mytilotoxine, 
Gadinine, . 
Typhotoxine, 
Unnamed, . 



Tetanme, . . 
Unnamed, . . 
Tyrotoxicon, . 
Mydaleine, . . 
Spasmotoxine, 
Peptotoxine, . 



Formula. 



H5 N . 

H7 N . 

Hg N . 

H. N . 



C3 

Cs 

C9 

^: 

C5 

C, 

Cl3 
^- 



iN . 
5N . 
N . 
3N . 
5N . 
xN(?] 
iN . 
3N . 
3N . 
5N . 



e^2 



N, 



,N, 



iN O 
3N O 
1NO3 
5N O2 
3N O3 
5NO3 

3N o. 



c: 

Ci3H,oN20, 
Cv H,3N,0, 



Physiological Action. 



Non-poisonous. 



Poisonous. 
Poisonous. 

Poisonous. 

<( 

(( 
Non-poisonous. 



Non-poisonous. 

Poisonous. 

Non-poisonous. 

Poisonous. 

Non-poisonous. 

Poisonous. 



Non-poisonous. 
Poisonous. 



Poisonous. 



In stercoraemia, or constipation or arrested secretion from the 
intestines, the poisonous alkaloids accumulated in the bowels in 



■BACTERICIDES. 



883 



twenty-four hours would be sufficient to kill the individual, if it 
were absorbed. 

According to good authority, we resist incessant auto-infection 
by two distinct mechanisms ; elimination of the toxic principle, 
and its destruction by oxygen. Elimination by the kidneys can 
be proved, and the same experimenter has always detected 
alkaloids of the nature of ptomaines in normal urine, though in 
feeble quantity, and the proportion materially augments in 
certain pathological states such as typhoid fever and cerebral 
diseases. 

Elimination by the digestive tube is also probable. 



In the etiology of cutaneous hemorrhage, 
Purpura. the causes may be embraced under the foUow- 

{Ecchymosis}) ing : Certain blood changes, due specially to 

the presence of disease germs in the blood, 

abstracting the oxygen from the corpuscles, such microbes 2& 

the amylobacta of rheumatism and the tubercular bacilli ; to a 

want of tone in the nerve centres. 

In the chaotic condition, induced by the presence of these and 
other germs, the walls of the vessels rupture, and transudation of 
both red and white blood takes place. 

Although the appearance of the effusion of blood in the skin 
is usually preceded by lassitude, faintness, great prostration, pains 
in the limbs, etc., still it bears no relationship whatever to scurvy. 
Extravasation in both affections is liable to occur from the free 
surface of mucous membrane, into the skin, in serous cavities 
and within the parenchyma of organs. In purpura there is an 
entire absence of the swollen, spongy, pallid or livid gums, and 
peculiar foetor of the breath that we have in scurvy. Vital power 
is more depressed in scurvy than in purpura. 

Two varieties, acute, small hemorrhagic spots, like petechia on 
the body ; chronic, large patches, vibices and ecchymosis. 

The vital integrity of the lympathic system, spleen, pink mar- 
row, etc., is greatly impaired. 

In the treatment, complete rest in the horizontal position must 
be insisted on, bowels regulated with cascara sagrada lozenges. 
Digitalis in alternation with the mineral acids and quinine should 
be tried; if their effects are not speedily visible, try the following: 

Glycerite of kephaline, six ounces ; sulphate of strychnine, 
one grain. Mix. Half a teaspoonful every three hours, added 
to water. Ergot has met with good success ; also fluid extract 
hamamelis. Terebinthea in emulsion has also been of utility. 



884 



DISEASE GERMS. 



Pyaemia. 




The streptococcus pyogenes; the 
germ as seen actively breeding in 
the blood in pyaemia. 

localize themselves in 



During the process of inflammation, lymph or 
plasma is apt to be eflused from the blood in the 
part which has a partial death, and this lymph, 
provided the vital forces be low or the treatment inefficient, very 
liable to become pus — living matter of the very lowest organiza- 
tion, which if, by any accident, it finds its way into the blood, 

through an abrasion, scratch, wound, 
or otherwise, is liable to give rise to 
pycemia; a contagious and infectious 
disease due to the presence of the 
micrococci of pus. The entrance of 
this disease germ into that vital fluid, 
the blood, is most disastrous as it gives 
rise to extreme bacterial evolution 
with embolism, and the pus microbe 
breeds so rapidly, that entire colonies 
every tissue, gland, and organ of the 
body, attended by the formation of infarctious, metastatic abscess 
in which the protoplasmic elements of the pus germ proliferate. 
Rigors are indicative of pus growth ; its progress, its volume, 
rapidity. Its destructive action can be appreciated, nay, calcu- 
lated by the intensity, frequency, and violence of the chills. 

The cocci of pyaemia, strep- 
tococcus pyogenes, are seen 
occurring singly or in chain 
and in zoogloea. 

Pus when absorbed begins 
a new era 'of germ life, and 
microscopic organisms begin 
to breed and multiply in every 
tissue of the body and cause 
suppurative pyaemia. 

The microbe bears culture 
well in any rich animal broth'; 
cultures injected into animals 
give rise to the disease in all its malignancy. 

The formation of pus, its confinement within a cavity, in the 
cellular tissue, bone, carbuncle, pustule, or its reception by a dis- 
secting wound, or a laceration, all lead to pyaemia, colonies of 
micrococci everywhere, with thrombosis and embolism due to 
bacteria. 

This history of the case, with marked, decided rigors, followed 
by a great rise in the temperature of the body, being out of all 
proportion to the phenomena of chill. This is followed by pro- 
fuse colliquative sweats ; great irritability ; heart failure, with at 




Full developed streptococcus pyogenes ; 
genie microbe of pyaemia. 



BACTERICIDES. 



885 




first a small very rapid pulse and latterly intermittent ; conjunc- 
tiva and skin assume a yellow tinge ; later on, jaundice. The 
breath, sweat, sickly odor ; tongue, white, dry, fissured, later 
glazed, brown sordes on teeth, nausea, vomiting, great thirst; 
abscesses on all the internal organs, followed by dull apathy, 
delirium, labored respiration, face of a leaden color. 

In order to perfect a correct diagnosis of all cases of pyaemia, 
it is imperatively necessary to make a microscopical and chemical 
examination of the stools and urine for the strepococcus pyo- 
genes which is always present in great abundance. When the 
cocci are found in the urine, it may point to suppuration in the 
urethra, prostate, bladder, kidneys ; but when persistently present 
in the stools, isolated from necrotic patches in the liver, we can 
see the organisms, study their ameboid movements, witness their 
sprouting in the form of 
spherical outgrowths, 
looking like mulberries, 
full of live cocci in vio- 
lent, unceasing motion. 

In the treatment of 
this destructive germ 
malady, everything 
should be avoided that 
would favor the develop- 
ment of the micrococci. 
The most rigid antisep- 
tic precautions in all 
surgical and obstetrical 
procedures, cleanliness, 
good ventilation, sun- 
light, avoidance of all insanitary states. 

The strength of the patient should be well supported by the 
largest amount of nourishment possible, together with stimu- 
lants. The indication for nourishment and stimulants are most 
pressing. If possible the germ must be destroyed and elimi- 
nated by the intestinal tract. 

With this object in view, the annihilation and sterilizing of the 
germ, some of the following remedies should be tried ; quinine 
is the drug which is most extensively employed for its antiseptic, 
stimulant and antipyretic effect ; we endorse its use. In alterna- 
tion the most energetic effects are derived from the peroxide of 
hydrogen in one to three drops administered every hour ; wound, 
if there is one, dressed with the same. 

This failing, most excellent results have been obtained from 
ten grains of resorcin every hour combined with two of sulphate 




Streptococcus pyrogenes pus germs in the urine and stool 
in pyaemia. 



SS6 DISEASE GERMS. 

of thallin. The sulphites, hyposulphites of sodium, calcium, 
manganese, especially the two latter, have met with admirable 
success, and are worthy of a trial. 



The microbe of rabies exists chiefly within the mi- 
Rabies, grating cells of the plasma-spaces of the nerve cen- 
tres, and in similar cells found in the cerebro-spinal 
fluid ; and the mode of securing these is as follows : As soon as 
dog suffering from the disease dies, the skin and muscles should 
be dissected from the back of the neck, so as to expose the atlo- 
occipital articulation ; the carcass should then be placed on an 
inclined plane with the head downward ; then, with the thermo- 
cautery, an eschar should be made over the articulation, and with 
a sterilized bistoury the sheath of the cord is opened through the 
burnt space. The fluid is then collected in small spindle-shaped 
tubes with capillary ends, which have been, of course, sterilized 
when made, and the points melted, these are broken off at the 
moment of filling, and at once resealed. The rachitic fluid of a 
single dog will fill a dozen of these little tubes ; when charged 
they are placed horizontally in a box, and left for some time in 
complete repose. After a few days, at a temperature of 20° Cent, 
one sees in some of the tubes a pale line of deposited cells with 
one or more white points, extremely small, yet still visible to the 
naked eye ; these are colonies of the microbes in question. The 
groups are always few in number, and only one out of many tubes 
may contain them. This explains why animals may be inocu- 
lated with the cerebro spinal fluid of an unquestionably rabid 
dog, and yet not acquire the disease. And is probably due to the 
paucity of the pathophoric cells which contain the microbes, or 
that these latter have not always vitality enough to make their 
way through their walls. By succussing the tubes strongly the 
colonies can be broken up, and the fluid becomes opaline ; whilst 
healthy lymph from the same source, and treated in the same 
way, undergoes no change whatever. 

The activity of the poison used has been in every case proved 
by inoculation in a series of dogs and rabbits. A drop from one of 
the arachnoid shows cells filled with sarcinoid masses of 
coccus and glomerules separated therefrom. In other spaces this 
is not seen, but agglomerated microbes bacillar in form, which 
the author believes to be a transitional condition. These germs 
are easily cultivated in slightly alkaline broth, in gelatine and 
agar-agar with or without glycerine. The first cultivations should 
always be made in broth, and be afterwards transferred to solid 
media. Their liquefying action on the latter is slight, but in some 



BACTERICIDES. 887 

cases it is complete, and may have been owing to some defect in 
the gelatine itself. In broth, after five days, at a temperature of 
20° Cent, there are numerous globular or irregular deposits at 
the bottom of the tube ; in some it adhered firmly, like a myco- 
derma to the glass ; but in most a vigorous shake was enough to 
make the whole fluid opalescent. It would seem that there is 
some diastatic difference in these growths, but their pathogenic 
power is alike ; this was proved by physiological reactions — by 
the fatal inoculation of other animals. 

We have succeeded in isolating the microbe from the spinal fluid 
of rabbits dead through the disease communicated from dogs by 
corneal incision, and in others inoculated in series for the anti- 
rabic treatment. For instance, amongst twenty tubes filled from 
one of the latter, two or three have been found to contain the 
specific m.icrobe. It is very easily stained by gentian-violet and 
aniline-red — in diluted alcohol especially so. 

Pathogenic Action. — One of the incubating flasks is shaken so 
as to diffuse the germs ; then a drop of the fluid is allowed to fall 
into both eyes of a number of dogs, and a slight scratch is 
made in each cornea. The little wound heals very quickly 
without inflaming, although it has been the channel through 
which the poison has entered, and for eight or ten days the 
animals seem perfectly well ; then they become suddenly ill, and 
emaciate rapidly; are attacked by general paralysis, and, after 
two days of feverish hyperthermia, die exhausted. The eyes are 
throughout free from inflammation. It should be added that 
some of the same group of dogs become ill, but do not die, and 
that others may even be quite unaffected. 

The nerve-pulp, as well as the cerebro-spinal fluid of the animals 
which die will produce in indefinite series the typical rabies of the 
laboratory. But the ordinary tests of cultivation and microscopic 
examination have failed to show in any case the presence of the 
microbes in the humors and tissues of the animals killed by 
keratic inoculation with the artificially-cultivated germs. On the 
other hand, hypodermic injections in large doses {de dosis 
masivas), twenty to thirty cub. cent, of the sediment in the cul- 
tivating flasks have not the slightest effect on the animals so re- 
ceiving it ; no more, indeed, than if one had injected as much 
pure water. But there has not been time enough to decide if no 
remote effects follow. It should be observed that all these ex- 
periments were made with cultivations between the fourth and 
tenth in series, so that the effects of the germs contained in the 
cerebro-spinal fluid itself dropped into the first flask, should be 
eliminated. And it has been proved by experiment that this fluid 
has very little poisonous action. Nevertheless, it cannot be 



888 DISEASE GERMS. 

denied that this fluid is more active when injected than the culti- 
vated microbes from the original tubes. This leads one to believe 
that the microbe of rabies during its intercellular life may undergo 
some modification which renders it less fit for subsequent seg- 
mentation in cultivating media. Apart from this, the success of 
the first trials therewith depends upon the presence in sufficient 
numbers of the phytopherous cells in which the microbe may 
multiply freely after, probably, the digestion of their envelopes. 
(See Hydrophobia}) 

Distinct races of men exist all over the earth ; the 

Races, living witnesses are before us in the Mongolian, the 
Negro, the Malay, the Indo- American, and the Cau- 
casian — essentially different types of mankind ; different in color, 
organism, construction, physiognomy, and blood. Besides the 
difference in complexion and physiognomy, there is a marked 
variance in their anatomical and physiological structure, an in- 
comparable, impassable difference in bones, brain, nerves, senses, 
vessels, glands, and in language, which latter alone, when con- 
sidered, makes a distinction, a perfect line of demarcation, so 
that neither race can be traced to a common source or origin. 

One group or family of languages form a class known as the 
inflectional, and are distinguished from all others on the globe as 
the only languages that are adapted to and possess a literature, 
a science, art, progress. This is the property of the Caucasian, 
the sole civilizing race in the world, and was doubtless taught to 
him in the Garden of Eden. The other groups of languages are 
monosyllabic, and are destitute of all grammar; the nouns have 
no number, declension or cases, and the verbs are without con- 
jugations, moods, tenses or persons. 

The variety of races is no mystery ; each is a separate, dis- 
tinct creation, for a gradation of species is absurd and inconsis- 
tent. A changing, a negation, an amalgamation, is death and 
extinction to all concerned in the effort ; a change from black 
to white an absolute impossibility. 

We have abundant evidence to show that the different races 
existed four thousand years ago, as distinct as they are to-day ; 
accurate likenesses on monuments and other historical evidences 
are prolific and available on the subject. Incontrovertible evi- 
dences — geological, archeological, philological, physiological, 
psychological, anatomical, and historical — all tend to establish 
the proposition, that of all the distinct races of men which are 
now and which have been on the earth from time immemorial, 
and inhabited its respective sections, the Caucasian was the last 
to make his appearance ; a masterpiece of creative mechanism, 



BACTERICIDES. 

made out of God himself. The record of Moses does not in any 
way contradict the existence of other races before Adam. AH 
attempts to trace the different races in a degradation from Noah 
result in glaring failure. It is well known that both the Chinese 
and African nations existed centuries before Adam. 

There can be little doubt but that the intermarriage of the 
Adamite daughters with the adjoining races was the real cause 
of the flood. God foresaw the terrible results of incompatibility 
of races ; that the stock produced was inferior to either of the 
mingling parents ; derogatory to the welfare of His people, and 
would tend to extermination. 

The Bible should be regarded as the history of a particular 
race — the Adamite. His creation, his fall, his restoration to 
paradise, are the themes of holy writ. Salvation is proclaimed 
to the heathen by faith in Christ, and as it is free and bountiful 
enough, other races are permitted to participate in its benefits. 

Truth, in whatever department of science it appears, cannot be 
contradictory of Revelation. There oftentimes may be an ap- 
parent antagonism, but it is not real. When they are not recon- 
cilable, either Revelation or science is misunderstood. The word 
of divine truth stands sure. Scientists may err, but the ultimate 
deductions that we, the Adamites, are to infer, are, that the mix- 
ture of races does not produce a true hybrid condition, but 
something analogous to it. It degrades the bioplasm of both 
races concerned, by producing stock highly tubercular ; so much 
so that it will inevitably terminate in the utter extinction of any 
given race concerned or implicated, and as the mixture of races 
was the cause of the flood, so it will, if persisted in by our peo- 
ple and government, infallibly produce a condition of national 
decadence and ultimate annihilation of all the parties. Words 
fail to express the supereminent degradation inflicted on any race 
by a deterioration of its original properties, its organic elements. 

If space permitted, we could easily show a perfect distinction 
of races in other points, as construction, craniological develop- 
ment, difference in bones, senses, etc., and their perfect incom- 
patibility. We have an excellent national example in Mexico, 
where we have the noble Spaniard coupling with the aboriginal 
Indian, giving us a race much inferior to either of the mingling 
parents ; a rate that must inevitably die out. 

Marriage, to give a good stock, must be consummated within 
the race. And marriage among the Caucasians of individuals 
of the same temperament, identical in color of hair, skin, eyes, 
conformation ; or persons related by consanguinity, should be 
prohibited by law, as they entail on their offspring tuberculus, 
an element of deterioration and death within the races. Still. 



890 



DISEASE GERMS. 



withal, a morbid race cannot be established in the true sense 
of the term, for the evil cures itself by non-procreation. No 
sensible deterioration in size, beauty of form or expression, can 
take place, for the moment the boundary line is reached the evil 
cures itself in non-procreation, so that the Caucasian to-day is 
a perfect fac-simile of our prototype, Adam. 

It seems to be a difficult matter to get the hide-bound, or so- 
called orthodox. Christians to appreciate the essential difference 
of races, but as they are distinct in their anatomy, so are they 
different in all other attributes ; their sympathetic systems are 
imperfectly developed ; that is, it exists in a more rudimentary 
condition ; consequently, they are incapable of taking on the dis- 
eases of the white man. It is impossible for them to take yellow 
fever, acute laryngitis, pneumonia, carditis, typhoid fever, etc., 
and if it is true that the soul of the Caucasian is located in his 
great sympathetic, and his moral nature there developed, where 
could there be a more decided element of disparity of race. The 
very senses and their organs are different, being more highly de- 
veloped in the colored race than in the white. 

This distinction of race comes home to us most strikingly in 
the aggravation of the types of all our diseases, when two or 
three dissimilar races are living in close proximity. Suppose 
the child of white parents contracts measles, scarlatina, small- 
pox, from the convalescing child of the Negro or Mongolian ; 
the so contracted disease, even though of a mild form in the 
colored, will become virulent and mahgnant in the white, and 
vice versa. Let a white man contract a gonorrhea from a 
colored woman, and he has something that no known drug will 
stamp out for months or years. The fact of two antagonistic 
races residing in close proximity is detrimental to the prosperity, 
health, happiness, longevity, and freedom from disease of either 
race. 

All physiologists and naturalists agree in asserting that the 
sexual instinct is much stronger in the male than in the female, 
so this fact must be accepted. In countries in which women 
keep their normal sphere, the number of male births exceed the 
female by five or six per cent. But that represents the children 
born alive, if we take the miscarriages and still-born, the male 
rate exceed the female forty or fifty per cent. 

The germ cell, or female, transmits the form and general he- 
reditary qualities of a race, while the sperm cell, or male, intro- 
duces the variations which fit the race to survive under new con- 
ditions of life, the sex being determined by the greater vigor and 
maturity, or greater fitness for survival in either parent. Where 
the ordinary conditions of life are uniform and constant, the 



BACTERICIDES. 



891 



germ cell will predominate and females be produced in excess ; 
where women leave their sphere and take on the strong-minded 
element, the offspring are all females ; where the conditions of 
life are variable or injurious to the race, the acquired vigor in 
the struggle for existence, the sperm cell will predominate, and 
an excess of males be the result. In the civilized condition the 
two sexes are of equal value, inclining to the side of the male, 
provided each keeps its proper sphere. Austria and Great 
Britain afford us an example in which the two sexes are on an 
equal footing or basis, and we find on examination of their birth- 
rate, that there are born one hundred and ten males to one hun- 
dred females, which shows an absolute excess of male births, and 
this excess occurs at the earliest and most vigorous portion of 
married life. 

The sex rate, also, seems to be largely dependent on the rela- 
tive maturity of the parents, as well as their vigor, the more 
mature parent being the most potent in determining the sex ; 
the sex being the same as the most mature parent. The follow- 
ing figures exhibit the proportion of male births in one hundred 
females : 

Father younger than the mother, 90 

Father and mother of equal age, . . . . = 94 

Father older by one to six years, 103 

Father older by eleven to sixteen years, 147 

Father older by eighteen or more, 175 

As females attain to maturity five years earlier than males, it 
is probable, from the above table, that with a difference of age 
of five years in favor of the father, the two sexes would be about 
equal. 

The hereditary physical and mental qualities are transmitted 
by the female, and that variation and adaptability to new condi- 
tions of life are introduced by the male ; we do not wish to 
imply that the germ cell is not modified by external conditions, 
but only that it is subject to fewer causes of variation — that it 
possesses a strong inherent disposition to resist change, and that 
it will be destroyed rather than accommodate itself to any 
marked changes in the condition of life. It is most tenacious of 
vitality, indeed we see the female embryo resisting violence of 
all kinds, action of drastic drugs and constitutional taints in the 
parents, living in spite of danger and disease. 

From statistics of the two countries mentioned (for our own 
are not reliable, being full of the strong-minded element, which 
by-and-by will render us a nation of girls,) it is probable that the 
proportion of births, marriage being properly regulated by age, 
should be the proportion of three males to two females, and this 



892 DISEASE GERMS. 

number would be a typical family, which would admit of the 
sacrifice, not necessarily the destruction, of one male, to accom- 
modate the race to the ever-changing condition of life, and to 
assure the constant accession of fresh vigor and maturity. The 
wealthy, living under the most favorable conditions of good liv- 
ing, of natural and sanitary surroundings, no struggle, have the 
two sexes equal, females slightly predominating. In embryonic 
and infantile life, boys do not possess near the vitality of girls, 
which may account for the unusual destruction of males at birth, 
their heads are larger and the diseases incidental to childhood 
always prove more fatal to male than female children. Races 
being distinct creations, are antagonistic to each other, so to pre- 
serve the vigor and vital integrity of a given race, its members 
must marry within it, for if they mix with other races, they im- 
plant deterioration, disease, and death on their offspring. 

Individual members of the Caucasian race must maintain and 
utilize their vigor, and in order to do that should not marry one 
of sim_ilar temperament and physique, nor in similar conditions 
of life ; a literary man never should marry a literary woman, nor 
a tailor a seamstress. Cross fertilization within the race produces 
the best stock. There should be no m-and-in breeding in tem- 
perament, nor in similar conditions of life, far less than among 
blood relationship. 

There is a growing error in the public mind on maturity. It 
is a great error to suppose that puberty in either sex is a sign of 
fitness for marriage. Growth and reproduction cannot go on 
beneficially together, reproduction being a diversion of growth or 
development in a new direction, namely, from the individual to 
the race. Men do not cease to grow until they are twenty-five, 
women till they are twenty-one, according to the good or bad 
nurture they receive, the best nourished attaining maturity first. 
It is obvious that those ages are the very earliest that marriage 
should be consummated, and, indeed, the father should be much 
older, if male children are desired. The best way of increasing 
the male births is to keep women in their proper sphere and di- 
rect our energies to the preservation of males at birth. This has 
been done to some extent by the grand improvements in the art 
of midwifery, but the mischief lies in the disproportionate size of 
the head of the male foetus and the mother's pelvis, which has 
been constricted by dress, tight lacing and abnormal mental cul- 
ture. For the curve of the sacrum and crook of the coccyx is a 
true index of the mental culture of the mother ; the higher the 
one the greater the other. It is impossible to estimate the great 
loss the race sustains in superior and mental qualities by this 
unnecessary destruction of its finest products. 



BACTERICIDES. 



893 



At birth, in children born aUve at full period, the average 
length of male infants is nineteen and one-half inches, and of 
females eighteen and one-quarter inches ; while their average 
weights are : males, seven and one-half pounds ; females, six and 
one-half pounds. The waste of male children, owing to the 
large size of their heads and the contracted condition of the 
modern civilized female pelvis is immense. The remedy for this 
is apparent, and to be found in direct improved development of 
the girl's physical education and dress, an avoidance of the 
defects of civilization and a more careful guarding of the sexes in 
marriage. 

The average stature of the American woman is five feet two 
inches to five feet three inches, and of man five feet seven inches 
to five feet eight inches. The difference between the two sexes 
being four to five inches ; and as stature carries with it other re- 
lative proportions of the body, it is probable that if these limits 
.were observed all through the scale of heights there would be 
fewer male still-births. It was at one time thought that 
the intellectual struggle going on caused an increased develop- 
ment of the brain. in children and consequently larger heads in 
male children, but this has been found to be erroneous, for ever 
since the introduction of w^oman's rights movement the heads of 
boys and consequently men have become notoriously small, and 
the male children of such women effeminate, so that the recent 
impetus given to the so-called education of girls and the em- 
ployment of women in intellectual pursuits is adding to the diffi- 
culty, and if it does not end by producing sterility, as is probable, 
or in the birth of female children only, which is still more prob- 
able, it must at least tend to the destruction, more and more, of 
males at birth. It is obvious that whether we consider the 
health and happiness of the individual or the future prosperity of 
the race, the healthy physical development of girls is of first 
and supreme importance. The boy is father of the man, the girl 
is the mother of the race, for to her is entrusted the hereditary 
characteristics of our forefathers. She has the means of trans- 
mitting them and indirectly of acclimating and accommodating 
the race to new and varying conditions of life. 

The reproduction of characteristics resembling those of the 
father in the son, is in a large measure effected through the 
agency of the female where there is a strong affection on the 
part of the mother for her husband ; his likeness, physical and 
mental is impressed on the son through the agency of the 
mother's psychic force. The feeling, impulse or sentiment 
which pervades the mind of the mother controls and influences 
the development of the child. Peculiarities of feature and 



894 



DISEASE GERMS. 



form that impress her powerfully, whether with admiration or 
abhorrence, are reproduced in the offspring, and if her mental 
conditions be particularly strong, the impression may be trans- 
mitted in exaggerated intensity. These things happen in male 
children, which are specially the mother's. The likeness which 
female children bear to the male parent is the direct effect of re- 
production in kind. The maternal influences are less evident in 
a female than in a male offspring. Perhaps a good view to take 
of the subject would be the following : sex is the result of an 
arrest or repression of the force of development in the case of 
the female. The male of every family in the animal kingdom is 
the best and fullest specimen of development, having regard to 
the purposes and habits of life of the species, class or family. 
The arrest in point of development which characterizes the 
female, has nothing in common with immaturity, and is no proof 
of inferiority. It is simply a repression of the formative force, 
and the physical result of that repression is a perpetual effort to 
develop or reproduce. The force arrested in the individual 
gathers intensity and expresses itself in a perpetual and char- 
acteristic longing to produce a perfect animal. The perfection 
denied or inhibited in the individual is sought for in the progeny. 
Hence, the natural tendency of the female to produce male chil- 
dren, and as a necessary result most of the children born are 
males. 

It is not a question of ardency in the two sexes, but of the 
direction or force of intention or purpose of nature, that is, the 
inner working of natural laws. The tendency of what is called 
ardency in the performance of this function is to neutralize or 
control the productive force of the female, and thus determine 
that arrest of development which results in female offspring. 
Here, again, there is no question as to the comparative amount 
of ardency in the two sexes, because the ardency of the male 
may be dissipated by the extent of its activity so as to be in no 
instance dominant, or it may be restrained or intensified, and, 
therefore, when it acts, assert supremacy. 

The way constitutional strength comes into play, as it un- 
doubtedly does in sex determination, is by giving vigor to the 
natural action of natural laws, not by changing the operation of 
these laws, so as to make them non-natural. Throughout the 
organic kingdom, we see nature preserving and developing the 
germ cell, while on the other hand, we are constantly reminded 
of her lavish production and apparent wastefulness of sperm 
cells. 

The function of the male is not one of production, but fecun- 
dation. The laws governing the development of monsters are 



BACTERICIDES. 



895 



laws of development, rather than of procreation, and they come 
into play after conception.^ The natural tendency of the female 
is, if she does not exhaust her brain force, to produce male chil- 
dren in excess, and, as a result, when mothers live properly a 
large percentage of the children born are males, but let the child- 
bearing mother exhaust her mental powers as a teacher, preacher, 
astronomer, or other literary avocations, her children will be all 
females, and if there should occasionally be males, they will be 
effeminate, have small heads and feeble brains, and resemble girls 
in their actions. Woman may be more perfect in her anatomical 
construction than man, but her great sympathetic is merely 
rudimentary, so she needs a man to complete her component 
parts. The practice of women engaging in literary pursuits and 
learned professions is well enough, if they maintain celibacy ; 
but if they ever marry and bear children, then they are sapping 
and deteriorating the elements of national growth and vigor. 



The ill effects following injuries met 
Railway Injuries, with in railway accidents are of a some- 
what peculiar nature, irrespectively of 
such forms of accidents as are mentioned elsewhere, such as 
fractures and dislocations. These injuries consist of concussions 
of the spine and spinal cord, and from the frequent absence of 
outward signs, and the obscurity of the early symptoms, are of a 
very insidious character, and their diagnosis is of the utmost im- 
portance to a medical man, as they so frequently are the sources 
of medico-legal inquiry. A well-known author, speaking of this 
class of injury, says : — " That in no ordinary accident can the 
shock be so great as those that occur on railways. The rapidity 
of the movement, the momentum of the person injured, the sud- 
denness of its arrest, the helplessness of the sufferers, and the 
natural perturbation of mind that must disturb the bravest, are 
all circumstances that of necessity greatly increase the severity 
of the resulting injury to the nervous system and that justly 
cause these cases to be considered as somewhat exceptional from 
ordinary accidents. This has actually led some surgeons to 
designate that peculiar affection of the spine that is met with in 
these cases as the 'railway spine.' Injuries of the spine and 
spinal cord have been already treated of generally, and it is 
hardly to the purpose to reconsider them specially in reference 
to the subject in hand, and we shall therefore pass on to such 
matters as relate to those cases where the fact of injury sus- 
tained on a railway has been the cause of litigation." Concus- 
sion of the spine from a direct and severe injury to the back may 



896 



DISEASE GERMS. 



terminate, according to the same authority, m four way: — i. In 
complete recovery, after a longer or shorter time. 2. In incom- 
plete recovery. 3. In permanent diseases of the spinal cord and 
its membranes. 4. In death. It is a very remarkable circum- 
stance that, although the patient has apparently sustained in 
many cases a very trifling injury, the result is widely dispropor- 
tionate, the reason for this being that the symptoms indicative of 
concussion of the spine and of the subsequent irritation and 
inflammation of the cord and its membranes are so slowly pro- 
gressive. A patient is often quite unaware that anything serious 
has happened, feeHng perhaps only violently jolted, and a little 
giddy or confused. After a while, however, when he has reached 
home, the effects of his apparently simple injury begin to declare 
themselves. " A revulsion of feeling takes place ; he bursts into 
tears and becomes unusually talkative, and is excited ; he cannot 
sleep, or if he does, he wakes up suddenly with a vague sense of 
alarm. The next day he complains of feeling shaken or bruised 
all over, as if he had been beaten or had violently strained him- 
self by exertion of an unusual kind. This stiff, strained feeling 
chiefly affects the muscles of the back and loins, sometimes ex- 
tending to those of the shoulders and thighs. After a time, 
which varies much in different cases, from a day or two to a 
week or more, he finds that he is unfit for exertion and unable 
to attend to business." Such is generally the early history of a 
case of railway concussion. Sometimes the serious symptoms 
begin to develop immediately after the receipt of the injury, and 
ins some cases not till long afterwards, and most marked and 
distinct changes are visible in the countenance, the state of the 
memory, the thoughts become confused, all business aptitude is 
lost, the temper becomes irritable, the sleep disturbed, restless, 
and broken ; there are often loud and incessant noises in the 
head, the vision is frequently affected in various ways, the hear- 
ing, taste, smell, and the sense of touch become perverted ; the 
sense of speech is rarely affected, and usually the attitude of those 
afflicted is peculiar. There is a loss of freedom in the efforts of 
motion or movement, and the individual appears afraid to make 
such efforts ; the gait again is very characteristic ; he walks un- 
steadily, and in a straddling manner; the power of walking is 
very limited, and he is unable to ride ; the nervous power of the 
limbs will be found to be affected ; sensation and motion, or 
both, may be impaired. Coldness of one* of the extremities, 
owing to loss of nervous power and defective nutrition, is often 
noticed. The prognosis in these cases is very unfavorable, and 
patients have never been known to recover, completely and en- 
tirely, so as to be in the same state of health as before the acci- 
dent. 



RACTERICIDES. 



897 



With regard to the treatment of concussion of the spine 
brought on by such injuries, the first thing obviously is complete 
rest, and the patient should be compelled to lie on a prone couch, 
and the mind must be kept as much as possible at rest also; ice 
bags over the injured part of the spine ; internally the glycerite 
of kephaline in quinine or bark ; nux vomica, strychnine, and 
iron are all of great value in certain cases. Salt-water douches 
to the spine, and galvanism, are recommended in some instances. 
The great thing to be done is to endea\or to improve the gene- 
ral health, and " prevent the development, if possible, of second- 
ary diseases, such as phthisis, dependent on mal-nutrition, and a 
generally broken state of the health." 

Brain shocks, especially in men over sixty-five, are unusually 
common. This is undoubtedly due to the atrophy, induration 
of the brain incidental to that period of life. 

Such jars give rise to white softening. 



is a tumor situated below the tongue, bluish in color, 
Ranula translucent, and cystic in character. It sometimes 

attains such a size as to displace the tongue and im- 
pede its movements, causing serious inconvenience in mastication, 
deglutition, and articulation. It may be caused either by ob- 
struction of a salivary duct, or by the occlusion and dilatation of 
a mucous cyst, or dilatation of a bursa mucosa said to exist on 
the outer surface of the genio-hyoglossus muscle; or it may be 
a new growth of itself, a myxomatous cyst. It may be healed 
by simple incision, or by cutting out a portion and evacuating 
the contents, an3 to prevent premature closing a strip of lint 
should be introduced ; or frequently the introduction of a seton 
suffices. In the case of cysts containing a thick putty-like ma- 
terial, the cyst wall must be dissected out entire. The injection 
of iodine is sometimes followed with good results. The contents 
of the cyst are gummy or albuminous in character, containing 
simple round mucous globules as their only structural element. 
Occasionally phosphatic concretions are met with. 



The terminal portion of the alimentary canal is 
Rectum, thus named from its being comparatively straight. 
It is situated in the pelvis, or lower portion of the 
abdomen, behind the bladder, and in front of the sacrum. It 
measures from six to eight up to ten inches in length in average 
sized individuals, its outside diameter is about one to one and a 
quarter inches when moderately distended, but capable of very 

57 



898 



DISKASE GERMS. 



great distension, or dilatation, or it may be contracted by strictures 
to an infinitesimal degree, even to occlusion. 

Its lowest portion is closed by a strong band of muscular fibres, 
about an inch broad, which is termed the sphincter muscle. The 
upper and lower edges of this band are very much thickened and 
are technically called the internal and external sphincters. These 
muscles are abundantly supplied with nerves, which are highly 
sentient and to some extent under the control of the will. 

The walls of the rectum consist largely of longitudinal and 
circular muscular tissue, with a lining of smooth, mucous mem- 
brane. Blood vessels, nerves, absorbents are numerous, but 
nerves of sensation are limited, except in the sphincters, where 
they are abundant and highly organized. 

The chief source of nerve supply to the rectal walls is from 
the spinal and sympathetic, which in a state of health are not 
sensitive, and this fact exposes it to abuse, grave, injurious, hid- 
den lesions, without apparent suffering to the individual. 



The administration of remedies by the rec~ 
Rectal tum for the cure of disease is of the greatest 

Medication, importance. It is not, however, as well appre- 
ciated as it should be, neither is it taken advan- 
tage of in those grave emergencies where human life could often 
be saved by its use. 

Every remedy in the materia medica has a distinct chemical 
composition, the atoms of each are arranged in a certain way, in 
definite proportions, has an affinity either to depress or elevate 
certain tissues or glands of the body; every germicide has 
special definite action on each disease-germ respectively ; any 
change in its atoms or chemical composition changes, or destroys 
its action. 

The juices of the stomach are acid, those of the intestines 
alkaline. 

Remedies administered by the mouth into the stomach, thence 
to the bowels, thence to the blood, and finally to the tissue or 
germ for which it has an affinity, meet with numerous chemical 
changes, which alter its composition beyond recognition, and 
often renders it wholly worthless for the proper purpose. This 
is not, however, true of all remedies. Medicinal agents do not 
require digestion, but when they are submitted to that process, 
many of their best properties are destroyed. 

The rectum possesses the most active absorbent system, and 
all the requisites for perfect assimilation, in a more rapid, ener- 
getic and effective degree. 



BACTERICIDES. 



899 



The most decided impressions can be made on the nervous 
system and blood by remedies administered through that organ 
— the most efficacious way in which to reach the uterus, bladder, 
prostate gland, urethra, seminal vesicles. 

All these organs can be reached when in an irritable state ; they 
can be vitalized by remedies inserted into the rectum; in all 
cases with less disturbance than through the digestive tract. 

It possesses all the requisites, every essential for the specific 
treatment of disease, with the success never dreamed of in oral 
medication. The method is unsurpassed in reaching disease- 
^erms in the blood and nervous system. 



The power of the medulla oblongata 

Reflex Irritation, to receive irritation or stimulation from 

different points in the body, is generally 

conceded ; that if either is of sufficient intensity it is indelibly fixed 

there ; in the one case raising vitality, in the other lowering it. 

Slight or low grades of irritation simply depress or enfeeble 
the medulla, the seat of life, causing defects in nutrition or a 
degradation of primary molecules, an alteration or change in living 
matter into the tubercular bacilli. 

An irritation of the gray or sensient nerve tissue in any part 
of the body is transmitted to the medulla oblongata, where it 
sets up an irritation similar in kind and degree, which if it be of 
sufficient intensity, is reflected back by the \\ hite or motor nerves 
that supply the muscles, causing a contraction or spasm. 

A general weakness, an impairment of vital force, predisposes 
to the reception of the irritation, and it is necessary that the irri- 
tation be great in degree. 

Irritation, great in degree or intensity, reflected according to 
this reflex law, sets up an analogous irritation in the medulla to 
what exists in the periphery. 

The most common causes are laceration of nerves, or their 
neurilemma, a tooth merging through the indurated gums, a 
worm nibbling at the periphery of a nerve in the bowels, the 
presence of the head upon the sacral plexus of nerves in labor. 

Our best remedies to wipe out irritation of the medulla and 
-also to suspend its impressibility, are ozonized fluid extract of 
musk root; Scutellaria. 



is the process by which the air enters and 
Respiration emerges from the lungs, and in doing so causes 
the aeration of the blood, and converts the 
4)lack venous blood into the scarlet arterial blood. 



QOo DISEASE GERMS. 

Respiration consists of two parts, inspiration and expiration^ 
and as a rule an individual breathes fifteen times in a minute. 
The lungs always contain air, and no expiratory effort, however 
forced, can empty the lungs ; the amount of this air, which can- 
not be got rid of, is called residual air, and is on the average 
from 75 to lOO cubic inches. About as much more in addition 
to this remains in the chest after an ordinary expiration, and is 
called supplemental air. In ordinary breathing, from 20 to 30 
cubic inches of air pass in and out of the chest; this is called 
tidal air ; thus, at the end of an ordinary inspiration, about 230 
cubic inches of air are contained in the lungs; in addition, by 
taking a very deep inspiration, another 100 cubic inches, called 
complemental air, may be added. Of the 230 cubic inches con- 
tained in the lungs at the end of an ordinary inspiration, about 
one-seventh of this amount goes out at every expiration, and is 
taken in again at the next inspiration, and so on ; thus it will be 
seen that it is important that the air in a room should be con- 
stantly renewed, or else a person would be breathing over again 
his expired air. Now this expired air is less pure than the in- 
spired air, because it is deprived of some of its oxygen by the 
action of the blood, and it has received in return carbonic acid 
and moisture; the more oxygen there is in the air of a room the 
better it is for health, for if carbonic acid accumulates, it pro- 
duces headache, lethargy, and, if in large quantities, a fatal re- 
sult, (See Asphyxia by carbo7tic acid gas) About 350 cubic feet of 
air pass through the lungs of an ordinary man in a day; in pass- 
ing through the lungs, the air would lose from 4 to 6 per cent, 
of its volume of oxygen, and gain 4 to 5 per cent of carbonic 
acid. During twenty-four hours there will be consumed about 
10,000 grains of oxygen, while 12,000 grains of carbonic acid 
will be produced, corresponding to 3,300 grains of carbon. Dur- 
ing this time about 5,000 grains, or 9 oz. of water, will be ex- 
haled by the lungs. In twenty-four hours an ordinary man 
would vitiate 1,750 cubic feet of pure air to the extent of i per 
cent., or 17,500 feet of pure air to the extent of i in 1,000. Tak- 
ing the amount of carbonic acid in the atmosphere at 3 parts, 
and in expired air at 470 parts in 10,000, the body would require 
a supply per diem of more than 23,000 cubic feet of ordinary air, 
in order that the surrounding atmosphere might not contain 
more than i per 1,000 of carbonic acid ; and more than this pro- 
portion is injurious; every one ought, therefore, to have at 
least 800 cubic feet of well-ventilated space. In all works on 
physiology a description has been given of their structure, and 
of the various changes which the air and blood undergo. 
The mechanism of respiration need not be fully described 



BACTERICIDES. 



901 



here. During inspiration the diaphragm descends, and the depth 
of the chest from above downwards is thereby increased ; at the 
same time the ribs move upwards and outwards, so as to increase 
the cavity of the chest from side to side and from front to back. 
Thus the chest-walls expand in three directions during inspiration, 
and at the same time the lungs follow the expansion and become 
inflated with air. During expiration, the lungs, being elastic, re- 
tract, and the reverse movement of the diaphragm and chest- 
walls takes place. Any thing, as tight lacing, etc., which 
interferes with the due expansion of the chest, is therefore very 
injurious; any deformity of the chest, a habit of stooping, a 
curved spine, a pigeon-breast, etc., all act in diminishing the 
breathing area of the lungs. As a rule, the wider a man is round 
the chest the better is his state of health and capability of 
exertion. Exercise, gymnastics, drilling, rowing, etc., are all 
excellent means of expanding the chest and promoting good 
respiration. When a man runs he gets out of breath because 
the circulation of the blood is increased, and ne requires more 
air in a given time to aerate it. 

Through the nasal, laryngeal, bronchial lining membrane, no 
■disease-germ can find ingress to the blood. All microbes, factors 
of disease, find their way into the body through the skin and 
mouth. 

The great secret then, aside from a high standard of vital force 
for the prevention of disease is hoiv to breathe. Man should 
breathe exclusively by his nose in order to avoid all contagious 
disease germs. This is apparent from the following anatomical 
facts : The nasal chambers in man are remarkable for their ir- 
regularity of surface and anfractuosity, and consequently for the 
enormous area of mucous membrane they present within a very 
limited cubic space. The greatest ingenuity has been displayed 
in the construction- of the nasal fossa to give this immense sur- 
face without increasing bulk or weight. In pursuance of this 
principle, all the bones about the nose are hollowed out and the 
chambers so formed that the so-called sinuses or channels of 
those are brought into direct communication with the nasal pas- 
sages, and constitute supplementary air chambers or crypts, and 
every portion is utilized for its proper purpose. The entire sur- 
face of this extensive tract is covered with mucous membrane, 
remarkable for its vascularity and high nerve endowment. The 
upper or olfactory portion of the nasal surface proper, amounts 
to about one-half of the whole, and this is provided with an 
epithelium composed of non-ciliated columnar particles inter- 
spersed with fusiform or olfactory cells, whilst the lower half, 
which is essentially respiratory, is furnished with a ciliated col- 



^2 DISEASE GERMS. 

umnar epithelium, same as that which lines the upper surface ot 
the bronchial tubes. Over this extensive tract, supplemented by 
the accessory sinuses, the eighteen or twenty cubic inches of air 
which constitutes the volume of one inspiration, passes and is 
dispersed in thin layers and fine streamlets. The air in this act 
of nasal respiration diffuses itself into the chambers and recesses, 
and thus becomes heated to the temperature of the body, by 
coming in contact with the vascular lining. The greatest por- 
tion of the air that enters the lungs in ordinary nasal breathing; 
is drawn from those chambers and recesses after it has beea 
heated. The inhaled air is supposed to take the sides, and the 
expired air to occupy the centre. No doubt to some extent they 
mix and thus become vitiated, for the expired air is loaded with 
carbonic acid gas and is heavier than the lighter and static air 
lodc^ed in the nasal cavities. 

The initial portion of the nasal respiration is devoted to dif- 
fusion through the sinuses and chambers, where it is raised la 
temperature, thoroughly cleaned before it is transmitted to the 
lungs; it is thus freed from disease germs, mechanical impurities,, 
by a process of sifting which it undergoes by means of the cilia 
of the respiratory portion of the tract, where these extraneous 
elements become fixed by the abundant viscid mucus secreted in 
those passages. When such impurities are in excess as in the 
case of a miner, cotton operative, knife-grinder, wool-sorter, the 
natural protection is not sufficient, and irritation and disease is 
the result. But under all ordinary circumstance the natural pro- 
cess is sufficient to catch or filter, or sift the breathed air from 
all disease germs. The crusts that form in the nose when not 
due to ulceration, are the product of sifting, filtration and depo- 
sition. 

The air inhaled through the nostrils is hygrometrically altered 
by coming in contact with moist mucous surface and thus be- 
comes charged with a percentage of aqueous vapor inversely 
proportioned to its previous hygrometric condition. This effects 
a most salutary change in softening, mollifying a dry or parched 
atmosphere, such as we often experience in our violent wind 
currents. 

The dry air, if breathed into our lungs unchanged, would 
cause too rapid evaporation from the lining surfaces of the bron- 
chial tubes, lower their temperature inordinately and interfere 
with gaseous exchange within the lungs and give rise to asthma, 
bronchitis, and pneumonia. 

The cavity of the mouth of man presents none of these advan- 
tages for breathing, indeed, it is not adapted for breathing at all 
The mouth, the buccal and laryngeal portion of the pharynx are 



BACTERICIDES. 



903^ 



covered with stratified squamous epithelium, and like all surfaces 
so provided are, by comparison with columnar and ciliated sur- 
faces, lowly endowed with vascularity and sensibility. There 
are no subdivisions in the mouth into chambers, recesses, sin- 
uses. No multiplication of surfaces by projections and depres- 
sions of surfaces as in the nasal cavities. Hence a column of air 
breathed through the mouth is not searched, cleansed, sifted and 
filtered of foreign bodies, neither is it warmed and moistened as 
if breathed by the nose. The saliva will not impart vapor to the 
air passing through the mouth, not to any appreciable extent, 
neither does air furnish a reflex stimulus for the secretion of 
saliva. This is readily perceived in those who habitually sleep 
with their mouths open during the night in the dry, parched 
state of the mouth in the mornings. During the seven or eight 
hours of sleep with an open mouth, no stimulant other than air 
is applied to the incident or excitory nerves of salivation, hence 
the parched state of the mouth. The inferences to be deduced 
then are: that the nasal passages are the natural channels for the 
entrance and exit of air, and if judiciously employed, they are as 
air passages adequate for the purpose of respiration and warding 
off disease. They are the natural channels for the introduction 
of air into the lungs and its expulsion therefrom. Their con- 
struction and organization are such as to keep man free from all 
contagious diseases. The preservation of the nose is of great 
importance ; it should not be injured by snuff, smutty atmos- 
pheres and dust. 

Breathing through the nose in the great prophylactic to all 
contagious or bacterial diseases. The mouth and fauces are the 
natural passages for food ; if used for breathing purposes there is 
great risk of disease. An open mouth is mischievous, it is a re- 
ceptacle for all noxious germs ; a closed mouth in breathing is a 
sure preventive of all diseases of the lungs as well as a proper 
safeguard against all living disease germs. Man can face the 
most deadly living poison with a closed mouth. 

To guard against disease germs floating in the atmosphere, 
breathe exclusively by the nose ; but it is very difficult to lay 
down rules for the prevention of the ingress of disease germs 
by local contact. It is impossible to say how cancer, syphilis, 
tuberculae, small-pox, typhoid fever, scarlatina, diphtheria, 
etc., can be restrained as these human pests can be communi- 
cated — 

By living in close proximity, sleeping on the same bed, using 
the same blankets in a sleeping car, or the sheets or towels of a 
steamship, or hotel. 

By wearing bathing suits, ball or funeral dresses hired out. 



904 



DISEASE GERMS. 



By drinking water, but especially milk, from a farm where 
those diseases exist, the use of cups, tumblers, spoons. 

By the water in cars, by the use of water closets, car seats,j 
bedding, by breathing the dried sputum of tubercular patients. 

By brush, comb, hats, dentists' tools, or vaccination. 

By handling ordinary articles as car straps, brooms. 

By toys sold to children on the streets — the seller, probably 
syphilitic, tests the whistle in his mouth and hands it to a child 
who is at once contaminated, as the saliva of diseased persons is 
full of germs. 

By the handling of books, cards, car tickets, canes, gloves, 
pipes, and specially by cigars, the makers of which may be dis- 
eased, and wet the wrappers with their saliva. 

By kissing, in all ages. 

Seeing that there are a thousand channels through which liv- 
ing contagion may reach man, it behooves all to eat the best of 
food, wear woolen clothes, and daily to cleanse off the entire 
body with a bath. To have a variation in diet, in exercise, in 
occupation, in amusement, as change is most conducive to a high 
state of mental and physical existence ; as essential as pure air is 
to oxygenate the blood. 



During the process of dying, there is 
Rigor Mortis. a perfect struggle between vital force 

{^Cadaveric Rigidity}) and microbial life. In the condition 
known as death, vital force succumbs, 
microbes conquer. For some time after death the same mi- 
crobes, which were instrumental in its causation, continue 
to live and excrete ptomaines, until they have used up in their 
own nutrition all the elements fit for their nourishment and 
growth. 

During this process of microbial existence, ptomaines germ 
excreta, cadaveric alkaloids, cause a coagulation of the myosine of 
the muscle. Ptomaines differ in their chemical constituents, the 
more toxical, such as the comma-bacillus of cholera, or the mi- 
crococci of tetanus, or hydrophobia, effect rigid contraction ; that 
the disease from which the patient dies, or rather its ptomaine ex- 
ercises an influence over the rigor. 

When the coagulation takes place, the acids, which are being 
constantly formed, and as continuously removed during life, ac- 
cumulate in the muscle and gradually effect a solution of the 
myosine, and then the azotized matters undergo decomposition 
and develop ammonia, which in its turn dissolves the myosine, 
and thus occasions the disappearance of the rigor. 



BACTERICIDES. 



905 



In this process, when rapid, great heat is often evolved, espe- 
cially when the rigor is being established ; the rigid muscle 
slightly diminishes in volume. 

Following that the body returns to its natural earths or gases, 
all except the cadaveric alkaloids, which remain as permanent 
salts, and are not destroyed even by cremation. 

The amount of indestructible cadaveric alkaloids present in an 
ordinary sized human being, varies from six to eight grains, de- 
pending greatly upon the development of his intellectual capacity 
or powers. ^ 

Vomiting is due to forcible and repeated 
Retching contraction of abdominal muscles, the dia- 

and Vomiting, phragm being pressed by closure of the 
glottis ; the stomach is thus compressed 
against the diaphragm, and by this force, together with its own 
contraction, the pylorus being closed, and the cardiac sphincter 
relaxed, the gastric contents are expelled upwards. In retching 
there are fruitless attempts to empty the stomach, the cardiac 
sphincter being contracted, or the stomach empty. 

Nausea, vomiting and retching, are present as symptoms in 
many diseases, as in cerebral, spinal, pulmonary, biliary, gastric, 
pancreatic, intestinal, uterine, ovarian disorders. They are often 
reflex, as in pregnancy, irritation of pneumo-gastric nerve, as in 
poisons and irritating substances. To disease-germs in blood, as 
small-pox, scarlatina, yellow fever, ichoraemia, etc. To acute or 
chronic gastritis or peritonitis. To abdominal aneurisms, tumors, 
ascites, to invagination of bowels, strangulated hernia, or some 
latent, morbid state. 

When the vomiting is due to some derangement of stomach, liver 
and intestines, it is likely to be preceded by nausea, discharge of 
contents of stomach, biliary matters, offensive secretions, acid 
matter, pus, blood ; tongue usually coated, breath foul, white of 
eye tinged, abdominal griping pain, fetid eructations, diarrhea, 
-iinhealthy stools, and the headache is frontal. 

When due to some brain difficulty or reflex condition acting on 
a weakened bulb, there is no nausea, tongue clean, breath sweet or 
pure, and if there is headache, is mostly behind ; no belching of 
foul gases. 

]f vomiting and retcJdng is due to disordered stomach, liver, 
pancreas, bowels. Lobelia emetic, cleanse out bowels, saline 
purge, or compound licorice powder, and follow with cinchona 
and nitro-muriatic acid ; a bland, simple diet, rest. 

If due to diseased-germs in fevers, give antiseptics, as ozone- 
^water, carbolic acid and tincture of iodine, yeast and milk. 



go6 



DISEASE GERMS. 



// dne to inflammation, as acute gastritis, peritonitis, yellow 
fever, green root tincture gelsemium and morphia, mustard over 
region of the stomach. 



The increasing prevalence of cere- 
Rheumatism, bral disease, due in a great measure to 

{Bacillus Amylobacta.) neurasthenia, defects of civilization, 

and the daily increasing struggle for 
existence, with other causes which engender a feeble vitality, under 
which we have slow or retarded digestion, the starcliy or saccha- 
rine elements of the food undergo fermentation, with their con- 
version into acids ; if gastric catarrh, with its sarcinae ventriculi 
has not preceded, it very soon follows, and acts as an addi- 
tional ferment in the elaboration of lactic and butyric acids. 
These morbid elements enter the blood, and have an especial 
affinity to the white fibrous tissues of the body (if they are weak- 
ened), such as the membranes of the brain, pleura, pericardium 
of the heart, synovial membrane of joints, periosteum of bone, 
sclerotic coat of the eye. 

In acute and chronic rheumatism, there are invariably present 
numerous other microbes due to the degraded bioplasm of nutri- 
tion, which are always present in mal-nutrition, these are bacteria, 
sarcinae, the bacillus amylobacta, the microbe of butyric acid, etc. 
The microbe when present in any given 
A A \ \ M case of rheumatism is usually found on the 

v^ ^V^ I ^' tongue, tonsils, breath, sweat, urine, faeces 
%% B *"***** ^"^^ ^" ^^ atmosphere for over twenty feet 

\^ ^ y^ A around the patient. This evolution of fer- 

^ 1^ ^ ^ n mentation, vegetates in the form of slender 

* « f ^ cylindrical rods, united at most in short rows 

^ and usually in a state of undulating motion. 

^Srped^'"fSmrtncTuding ^^ vcgctatcs luxuHantly in patients whose 
oval spores. vital forccs arc at a very low ebb. The fer- 

mentation of which butyric is the primary product is invariably 
accompanied by other micro-organisms, of a different species, 
which ^\\f^ rise to special chemical changes among lactates; 

The bacillus amylobacta excrete ptomaines freely, and is 
pathogenic of rheumatism. 

The isolation of this microbe in all cases of acute and chronic 
rheumatism marks an entirely new era in therapeutics. 

The predisposing cause of the evolution of this microbe is an 
impairment of the integrity of the nerve centres, which gives us 
feeble vital power, weak digestion, the generation of acids, lactic 
and butyrics. Add to this isolation, sameness, monotony, dele-^ 



BACTERICIDES. 



907 



terious trades, insanitary abodes, tobacco, whiskey, excess of 
starchy or saccharine food, and other states which in some mys- 
terious way alter, change, degrade certain primary elements of 
nutrition into a disease-germ, the bacillus amylobacta. 

This microbe is in the blood in all cases of acute and chronic 
rheumatism, but it has a special affinity to localize itself in and 
on the white fibrous tissues of the body, if that tissue or struc- 
ture is weakened by mechanical irritation, injury, cold, damp ; 
the weakening of the white fibrous tissue renders it obnoxious to 
the deposit of the germ and affords a suitable location for its 
growth and development. 

The bacillus and its ptomaines are the factors of the disease. 

In the acute form, either vital power is greatly shattered or the 
aggregation of germs is prodigious, for we have rigors, fever, 
with temperature, and rapid full-bounding pulse, with local joint 
pain, or in some white fibrous tissue. The fever and inflamma- 
tory local microbe-ptomaine evolution are due to excessive spore 
development. 

Symptoms are extremely variable ; temperature high, with 
joint pain very great, are common, with heavy ptomaine ex- 
cretion, coma, delirium and profuse sour-smelling fetid sweats. 
Urine high specific gravity, loaded with urates. Tongue and 
breath, the former heavily coated with the bacillus amylobacta, 
the latter, sour smelling. 

The fever is of a continued type^ corresponds to the ratio of 
germ growth. 

Some cases present anomalous symptoms, verging on gout, 
others truly rheumatic. 

Others, whose nervous systems are damaged by alcohol, with 
delirium all through the severity of the diseases. 

The microbe of rheumatism mostly pursues a very definite 
course or form of its own, and deviations from that bodes no 
good. So long as the symptoms follow the usual and orderly 
evolution, though that may be severe, there is not much danger ; 
but when unusual or strange s^^mptoms arise, when dangers 
threaten from unknown quarters, we do not like it. Articular 
rheumatism, though severe, when confined to joints or w ith but 
moderate cardiac complication, is a tolerably straightforward 
matter ; but rheumatic fever, with little joint affection and much 
delirium, or lung cedema, is quite a different thing. 

Individuals of all ages are attacked with this microbe, but 
most common between fifteen and thirty. 

The heart is affected in about seventy-five per cent, of all cases, 
and the cause of death in nearly all cases is cardiac trouble. 
Mortality is greatest among the young. Acute rheumatism most 
common among males. 



9o8 



DISEASE GERMS. 



In the treahnent of all cases of rheumatism, the indications are 
to endeavor to restore the tone of the nervous system ; improve 
digestion, kill and sterilize the microbe, and neutralize its pto- 
maines. 

The condition of stomach and tongue points to the utility of 
an emetic, which should be administered, followed by a saline 
cathartic and a vapor bath. Following which the patient should 
be kept in the recumbent position in bed between blankets. 
Silk or woolen underclothing. If tne heart suffers, apply over it 
concentrated ozone. 

Suitable doses of tincture of aconite, veratrum, and gelsemium 
should be at once administered, so as to quiet the circulation 
and lower heat. Pain should be allayed with small doses of pul- 
verized opium and diaphoretic powder. It is a sound and whole- 
some rule in practice, that no patient should experience pain, 
far less one suffering from the ravages of the bacillus amy- 
lobacta. After attending to the general preliminaries, such as 
bathing the patient thrice daily ; to a milk and beef tea diet ; to 
maintaining an active condition of the bowels ; to keeping bac- 
tericides over locations or parts in which the microbe is domi- 
ciled ; where the pain exists, for where that is, the bacillus amy- 
lobacta is there, giving rise to the irritation. How such a good- 
sized microbe penetrates those closed sacs through the blood 
currents into the joint liquid, is a mystery which bacterial inves- 
tigation has not yet made clear. A local germicide is needed, 
the concentrated ozone wherever applied sterilizes the microbe ; 
ozonized tincture of iodine, iodized oil, iodoform, iodol, sulphur 
compresses, are excellent local bactericides, and can be used with 
most satisfactory results. 

Then a selection of two of the following remedies should be 
made and administered alternately in the treatment of the case in 
sterilizing and annihilating the bacillus amylobacta. 

A mixed course of treatment is the best, and what the reme- 
dies are to be, we must leave to the judgment of the physician in 
charge ; we simply give a brief synopsis of each. 

Although the peroxide of hydrogen is the great scavenger of 
microbe-laden blood, and will, if carefully administered in rheu- 
matism, do great service, still from some unknown cause, it acts 
most energetically upon the amylobacta, administered either in 
the form of glucozone, or better still, in the uric acid solvent. 

The uric acid solvent is composed of the extracts of pichi, 
chionanthus virg., iris, cleavers, triticum repens, acetate of soda, 
nitrate potass and peroxide of hydrogen. ' It forms a most effi- 
cient, elegant preparation. 

When administered either in acute or chronic rheumatism it 
does excellent work in perfectly annihilating.the amylobacta. 



BACTERICIDES. qOq 

Still, excellent as this preparation is, most destructive to the 
microbe, we would strongly advise it to be administered in 
alternation with another germicide, as salol, glycerite of winter- 
green, manaca, etc. 

From extensive experience, we very strongly urge a mixed 
treatment of all cases. 

The uric acid solvent ozonized, is a complete destroyer of the 
germ ; it is an efficient stimulant to the neurasthenic liver; neu- 
tralizes the acidity upon which the microbe lives and breeds ; it 
•flushes the kidneys, blocked up by debris, and dissolves and 
washes out the uric acid crystals which had been, and were accu- 
mulating in the nephritic glands. 

The glycerite of wintergreen with the peroxide of hydrogen^ 
or as it is termed the ozonized glycerite, give us an active,, 
energetic germicide in killing and sterilizing the amylobacta, by 
the annihilation of the germ ; pyrexia is controlled, and the joint, 
pain ceases. The best method of administration is in moderate 
doses, frequently repeated and continued in diminished doses 
throughout convalescence. Its use possesses many advantages, 
its prompt action, unattended with any toxic effects, produces no 
irritation of the stomach. 

The ozonized glycerite of wintergreen, that is, the combination ofe 
oil of wintergreen C. P. glycerine and negative ozone, has a mar- 
vellous effect in annihilating the microbe of rheumatism. One 
teaspoonful administered every two or three hours, speedily^ 
causes the death of the germ, for in a few hours after repeated 
doses have been given, the germ disappears from the breathy 
saliva, sweat, urine, and a lowering of temperature, pulse, respira- 
tions is the inevitable result. The great superiority of this 
remedy consists in its rapid destruction of the germ, the preven- 
tion of cardiac complications, the infrequency of a recurrence of 
the microbe in the blood. 

The derivatives from the wintergreen oil, such as salicylic acid, 
salol, are inferior to the glycerite. 

In summing up the results of our experiments with the oil of gaul- 
theria, a brief recapitulation of the most important points brought 
out will recall more clearly to mind the advantages of this drug 
as an anti- rheumatic agent. We have found that it has all the 
valuable properties of salicylic acid, to which it is closely allied. 
Its action is more prompt and efficient in obstinate cases. It has 
a more agreeable taste. Relapses under its use are less frequent. 
The unpleasant effects of over-dosing are no greater, and it is 
less depressing. Cardiac complications are no more frequent. It 
is important not to substitute the oil of birch or a diluted article 
for it. Large and frequent doses are necessary to get the best 



^jQ DISEASE GERMS. 

effects. It is an efficient palliative remedy in chronic and 
irregular forms of rheumatism. It is a local anodyne to in- 
flamed joints. 

Whatever may be the peculiar action of the bactericide, sali- 
cine, salicylic acid or soda, there can be little doubt entertained 
that it has a remarkable affinity for the microbe of rheumatism 
to unite with it and kill it. 

That it acts most efficiently when combined with the acetate of 
ammonia. An extended experience has confirmed this idea. By 
administering from fifteen to thirty grains every two hours we 
cleanse the germ-laden blood in a short time, and in that way 
the urgent symptoms are relieved. 

As soon as temperature., pulse and respirations become normal, 
both the dose and frequency of administration of the drug can 
be reduced until it is safe to discontinue it entirely. The true 
salicylic obtained from the vegetable kingdom should only be 
used ; the artificial product obtained from carbolic acid, however 
much it may have been purified and dialized, an impure acid, 
will very quickly produce symptoms resembling delirium tremens. 
While administering the salicylate keep bowels open with cascara 
sagrada. 

The salicylic acid administered in the acetate of ammonia; 
the best acid, say from three to twenty grains to four drachms of 
the ammonia acetate, administered in small but repeated doses, 
kills the micro-organism ; hence temperature, pulse, respirations 
are lowered. 

In all patients under thirty-five the bactericide action of the 
salicylates is most decided when the microbe is in the joint sacs. 

If cardiac symptoms exhibited themselves before either of those 
remedies have time to kill the microbe, then the following mix- 
ture should be given : nitrate of potass, one drachm ; acetate of 
potash, three drachms ; water, eight ounces. Dose one ounce 
every two hours. The good effects of alkalies are immediate, 
and afford time to push other remedies, to thoroughly kill the 
microbe. 

In the treatment of acute rheumatism, as also in acute gout, 
the salicylate of lithium is quite as effective as the salicylate of 
' sodium. In certain cases of acute articular rheumatism treated 
with the sodium salt, there comes a period, after rapid and con- 
siderable improvement, when the joints still remain somewhat 
painful, stiff and swollen, notwithstanding the fact that the remedy 
is given in doses sufficient to cause toxic phenomena. Under 
these circumstances the salicylate of lithium will cause the last 
traces of the affection to disappear promptly. It is also more 
effective in the treatment of progressive subacute articular rheu- 



BACTERICIDES. gj j 

matism. In patients attacked with this most tenacious and trou- 
blesome form of rheumatism, Prof Day has employed, with the 
utmost perseverance, the most various medication, including 
large and repeated doses of the salicylate of sodium, without 
producing other than the most temporary and insignificant 
amelioration; and yet he has seen the salicylate of lithium bring 
about notable improvement in ten to fifteen days. Four grammes 
(about sixty grains) a day is the quantity of salicylate of lithium 
usually required. The effects cf the remedy begin to be mani- 
fest in a half to one hour, and consist in headache — which, 
however, disappears within a few hours — and vertigo and dulness 
of hearing, which are more persistent. In some subjects it also 
causes colic and diarrhea. The curative effect of salicylate of 
lithium is due in large part to the salicylic acid ; for, if the other 
salts of lithium are substituted for it, the same results are not 
obtained. Some portion of the beneficial effect is, however, due 
to the lithium, for the salicylate of lithium is more effective than 
the salicylate of sodium. The rheumatismal manifestations which 
resist the action of six and seven grammes (one a half drachms 
to two drachms) of salicylate of sodium yield to four grammes 
(about one drachm) of salicylate of lithium. To these observa- 
tions of Prof Day, the writer will add that he has found the 
salicylate of lithium very effective in myalgia or muscular rheu- 
matism, given in the quantity mentioned above — fifteen grains 
four times a day. 

Salol, as is well known, is a compound of salcylic acid, sixty 
parts, and phenyl, forty parts, and, according to the analysis of 
Tate, the ordinary commercial salol contains about thirty-six per 
cent of phenyl. Hence the question arises as to whether its 
action as an antirheumatic is simply due to the salicylic acid it 
contains, or whether salol possesses other properties which make 
it superior to salicylate of soda. At the present time, different 
observers are not agreed, since according to several it is stated to 
be superior to salicylate of soda. Others, however, consider that 
the only advantages of the use of salol are that its taste is not so 
unpleasant, and that its use is not so liable to be followed by 
toxic effects, as so frequently occurs with salicylate of soda. 
Whereas the latter usually subdues pain and fever in the first 
twenty-four hours, salol requires three or four days, though pain 
was greatly ameliorated within the shorter period. In conse- 
quence of its many advantages salol was adopted as the routine 
treatment by Aufrecht, but on the occurrence of a fatal case of 
acute endocarditis under its use — a thing not met with among 
600 cases treated by salicylic acid — it was discontinued. Since 
then what might be called mixed treatment has been followed. 



^12 DISEASE GERMS. 

In this, acute cases receive during each of the first two days 
ninety grains of the acid, after that the same amount of salol. 
Later, the patient still remained in bed, the salol is reduced to 
sixty grains daily. As salicylic acid is usually well borne for 
two days, but frequently no longer, this recommends itself as the 
best routine treatment If possible the acid can be continued , 
if, on the other hand, it cannot be taken, salol alone may be used. 
In chronic articular rheumatism salol is preferable in every 
respect, not only avoiding the dangers attending prolonged use 
of salicylic acid, but offering more positive assurance of cure. 
Salol does cause cerebral disturbance, as noises in the ears, and 
is well tolerated by the stomach. 

Betol, which is composed of naphthol and salicylic acid, is 
often efficacious. 

Peroxide of hydrogen is of especial value in all cases of rheu- 
matism, its use aids other remedies materially, administered in 
alternation with either of the remedies selected, militates disas- 
trously to the growth of the bacillus, cuts short the disease most 
effectually. 

Its energetic action upon the stomach, intestines, and kidneys 
as the great scavenger of nature, freeing those important blood- 
making organs from all disease germs, is besides a most valuable 
aid to digestion. 

The dose of hydrogen peroxide is from a half to one teaspoon- 
ful of the fifteen volume solution, added to the same quantity of 
glycerine, and then administered in water every four hours. 

Ozonized cascara sagrada lozenges. — Till recently the great 
value of the cascara sagrada was a tonic and stimulant to the 
liver and intestines in all cases of habitual or obstinate constipa- 
tion. 

The nauseous and persistent bitter so characteristic of the bark 
and its ordinary preparations have been a great drawback to its 
more general use ; we have by means of the peroxide of hydro- 
gen an almost tasteless extract. The destruction of the bitter- 
principle does not militate against its efficiency but rather in- 
creases the action of the drug, at the same time rendering it more 
palatable and elegant. Each lozenge contains a dose, equal to 
twenty drops of the fluid extract with saccharine lacta and kola 
nut. For constipation of all varieties they are invaluable. 

The remedy in this form, besides rousing up the liver, in- 
creasing the peristaltic wave, has the remarkable faculty of steriliz- 
ing and annihilating the bacillus amylobacta, the microbe of 
butyric acid, the tactor of rheumatism ; hence its value, its great 
eflficiency in all cases of rheumatism, acute and chronic. Un- 
paralleled success attends its administration in rheumatoid 



BACTERICIDES. gi^ 

arthritis, muscular rheumatism, pericarditis, and all forms of the 
malady. 

Irrespective of its germicidal action on the bacillus amylo- 
bacta, it also effectually sterilizes the sarcincB ventriculi and sar- 
cince intestines and the numerous cryptogams on the cutaneous 
surface. 

For constipation, one to two at bedtime, in rheumatism, from 
one to two thrice daily, according to the advice of the attending 
physician. 

The hepatic functions are generally defective ; this may be due 
to the excessive use of nitrogenous foods and the accumulation 
of waste products interfering with healthy function. These cases 
require careful dieting and the use of remedies to secure elimina- 
tion of bile, and disgorgement of the portal veins. There is in 
those cases a sort of neurasthenia of the liver, that is to say, the 
hepatic functions are sluggish, imperfectly performed, as a part of 
the general want of tone in the nervous and vascular systems ; 
here hepatic stimulants, like the cascara lozenges, are indispen- 
sable, together with massage. 

The patient may appear plethoric, but look at the case care- 
fully the arterial tone is weak, the blood hydraemic, decidedly 
impoverished. 

In the most ordinary cases, the blood is decidedly impover- 
ished by the microbe, and the patient needs generous diet and 
tonic treatment. In spite of the general practice of prohibiting 
this and that, the better plan is to be liberal in dietetics, and let 
the patient have what he relishes and digests well. 

Another important point is to secure a healthy action of the 
skin. This is invariably defective. It is necessary to secure free 
perspiration once or twice a week, but a healthy 'tonicity of the 
cutaneous surface should be maintained. 

The very variable character of the symptoms, together with 
many points of similarity, with wide points of difference, which 
are increased by variations in constitution and temperament. 
To treat such cases successfully requires an adaptation of method 
to the individual condition, and this the skill of the physician 
will supply. 

Manaca, the root bark is the part in which the medicinal 
properties of the plant reside^ and which yields the active prin- 
ciple in abundance. 

Its properties are that of a powerful bactericide, being capable 
of destroyincr the microbe of syphilis, cerebro-spinal meningitis 
and rheumatism. 

In a mixed treatment of rheumatism, manaca operates well, 
and becomes a very valuable drug. It should be administered in 

58 



gi^ DISEASE GERMS. 

small doses, every three hours, beginning with five-drop doses 
of a fluid extract, gradually increasing the dose until it operates 
on the bowels. It has a most decided action upon the bacillus 
amylobacta of rheumatism, killing the germ and subsequently 
eliminating it from the body. 

Manaca when thoroughly impregnated with four volumes of 
peroxide of hydrogen has a strong affinity for the bacillus of 
rheumatism, being in this state highly germicidal ; besides it is 
purgative diuretic, stimulant to the lymphatic system, eliminating 
the dead germs from the blood by the skin, kidneys, and bowels. 
Its administration requires great care, beginning with small doses 
of from three to five drops or more thrice daily. Cautiously 
increased. 

The so-called elixir of manaca and the salicylate, which is said 
to combine the virtues of the manaca with the salicylates of 
soda, potassa and lithia, is a most unreliable form for administra- 
tion ; the manaca in all cases should be given alone, as its effects 
can be more carefully watched. 

Comp. tincture serpentaria, or jaborandi, gives rise to an 
activity of the sweat glands ; gives a determination of live or 
dead microbes to the skin, and lowers temperature. The amylo- 
bacta themselves usually give rise to copious perspirations, and 
their elimination when killed should be promoted, and those 
remedies administered which will facilitate and assist cutaneous 
transpiration. In all cases the skin should be bathed thrice 
daily, so as to remove all the stagnant, fetid matter on its sur- 
face. Even the body, linen and bed-clothes should be changed 
daily, so as to remove the putrefying germ-laden perspiration — 
sour, stench smelling, which de-appetizes the patient. 

The next in*(iication in the treatment of all cases of acute rheu- 
matism is to augment vital force, increase vital stamina, so as to 
cut off the evolution of the microbe. A great variety of reme- 
dies have been pushed forward for this purpose, as tincture of 
cimicifuga, apocynum, bryonia. 

Preparations of cinchona, or its alkaloids, con. tincture kurchi- 
cine, Warburg's tincture, etc. 

Of these, cimicifuga, alternated with the hydrobromate of qui- 
nine in four grains, is undoubtedly the best. Kurchicine acts 
well. 

Precisely the same condition, same germ, 
Rheumatism, but of long standing, as the acute. 

Chronic. It may follow as a sequela from a more 

active state of microbial evolution, or it may 
come on of itself 



BACTERICIDES. pic 

The fibrous textures around the joints, or the fibrous enve- 
lopes of the nerves, or the aponeurotic sheaths of the muscles, 
coverings of tendons, periosteum, etc., are those that sufifer most. 
It receives different names from the locality of the irritation ; as 
neuralgia, when it attacks the nerves ; lumbago, when the muscles 
of the loins are affected ; sciatica, when the sheath of the great 
sciatic is involved ; pleuradynia, when the pleura and intercostal 
spaces are implicated. In any case there is usually little consti- 
tutional disturbance ; but the sufferer is constantly annoyed and 
his existence made very miserable from chronic pains, causing 
him to be restless at night and destroying his comfort in the day 
time. In some instances the pains are worse at night, being ag- 
gravated by the warmth of the bed ; in others, warmth affords the 
greatest relief. 

The blood in chronic rheumatism is usually thoroughly 
charged with the bacillus amylobacta, but the germ does not 
breed so actively as it does in the acute, neither does it produce 
such havoc with the blood discs, nor is it of such an erratic char- 
acter. 

There is little difficulty in the recognition of chronic rheuma- 
tism — the mal-nutrition, the microbe on or in the scraping of the 
tongue ; urine loaded with lithiates, the character of the tissue 
affected (the white fibrous), etc. 

The management of all cases of chronic rheumatism requires a 
general alterative and tonic course of treatment, comp. saxifraga 
and Phytolacca, in alteration with tonics, as compound tincture 
cinchona, and hydrobromate of quinine, con. tinct. kurchicine, 
etc. Some bactericide should also be invariably administered, 
either the ozonized uric acid solvent, or manaca, or the salicylate 
acid in the acetate of ammonia, or the glycerite of wintergreen, 
or guiacum or salol. 

Pain in all cases must be alleviated, and local germicides over 
the seat of pain (damaged white fibrous tissue) are always in 
order, as con. ozone, menthol, ozonized iodine, iodol. 

The general health should be improved by every possible 
means, by daily alkaline baths, sulphur and iodine baths, mas- 
sage. 

The diet should be generous to a fault, restricting saccharine, 
starchy, and animal food. 

If the case does not yield promptly, the sphere of remedies 
should be enlarged. 

Much good is often derived in chronic rheumatism from such 
remedies internally as iodide of potassa, chlorate of carbon, 
cimicifuga, bryonia, iris, phytolacca, saccharated sulphur, colchi- 
cum, dulcamara, terebene, sulphur- water ; and locally, con. 



9i6 



DISEASE GERMS. 



ozone with chloroform and menthol, oil of stillingia, solidago, 
turpentine, hemlock, sassafras, etc. ; all failing, a persistent appli- 
cation of the irritating plaster. 

Rheumatism and gout are often associated together, although 
both are essentially different. In rheumatism we have a bacillus 
to deal with, and microbicides must be used to kill it, whereas, 
in gout we have a mechanical source of irritation in the urate of 
soda. This, no drug can remove, but by a long persistent use 
of the uric acid solvent ozonized, it often melts away. 

Clinical observation has established a pathological connection 
of great practical interest. It has been long known that chronic 
rheumatism and gout may prepare the way for osteo-arthritis by 
lowering the textural force of the joint structures, and thus lead- 
ing to morbid change of degenerative kind. In people of the 
so-called tubercular diathesis, or who have near kinsfolk dis- 
tinctly *' consumptive," repeated rheumatic attacks may beget a 
condition commonly called rheumatoidal ; and this, -again, may 
gradually pass into the more complete and incurable state which 
enjoys the official title of osteo-arthritis. 



When the structure of the larynx 
Rheumatism. is weakened and the amylobacta 

(Rheumatic Laryngitis}^ present in the blood, it often local- 
izes itself upon the vocal cords. Its 
presence here gives rise to pain, hoarseness, aphonia, and fatigue 
of the parts after talking, and sometimes to obstruction of the 
glottis. 

It is met with in both the acute and chronic form. 

Its diagnosis is not difficult, occurring in persons of a rheu- 
matic diathesis, attended by no erosions or ulceration, by little 
congestion or swelling. 

Patients commonly refer the pain to one side of the larynx, 
when this organ alone is involved, but in some cases it is also 
referred to the trachea, the region of the greater cornu of the 
hyoid bone, to the base of the tongue, or to the lower part of the 
tonsil on the corresponding side. In similar cases we sometimes 
find the pain confined to these latter regions, there being no in- 
volvement of the larynx, but even in these the patient is liable to 
experience fatigue of the vocal organ after talking. Hoarseness 
and loss of voice are also frequent symptoms. 

Rheumatic laryngitis is most likely to be confounded with neu- 
ralgia or para^sthesia of the organ. In distinguishing between 
these, the history must be carefully scrutinized, and rheumatic or 
neuralgic pains must be looked for in other parts of the body. 



BACTERICIDES. 



917 



In the rheumatic affection there are usually slig^ht redness and 
swelling ; not so in neuralgia. For confirmation of the diag- 
nosis, we must sometimes await the result of treatmeit. 

Rheumatic laryngitis nsually runs a chronic cojr^e, extend- 
ing over periods varying from two months to one or more years. 
In most cases, if not in all, there are periods of immunity from 
the soreness, but at other times there are quite severe exacerba- 
tions of pain. I recall one case which was troublesome at times 
for four or five years. Recovery may be expected ultimately, 
and the patient may and should be assured that the disease does 
not endanger life. 

In the treatment of chronic laryngitis, great benefit is derived 
from the use of hot atomized sprays of resorcin, creolin, benzoate 
of soda, peroxide of hydrogen, together with electricity, although 
as rule our main reliance is placed upon internal remedies. In- 
variably, splendid results follow the use of the glycerite of winter- 
green, manaca, and cascara sagrada. 



The amylobacta impairs both the blood discs 

Rheumatic and walls of the blood vessels, and permits an 

Purpura. extravasation of blood, and gives a form of 

purpura, due to rheumatism, closely allied to 

scurvy, but in which we have the cutaneous hemorrhages and 

joint affection as the prominent features. 



An infectious and contagious granuloma, 
Rhinoscleroma. affecting the skin and mucous membrane of 
the nose and contiguous 
parts, characterized by the formation of ex- /2^" — ^ 

ceedingly dense, painful, flattened or elevated ^^^^'^S^y"^ 
nodules, or tubercles, which may be isolated K^lr**^^^^^^ ^ ** 
or confluent. ^(^^^(^ ^* 

An examination of these lesions, microscopi- ^ ^ 

cally, reveals a bacterium in the tissue, rod- ^p9 
shaped, one and one- half times longer than 
they are broad, with micrococci in their centre. Bacteria of rhinosciero- 

^ . , , . -,..., nia ; rods surrounded 

This neoplasm admits of cultivation in almost ^'th their capsules , 
any nutrient fluid ; cultures injected into ani- foSaded b*y^T\ingre 
nials cause a series of ivory nodules to appear f^XtbU'Todis^m" 
on the nasal septum, hence it is pathogenic of wing a coccus. 
the disease. 

The favorite habit of this microbe is either the septum or alae 
of the nose, in which it breeds slowly, but, progressing, en- 



91 8 disease: germs. 

larges, becomes as dense as ivory, without any inflammatory 
symptoms being present. 

The special lesion, or microbial colony, or patch, or nodule of 
germs, gradually grows either flat, or indurated or elevated, 
while respiration is often impeded by stenosis of the nares. 

This neoplasm is met with in both sexes, between fifteen and 
fifty, in all social positions of life. 

The micro-organism, imbedded in the nasal tissue, can never 
be mistaken ; its location, the disfigurement it occasions, the 
induration, the ivory-like elasticity, its transformation into 
osseous formation and the extreme rarity of ulcerative de- 
generation. 

The future of the patient is one of great gravity, as the 
growth and organization of the microbe is slow, but progress- 
ing and persistent. 

The old treatment of extirpation, dilatation of the nares, has 
been entirely superseded by the local application of peroxide of 
hydrogen externally and in the nasal fossae, and by the adminis- 
tration of Chian turpentine and peroxide internally. Ozone oint- 
ment, resorcin and salicylate soda externally. 

These seem fo be our most effective germicides in rhino- 
scleroma. 



Rose rash resembles eruption of measles, but 

Roseola, there is no watering at the eyes and nostrils, 
neither is there cough. 

The skin is mottled, of a rose-color, the patches being of no 
great size and of irregular shape ; sometimes the eruption appears 
as a cross of small slightly raised rose- colored spots. At first the 
eruption is bright red, but gradually it fades and finally disap- 
pears. The constitutional symptoms are slight. The rash fades 
in from three to six days. Sometimes the throat is affected 
slightly as in scarlatina, which has led some to believe that the 
malady consists of a mixture of scarlatina and measles, but of 
that there is no proof whatever. 

Various maladies give rise to roseola, the most important of 
these is syphilis. Usually syphilitic roseola is the earliest of the 
constitutional symptoms ; it commonly makes its appearance 
within six weeks of the primary attack, but it may be so slight 
as to give rise to no inconvenience, and so frequently escapes 
observation. 

Syphilitic roseola ordinarily consists of a number of rose 
copper-colored spots, completely isolated and even with the sur- 
face, but sometimes they are fused together so as to give rise to 



BACTERICIDES. 



919 



patches which are above the surface, and so merge imperceptibly 
into the papules which commonly follow in order of secondary 
symptoms. At the same time the fauces present a rim of redness 
corresponding to the external rash. Belladonna sometimes pro- 
duces a roseolar rash, but not very often. 

Various microbes give rise to roseola, as the bacteria of mal- 
nutrition, dyspepsia, rheumatism, dentition. 

An alcoholic vapor bath ; opening the bowels and administer- 
ing some microbicide as glucozone, or salol ; ozone tablets are 
usually sufficient. 



A rare skin affection, in its typical form, a denizen 
Rupia. among the dregs of humanity, always syphilitic. It 
consists of masses of the germ syphilitica with that 
of pus, in the form of hard, conical, laminated crusts of a limpet- 
shell shape ; when these crusts are removed, an ulcer is exposed 
crowded with the microbes. 
Same treatment as for syphilis. 



Rupture of the heart may occur from 
Rupture of the previous disease, or it may be caused by 
Heart. external violence. It may take place at 

any part, left or right side, walls of ven- 
tricles, rupture of valves, etc. Laceration of muscular walls, 
generally due to fatty degeneration, or to rupture of aneurism 
in ventricular wall. It is a common termination in dilatation 
with thinning of its walls. Embolism of the blood, such as we 
have in acute laryngitis, pneumonia, and also in ergotism in labor, 
as well as that due to eating bacterial food, as sausage, is a com- 
mon cause of rupture. The condition of embolism is so common 
from sluggish livers, non-aeration of blood by lungs and skin, 
and the muscular structure, feeble by excesses and tobacco, that 
rupture of the heart as a cause of sudden death is fearfully 
prevalent. 



If a muscle be weak, perhaps slightly degen- 

Rupture of erated,someof its fibres usurped by fatty nodules, 

Muscles. and it be subjected to violent, sudden, severe 

exertion, it may rupture, or its tendon may give 

way. 

It is readily recognized by the sudden snap, severe pain, loss 
of the use of the ruptured muscle. 



920 



DISEASE GERMS. 



Muscle, like bone, nerve or other structure, will unite, if it is 
kept at perfect rest and apposition, keeping the limb in such a 
position as will relax the ruptured muscle ; bandages and splints. 



A tumor or swelling, formed by the protrusion 

Rupture, of more or less of a viscus from its natural cavity. 

{^Hernia}) Thus, there may be hernia of the brain, iris, 

mucous lining of windpipe, lungs, liver, spleen, 

bladder, uterus and intestine. But when the word stands by 

itself it is restricted to signify protrusion of the abdominal 

viscera. 

The predisposing cause of hernia is some inherent weakness 
of organization ; some parts of the abdominal walls weaker 
than others, as about the navel, inguinal and crural rings ; or 
there may be a weakness from congenital deficiency, or from 
disease, wounds, abscess, bruises, distension of the walls by the 
pregnant uterus, dropsy, or from the relaxing effects of exces- 
sive solar heat. 

The exciting causes are compression of the viscera by the 
laction of the muscles that surround them, especially the dia- 
phragm ; hence, bodily exertion, lifting, hoisting, straining, 
jumping, coughing, hallooing, shouting. 

A hernia is composed of a sac and its contents. The sac of 
a hernia is a portion of the reflected layer of peritonaeum, 
which the protruded viscera push before them in their escape, 
and which forms a pouch containing them. It is very liable to 
contract adhesions to the surrounding tissue, and in consequence 
may not return into the abdomen when the hernia is returned. 
As the hernia increases in size the sac also increases, partly by 
growth, partly by distension, slight laceration or unraveling, and 
partly by fresh peritonaeum ; sometimes it diminishes in thick- 
ness, while increasing in capacity ; sometimes it becomes thick 
and divisible into layers. The narrow part that communicates 
with the abdominal cavity, is called its neck, usually becomes 
thickened, constricted, and sphincter fibres are often developed 
in it, which, on slight irritation, causes it to contract. Some 
hernias are destitute of a sac. This may happen if the viscus is 
not covered by peritonaeum, if the hernia is the result of a 
wound. 

Symptoms. — Usually the patient can speak of it as of some- 
thing having given way, and on examination a soft, compres- 
sible swelling can be detected at some part of the abdominal 
walls, which increases in size when he stands up ; diminishes or 
disappears when he lies down ; dilates when he coughs or makes 
exertion, and, when properly directed pressure is made upon it, 



BACTERICIDES. 



92: 



it may disappear. When it contains only intestine it is termed 
Enterocele ; when only omentum, Epiplocele. The former is 
smooth, round and elastic, and flatulent croakings are heard in 
it, and, when pressed upon the bowel, returns to the abdomen 
with a sudden jerk or gurgling noise ; the latter is flat, inelastic, 
flabby, unequal to the touch, and when pressed upon returns 
without any noise and very slowly. A large number of hernia 
contain both omentum and bowel, and are called entero-epiplocele. 

Division. — Hernia is divided into several varieties, according 
to its location, as umbilical, inguinal, femoral ; and according to 
the condition of the protruded viscera, which may be reducible, 
irreducible, or strangulated, or subject to some constriction that 
prevents its return, interferes with its contents or circulation. 

Pathology of Hernia. — But few attempts have been made to 
investigate minutely and exactly what was meant by that condi- 
tion which we so frequently see, but so rarely thoroughly appre- 
ciate, and which we call hernia. We divide it, according to its 
clinical appearances, into inguinal, femoral, umbilical, or into 
congenital and acquired hernia, but of the conditions which went 
to produce each variety we have been up till quite recently com- 
paratively ignorant. It has been assumed, because the intestines 
in the case of hernia protruded more easily from the abdomen 
than is normally the case, that therefore we had to do with the 
elongation of the mesentery. Many authors do not take this 
statement for granted, have measured a large series of abdomens 
and mesenteries, both healthy and unhealthy, and have come to 
the conclusion that elongation of the mesentery is a compara- 
tively rare event. 

Perhaps it will be more easy to follow these conclusions and to 
estimate them at their true Value if we first consider congenital 
hernia, and afterwards those forms which are acquired. It has 
long been known that many cases of congenital hernia yielded to 
the treatment of a truss, underwent cure before adult life, and did 
not show any special tendency to return again later on. Perhaps 
the most obvious instance of this is afforded by umbilical hernia 
in childhood. Of the innumerable cases which one sees in 
children in the large out-patient departments there is scarcely one 
which ever survives to the adult life of its possessor, and this 
notwithstanding the fact that the treatment of these cases is 
notoriously conducted by the parents on the most slipshod prin- 
ciple. As age advances and fat accumulates on the mesentery 
umbilical hernia again acquires prominence ; but we do not 
remember to have ever come across a single case in which it 
could be shown that the possessor of one of these hernise in old 
age had previously been troubled with a similar affection early 



922 



DISEASE GERMS. 



in life. To a less extent these remarks also apply to femoral 
and to inguinal hernia, chiefly to the latter, because femoral 
hernia is almost unknown in childhood. There are certain 
periods of life at which the pelvis grows with great rapidity as 
compared with the rest of the abdomen, namely, from about the 
second to the fifth year, and again at the age of puberty, and it is 
at these two periods that we have to record the greatest number 
of cures of congenital hernia. It is extremely interesting to find 
that measurements fully bear out and support these facts to 
which we have alluded. Elongation of the mesentery is practi- 
cally unknown in children, whilst that other condition which has 
been mistaken for it, namely, prolapse of the mesentery, and 
which we shall come to further on, is apparently without exist- 
ence at all in childhood. The fault of growth which has given 
rise to hernia in childhood lies with the abdominal wall, and is 
due to imperfect closure either of the inguinal canal or of the 
umbilical orifice. It is clear, then, that if operative interference 
is of any avail at all in the cure of such a condition, the best 
results ought to be obtained by operating on those herniae which 
occur early in life. This conclusion has also been arrived at 
independently by other writers on the subject, who have ap- 
proached it rather from the practical side than from the patho- 
logical. One writer has, we believe, gone so far as to state that 
if operations were confined to childhood there would be no 
failures to record; and from these facts we may at least draw this 
comforting assurance, that should a congenital hernia prove 
rebellious to treatment by a truss or other simple means, we can 
give the very best hopes possible of its complete cure by opera- 
tiv^e interference. 

If we turn, however, from the consideration of the congenital 
cases to those which occur in adult life, the pathology at once 
becomes more complicated, and as a consequence the results of 
treatment will be less certain. The method which as been em- 
ployed to solve this question, is one to which no exception can 
be taken, though it is quite possible that those will not agree to 
all the conclusions. In order to take a fixed point from which 
to start measurements, a base line which could be fixed by some 
bony prominence or prominences required to be taken, and this 
was insured by drawing a line from the level of one anterior su- 
perior spine of the ilium to the other. By this means it was 
possible to ascertain with ease whether the mesentery lay in its 
normal situation or not. 

A true elongation of the mesentery is rarely found, and when 
it exists, appears only to be the result of long tension on a hernia 
which had existed for some considerable time. 



BACTERICIDES. 



923 



A further and more important fact has been pointed out, 
namely, that it is perfectly possible to ascertain during life, from 
the shape of the abdomen, whether prolapse of the mesentery 
and the rest of the viscera has taken place or not. This is, how- 
ever, equally clear from the resulty of these measurements, in 
which, as we have just seen, only eleven per cent, of the whole 
hundred individuals had their intestines so fixed up that hernia 
could not possibly occur, viz. : that the abdominal walls must be 
of considerable importance in the prevention of hernise ; in other 
words, hernia is the result of two conditions — (a) weakness of 
the abdominal walls ; (d) prolapse of the mesentery. To effect a 
radical cure both of these conditions must be reckoned with, but 
it is probably only in the severer cases that any operation for fix- 
ing up the prolapse of the mesentery should even be entertained. 
In all the slighter cases a complete closure of the abdominal wall 
is all that is required, but there are many points that go to make 
up this complete closure. In the first place, the operation must 
be conducted with aseptic precautions, otherwise, not only will 
the life of the patient be endangered, but the result of the opera- 
tion will not prove to have been so satisfactory as it ought, for 
the cicatrix which is formed will have a greater tendency to 
yield than if union by first intention had taken place. In the 
next place, the sac itself must be completely and absolutely re- 
moved, the canal which the hernia has made for itself must be, 
as far as practicable, obliterated ; if these two conditions are in- 
sured, then, and then only, can the operation be rightly described 
as radical. 

Such in the main are the points brought forward on this sub- 
ject, and the conclusions which are derived from them. For 
our own part, it seems to us that there is one source of fallacy in 
the measurements which have been taken. The majority of them 
have been drawn from bodies in themselves pathological, that is 
to say, from those who have died from disease rather than from 
accident ; and it is probably questionable whether a similar pro- 
portion of disease would be found in those who may be described 
as healthy individuals. Not that we wish by any means to imply 
that great credit is not due to Mr. Lock wood for drawing atten- 
tion to prolapse of the mesentery as the cause of hernia, but we 
think it possible that he has over-estimated the frequency with 
which it occurs. We are none the less sure that those who care 
to peruse the pages of his lectures, will derive much instruc- 
tion from the manner in which the investigation has been carried 
out, as well as from the results arrived at. 

I. Reducible Hernia. — One that can, by well adapted pressure 
or manipulation, be returned into its natural cavity, forming a 



924 



DISEASE GERMS. 



swelling that dilates on coughing, diminishes or disappears when 
the patient lies down. 

In the treatment of this rupture, the hernial mass should be 
returned to its natural cavity, smeared over with the Mexican 
liniment,* kept in its p(3sition by a pad or truss, or other appa- 
ratus ; and if the liniment is applied daily, compression moder- 
ately firm, it will contract the canal, excite adhesfve inflammation 
and a cure. 

2. Irreducible Hernia. — A hernia is said to be irreducible when 
the protruded viscera cannot be returned into the abdomen. 

Causes. — Adhesion of the sac to the bowel, by a deposit of 
lymph bands ; enlargement of mesentery, or omentum, or other 
organic changes. 

Symptoms. — Besides the ordinary symptoms, there is likely to 
be a dragging pain in the back and abdomen ; occasional at- 
tacks of vomiting, or obstinate constipation, and a feeling of ex- 
haustion. 

Treatment. — This may be either palliative or radical. The 
palliative treatment consists in the application of a hollow bag 
truss, or else a truss with a hollow pad, that shall firmly em- 
brace the hernia, and prevent all further protrusion. Violent ex- 
ercise, exertion, excess, or constipation, should be guarded 
against. The radical operation consists in cutting down upon 
the parts, breaking up adhesion, returning the bowel or omen- 
tum — an operation that is not justifiable unless strangulation 
has taken place. 

J. Strangulated Hernia.- — A hernia may be said to be strangu- 
lated when it is constricted in any way, so that the contents of 
the protruded bowel cannot be propelled onwards, and the return 
of the venous blood is impeded. 

Causes. — A sudden protrusion of bowel or omentum through 
a narrow aperture, as a result of some violent exertion, or disten- 
sion of the protruded intestine by flatus or faeces, or a tumefac- 
tion of the omentum, a swelling or contraction of the muscular 
fibres at neck. 



* This great remedy is in the form of a healing and strengthening ointment, whicli 
invigorates the weakened, flabby membranes and muscles stimulating natural secre- 
tions and causing healthy granulation, thereby contracting the hernial aperture and 
making the abdominal wall normally sound and solid. It is generally used in connec- 
tion with a truss, because most persons can more conveniently wear some kind of 
truss or supporter for a few weeks while a cure is being effected, than they can stay 
abed or hold the bowel in place with the hand during that time. Evils incidental to 
the wearing of a truss, such as induration or callousness, atrophy, chafing, etc , are 
counteracted by the remedy ; the pressure can be relaxed gradually as the cure pro- 
gresses, and eventually the use of a truss may be entirely discontinued. Children in 
arms are cured by the same remedy. 



BACTERICIDES. ^2$ 

Symptoms. — In addition to the ordinary symptoms of hernia 
we have, when it is strangulated, those of obstruction of the 
bowels and peritonitis. There is flatulence, colicky pains, a sense 
of tightness around the abdomen, a desire to defecate, and ina- 
bility to do so. Vomiting, first the contents of stomach, then 
mucous bile; and lastly, matter from small intestine. The 
hernial tumor cannot be returned ; it is uneasy or painful, tense 
and incompressible. There is a perfect obstruction ; the swelling 
does not now dilate. The neck of the sac becomes tender, and 
this tenderness diffuses itself over the entire abdomen, which 
becomes painful and tympanitic. Peritonitis sets in ; face white, 
pinched, anxious ; vomiting constant ; pulse small, hard, wiry ; 
patient restless and despondent, and after a variable time parts 
begin to mortify. There may be much variety in the symptoms, 
death taking place early or remote. 

Treatment. — The indications here are to return the intestine, 
and if this cannot be done to cut down upon the neck and divide 
it, and return the bowel and omentum. If inflammatory symp- 
toms have not appeared, the best plan is to relax the miiscular 
system by one or more of the following methods, and then per- 
form the taxis : 

To cause profound relaxation, you must be guided by what 
you can procure the quickest, and if it fails, then the others, one 
or more. We shall enumerate the best first, and so on ; they are 
simply auxiliary measures to aid the taxis. Let patient inhale a 
little chloroform, and when he is just going under, insert a 
hypoderniij injection of one-quarter grain of morphia into the 
cellular tissue. This causes very profound muscular relaxation, 
and lasts long. Or let the patient inhale alcohol, chloroform 
and ether, till anaesthesia is procured ; enemata of an infusion of 
lobelia or tobacco, with warm bath, with a little tobacco or 
lobelia, or an infusion or fluid extract of jaborina could be 
given. 

If there is any time to spare, large doses of opium and hyos- 
cyamus ; the latter drug has a remarkable influence over all the 
hollow viscera; and its liberal use in hernia often spares the 
surgeon's knife, and saves many lives. As a local applica- 
tion, heat is superior to cold ; hot poultices of belladonna, lobelia 
and linseed. Once thoroughly relaxed, patient free from all 
clothes, an intelligent assistant should be selected, and instructed 
to knead, or press the bowels gently well up to the diaphragm ; 
head and shoulders well elevated, and knees drawn up. Blad- 
der and rectum carefully emptied before relaxant is ad- 
ministered. 

The taxis is a term employed to signify the manipulation of 



926 



DISEASE GERMS. 



the hernial tumor by the hands of the surgeon. In performing 
the taxis the tumor should be drawn gently forward, between 
both hands (assistant kneading actively to diaphragm), in the 
aeris of the neck. Hold in this position a few minutes ; if patient 
is awake cause him to make a deep expiration, and hold his 
breath. Then press tumor between both hands, so as to squeeze 
out its contents, or gas and venous blood ; then manipulate with 
the fingers at the neck ; by pushing a little you will likely have 
the satisfaction of feeling it leave your hands and hearing a gurg- 
ling noise accompanying the return of the bowel into its natural 
cavity. To effect this, the position of the patient should be such 
as will relax every muscle ; the kneading must be vigorously car- 
ried out, and the tumor in all cases drawn gently forward. In all 
cases the taxis must be performed with gentleness ; no force or 
violence to bruise or injure. If not successful by the above plan, 
which is rarely the case, after a trial of fifteen or twenty minutes, 
it is often better to rest a little, and try again. Try every means, 
even to introducing copious injections up the rectum, or hanging 
up the patient by the heels. Good common sense, kindness and 
patience are great elements of success. When once returned, if 
insisted on by the patient, and his friends concurring, a radical 
cure should be effected by some of the following methods, each 
one having the same object in view, to wit : to excite a slight 
irritation, so as to cause inflammation, with effusion of lymph, 
which will block up the orifice and render the descent of the 
bowel again impossible. For that purpose the following are suc- 
cessfully used : 

If the parts are hairy, shave off, and apply the irritating plaster 
for about six weeks, and over it the truss, or pad, or compress. 
This plaster is to be spread fresh ev^ery morning, and applied, in 
size from three to four inches square. A good method, some- 
what painful and tedious, but safe. Another plan is to introduce 
a small knife and scarify around the ring. Still another method, 
and a favorite one with many, is to inject right against, or in the 
inner surface of the ring, some irritant, such as fluid extract of 
oak bark, tincture of cantharides, tincture of iodine ; this is done 
with the ordinary hypodermic syringe, or one specially prepared 
for the purpose. If those are used, case must be watched for 
peritonitis. Still another plan is the introduction of sutures of 
saddlers' silk, iron or silver wire, and other methods of a similar 
kind. 

If strangulated hernia cannot be reduced, an operation for its 
relief must not be too long delayed ; and when that is done, if 
successful, it invariably effects a radical cure. Although we say 
do not delay the operation, still, in aged people, witli large 



BACTERICIDES. ^2/ 

hernias, wait as long as possible and use remedies, and never 
forget the magnificent action of hyoscyamus and opium on the 
hollow viscera. 

The operation is a simple one, free from danger, if the sur- 
geon knows the parts and does not cut an artery or wound the 
bowel — dividing layer after layer over the tumor near its neck, 
down to the bowel, and then dividing the neck and returning the 
bowel or omentum, or both, into the abdomen, stitching up 
wound in the usual manner and applying a firm compress. In 
ail cases avoid purgatives in the management of cases, as irri- 
tating and injurious. 



Inguinal hernia is that which protrudes through 

Rupture, one or both abdominal rings. There are four 

Inguinal, different varieties — oblique, direct, congenital and 
encysted. 

The oblique is the most common. It takes precisely the same 
course as the testicle takes in its passage from the abdomen 
into the scrotum. It begins as a fulness, or swelling, at the 
internal ring, a little above Poupart's ligament, and passes into 
the inguinal canal, and, if the protrusion increases, it descends 
into the scrotum of the male, or labia of the female. The cov- 
erings of this hernia are skin, a layer of condensed cellular 
tissue, a tendinous layer, cremaster muscle, a cellular layer and 
the sac. The internal epigastric artery is always internal to the 
neck of the sac, the spermatic cord behind the sac, but in old 
cases parts are somewhat changed. 

The direct inguinal bursts through the conjoined tendon of 
the internal oblique and transversalis muscles, just behind the 
external ring. Its coverings are the same as the oblique. The 
epigastric artery runs external to the neck of the sac. 

The congenital hernia is a variety of the oblique, and is so 
called because the state of the parts admit of it at birth. 

The encysted is a variety of the congenital. The protruding 
bowel pushes before it a sac of peritonaeum, either into or behind 
the tunica vaginalis, and this tunic and sac adhere together, so 
that this hernia has two sacs. 

Diagnosis. — This hernia is to be distinguished by dropsy of 
the scrotum, as follows : Hydrocele begins at the bottom of 
the scrotum ; there is fluctuation ; if the serum is not turbid it 
can be seen through ; does not dilate on coughing ; whereas, 
hernia begins at top, is not transparent, does not fluctuate, 
dilates on cous^hing. In varicocele, where there is a varicose 
condition of the veins of the cord, it resembles hernia, as it 



028 • DISEASE GERMS. 

dilates on coughing, increases in erect posture, may disappear at 
night, but it feels like a bag of worms. Undescended testicles 
are very easily recognized. 

TreaUnejit. — If reducible it should be returned and kept in its 
place with a truss or other mechanical support ; if irreducible, a 
hollow bag or truss should be worn, to prevent further protru- 
sion ; if strangulated, relaxants and the taxis should be resorted 
to, and if it fails, and trying every expedient, an operation should 
be performed. 

In performing the taxis Yor this hernia, patient should be 
placed on back, head and shoulders well elevated, knees drawn 
up and thighs close together, the hernia drawn gently down ; 
then the assistant actively kneading the bowels well up to 
diaphragm and the pressure by the operator made upward and 
outward. 



Femoral hernia is that which escapes behind 
Rupture, Poupart's ligament, passes through the crural ring 
Femoral, and descends on the thigh. This hernia is cov- 
ered by skin, fascia of the thigh loaded with fat, a 
layer of cellular tissue and sac. From its surroundings it never 
can become of great size. It is almost peculiar to females, on 
account of the extreme breadth of their pelvis. It is easily 
recognized by its location, increasing in size when she stands up, 
dilating in coughing; it is usually small. Psca^ abscess also 
dilates when she coughs, diminishes or disappears when the pa- 
tient lies down ; but hectic and disease of the spine are always 
present in that form of abscess. Varix of the femoral vein bears 
some likeness to it, as it dilates when the patient coughs, dimin- 
ishes or disappears when she lies down ; but a careful observa- 
tion will reveal the difference. It would certainly be a person 
grossly ignorant that would mistake it for bubo. 

Treatment. — The reducible should be returned and kept in 
position by a truss. The irreducible supported by a hollow 
truss. 

If strangulated, the taxis must be tried, and in performing 
this the patient should be placed in the usual position on back, 
head and shoulders elevated, knees drawn up, with the thigh of 
the affected side rolled inward and crossed over toward the other 
side. The tumor should be drawn downward, the kneading 
vigorously carried out, and the tumor pressed with the points of 
the fingers backward and upward. If the taxis and chloroform 
do not succeed, the operation should be resorted to. 



BACTERICIDES. 929 

Rupture at the navel is most common in chil- 
Rupture, dren at birth, and in women who have been fre- 

Umbilical. quently pregnant; although in the so-called 
hernia of adults, the hernial aperture is really 
not at the umbilicus, but a little on one side of it. The cover- 
ings of this hernia are skin, superficial fascia and sac. They are 
always thin and rarely become adherent. 

Treatment. — If reducible, there should be strapped over the 
ring or neck a convex piece of some hard substance, its convex 
side toward the abdomen, strapped to the abdominal walls by 
adhesive plaster, and over all a bandage or belt; The irreducible 
should be supported by a hollow bag or truss. If strangulated, 
the taxis should be resorted to*; patient in usual position ; all 
failing, an operation should be resorted to. 

Ventral Hernia. — When the protrusion occurs at any other 
part of the abdominal walls, save at the ordinary places, usually 
a consequence of wounds or bruises. 

Perineal Hernia. — Descends between the bladder and rectum, 
forcing its way through the pelvic fascia and levata ani. 

Vaginal Hernia. — In which the tumor projects into and blocks 
up the vagina, displaces the uterus, obstructs the rectum. Very 
common cause, usually, tight lacing or wearing belts, in order to 
have a small abdomen. 

Labial or Pudendal Hernia. — Descends between the vagina 
and ramus of the ischion, and forms a tumor in one of the labia. 
It is to be distinguished from inguinal hernia by the absence of 
swelling at the abdominal rings. These hernias are to be re- 
placed by pressure with the fingers, and kept in place by pads 
and trusses. 

Obturator, Ischiatic, and Diaphragmatic Hernia, so-called from 
their location, are very rare. 



This is very prone to take place during 
Rupture labor, provided there be some obstruction, 

of the Uterus, and ergot administered too freely during the 
first stage. The principle causes of obstruc- 
tion are tumors, hardened faeces, exostosis of the promontory 
of the sacrum, deformed pelvis, an abnormal presentation, turn- 
ing during a pain. 

Some pathologists are inclined to the theory of degeneration 
of some of the muscular fibres oi the uterus, or a thinning of its 
walls. 

It is easily recognized by the sudden cessation of pain, faint- 
ing, pallor, death-like coldness, and on placing the hand over the 

59 



930 



DISEASE GERMS. 



abdomen, the child can be detected out of the uterus, in the cavity 
of the uterus. 

If such an event should take place, the abdomen should be slit 
up, its cavity exposed, the child, after-birth, blood, clots and 
water carefully sponged out, the cavity of the uterus cleansed, 
the whole stitched up and bandaged. An effort should be made 
to rouse up the patient by the administering diffusible stimulants ; 
and if she rallies, treat like vietro-peritonitis. 



Literally speaking, the best means of pre- 
Sanitary Science, serving health and avoidance of all condi- 
tions which would be likely to impair vital 
force. A science of immense utility to man, or it teaches how to 
resist the action of disease germs. 

What are disease germs ? What are bacteria ? 

Vegetable and animal organisms, each consisting of a single 
cell, microscopic in size, usually colorless, capable of rapid, enor- 
mous growth by fission, or by spores produced in their interior. 

Under a magnifying power of from five hundred to two thousand 
diameters, they are seen in three forms, globular (micrococci), 
cylindrical (bacillus), and spiral (spirillum). 

These germs are found whenever organic matter exists in the 
process of decay ; and decay begins where life ends ; they are to 
be found in the earth, air, water, food ; the spores of some being 
indestructible unless under a great heat. Quite a large number 
of microbes have been isolated and separated by culture 
and inoculation experiments and proven to cause each a particu- 
lar disease and no other, and are termed pathogenic. 

What diseases are they ? • 

Amongst the diseases thus proven, beyond a doubt, to depend 
upon the presence of special bacteria are : Anthrax or splenic 
fever, tuberculosis or consumption, relapsing fever and glanders ; 
cholera, typhoid fever, small-pox, vaccine disease, measles, diph- 
theria, leprosy, septicaemia and some others. 

The question now arises — If the bacteria of a given disease, 
tuberculosis, for instance, are almost universally present, n'hy do 
some contract the disease whilst others escape ? It is evident 
something more than the mere presence of the bacteria is involved 
in the production of infectious disease. 

Like many other things of which we know little or nothing, 
however, it has several names. We call it vitality, idiosyncrasy, 
etc. ; in effect it is the resisting power of living organic matter to 
the agents whose duty it is to reduce it partially or wholly to inor- 
ganic matter. 



BACTERICIDES. g^I 

We may consider then, as the two factors in the problem of in- 
fectious disease : (i) diminished resisting power ; (2) the bacteria. 

In other words, the soil and the seed ; either being inoperative 
without the other. To put the problem another way : It is as 
manifest that pathogenic bacteria, coming in accidental con- 
tact with healthy tissues, will fail to multiply in sufficient numbers 
to cause disease, as that com sprinkled upon a bouldered street 
will fail to produce a corn crop. 

But, we hear it argued, ^* Here is a man in perfect healthy stricken 
down with cholera, or small-pox, or some other infectious 
disease '' — how do we account for this ? Inquire into that man's 
history for a week, a month or perhaps for years — Has he in- 
herited a feeble organization ? Has he been underfed or over- 
worked ? Is he dissipated in his habits ? Have business or domestic 
affairs weighed too heavily on his mind? Does he sleep in a well- 
ventilated room ? — in short, Are his tissues, to use a commercial 
phrase, " beloiv par " from any cause whatever ? 

The cases of infections disease in ivhich some preceding anti- 
Jiygienic influence cannot be traced are certainly rare if not unknown. 
What then, is the most practical lesson we may learn from our 
present knowledge of the causes of infectious disease ? Simply 
this : The preservation of the normal integrity of the tissues is 
equivalent to depriving the bacteria of a soil in which they can mid- 
tiply to a dangerous extent. How may this be effected ? In a 
word, by hygiene, possibly by vaccination ; the future possibilities 
of the more extended application of this principle are great. 

Of all the routes by which the cause of infectious disease 
reaches any community, none perhaps are more important and 
less regarded than the food and water supply. 

The water supply then may be regarded as one frequent source 
of infection. 

A second source is the milk ; this may be a source of infection 
by reason of the water with which it is adulterated — or in v/hich 
the vessels containing it are washed ; or it may be a product of 
tuberculous cows. 

As we cannot well watch all sources of infection by fluids, 
what may we do to protect ourselves against them ? 

The most effective weapons then, with which we may resist the 
onset of infectious diseases are: (i) Hygiene, which renders 
unproductive the soil. (2) Heat, which destroys the seed. 

The idea that infectious disease will ever cease to exist is, of 
course, Utopian. It is a well-known fact, however, that these 
diseases are, in themselves, self-limited — that is to say, the bac- 
teria cease to multiply after a time, and favorable cases recover 
spontaneously within a definite period. 



Q^2 DISEASE GERMS. 

We may now ask the question, How do pathogenic bacteria 
produce disease ? Some affirm that by the rapid increase in 
numbers simply, the normal operations of the economy are so 
interfered with that disease is the result. In support of this, it is 
well known that blood-vessels are sometimes actually choked by 
the myriads of these organizations, and further, that the vast 
amount of oxygen required for their development must interfere 
with the physiological requirements ol the body. 

Others believe that the blood-globules, particularly the white 
cells, are greatly injured or entirely destroyed by the entrance 
into them, in too large numbers, of these organizations, as has 
been shown ; this power of the white cells, ordinarily so favora- 
ble, being now overwhelmed and themselves destroyed. No 
doubt in some cases this is a powerful factor. 

Still other theorizers, and particularly those who are opposed 
to this germ theory of disease, maintain that septic products are 
formed in the body by ordinary chemical or vital action — these 
poisonous ptomaines, as they are called, sometimes forming in 
quantity sufficient to react upon the body and produce disease. 

It is improper here to follow the successive steps taken in the 
evolution of this theory, largely brought out by the researches 
of M. Gauthier. It is at the present time well known that, as 
shown by this observer, such toxic products are formed and found 
in the animal body, and that while some of them are formed by 
the oxidation of tissues within the body, other like products, 
even more toxic, are the result of the agency of bacteria. Koch 
is of the opinion that the comma-bacillus secretes or excretes a 
ptomaine whose reaction upon the tissues may be the efficient 
cause, or one of the efficient causes, of cholera asiatica. 

In carefully studying these various theories in answer to the 
question. How do bacteria produce disease ? the opinion seems 
justifiable that all these agencies are combined in inducing the 
general result, namely, what we call disease ; that the bulk of 
numbers, the urgent demand for, and great consumption of, 
oygen not supplied from the external air, the injury or destruc- 
tion of the blood-globules, and the poisonous action of the bac- 
teria secretions called ptomaines, all together act to produce the 
pathological result. We may take it for granted, then, at least, 
for the present, that disease results from (i) great numbers of 
bacteria; (2) great waste of oxygen ; (3) injury of the blood- 
cells ; (4) the toxic action of one or more of the ptomaines. 

We now come to the more practical part of our subject, namely, 
the management of gynecological cases of disease induced by 
micro-organisms. The indications seem clear (i) to prevent the 
entrance of pathogenic microbes into the body ; (2) to aid as far 



BACTERICIDES. g^j 

as possible all the efforts of such infected body to rid itself of 
them, and of their effects. Nearly the whole subject of treatment 
is therefore included in what is known as antisepsis. 

Water in my hands serves as the safest and most efficient anti- 
septic. Water is the great cleanser, and may be used freely and 
everywhere. 

Fortunately for our race and for the advancement of true 
science, hygiene is asserting her lofty position in the conservation 
of human life. The power acknowledged for antiseptics may 
wane, hygienics never. Gynecologists, as well as others, have 
learned this well. Cleanliness cures septic diseases by forbidding 
even the presence of any and all noxious agents. Keep ourselves 
and our patient clean, and fear not — waiting, however, for the 
ideal germicide and antiseptic that may be discovered to serve as 
the handmaid of cleanliness. 

Sanitary science teaches us that the air of all our large cities is 
heavily loaded with micro-organisms of a most deadly character ; 
that these germs are most numerous close by and in sewers ; 
that the class of micro-organisms which preponderate are chiefly 
micrococci ; the saccharo-mycetes or yeasts, and the moulds. The 
schizomycetes include : bacilli (yo'l shaped), e.g., B. anthracis, B. 
tuberculosis ; micrococci (round), e.g., M. scarlatinae, M. vacciniae ; 
spirilla, or spirochaetse (twisted in spiral form), e.g,^ S. oberme- 
iera, the microbe of relapsing fever. 

The examination of the air of sewers is carried out as follows : 
five gallons of sewer air, from the centre of culvert is aspirated 
into a sterilized rubber bag. This air is pressed into liquefied, steri- 
lized, nutrient gelatine, and then poured out into a glass plate, 
covered with a bell-jar, and kept at a constant temperature for a few 
days when the germs have developed into colonies, which may 
be counted and their characteristics noted. If liquefaction 
of the gelatine be produced round a colony, it does not neces- 
sarily show that the germs there are pathogenic. Under the 
microscope the colonies may be separated into the different va- 
rieties of bacteria, moulds, or fungi. To distinguish which are 
pathogenic, pure cultivations must be made of each colony sepa- 
rately, and animals inoculated therefrom. 

Every disease-germ within the entire range of bacteriology is 
to be found in the common sewer air. Microbes in the atmos- 
phere ; ptomaines, possessing the most extremely poisonous 
properties in the liquid contents of the sewer. 

Five gallons of air were aspirated from a sewer in Fourth street, 
New York, at lowest level ; after two days' cultivation, numerous 
colonies, moulds. The colonies appear as minute, yellow, liquid 



934 



DISEASE GERMS. 



points, on the third day the plate liquefied, and the microbes 
proved to be the sarcina aurantiaca ; the mould was the penicil- 
lium glaucum. 





Sarcina Aurantiaca — Sewer air after three 
days' oiUivation. It appeared as yellow 
circular liquid colonies, cocci in masses. 



Saccharomyces. 



Five glallons of air were aspirated from a sewer on Fourth 
street, near Broadway, New York, one week later, at lowest level^ 
with most offensive smell ; numerous colonies and moulds, all 
white, raised, non-liquid and circular ; after five days' cultivation,, 
non-liquid colony appeared. 

Five gallons of air aspirated from sewer, later on near Broad- 
way, New York. Rain during the previous twenty-four hours ; 
after three days' cultivation, numerous colonies formed, together 




Aspergillus albus. — Sewer air. 



A species of Bacillus subtilis frcm sewer air. 



with moulds. A large number of the colonies were of a grayish- 
white, sharply-defined circles, with granular centre, and a point in 
the centre, liquefying the jelly (bacterium termo) ; some of the 
colonies were gray in color, irregularly circular, and liquefying 



BACTERICIDES. 



935 



the jelly. Moulds were nearly all aspergillus albus. One large 
one was mucor mucedo. A large number of micrococci. 

Five gallons of air aspirated from sewer, later on, on Lafayette 
Place, New York, colonies and moulds ; the colonies appeared 
as cream-white, non-Uquid, and yellowish-white 
liquid. The cream-white were bacilli ; the yellow- 
white are micrococci. The entire populace of the 
street, whose closets emptied in the sewer at this 
time, were afflicted with hay fever. 

Five gallons of air were aspirated later on from 
a sewer on Third street, New York ; after five 
days' cultivation, yield colonies and moulds. One 
whitish-yellow colony, liquid in centre, consisting 
of diplococci and short rods. One large white 
colony which is bacillus loevis. Most of the moulds 
aspergillus albus, the others penicillium glaucus. 



/:5 



Spirillum identical 
with that found 
on vegetable in- 
fusions, found in 
the same air, in 
dense swarms. 



were 




Bac llus Lcevis. — Source,sewer air magnified 
looo diameters. 



A form of yeast plant magnified 750, found in 
sewer air. 



tv*» 



Five gallons of air were aspirated from a sewer on Lafayette 
Place ; from six to nine days' cultivation, colonies of micro- 
organisms and moulds formed, with spore- 
like bodies. Very small cocci. After five 
days' cultivation, they appear as small circular, 
non-liquid colonies. 

The moulds were penicillium glaucum ; mu- 
cor mucedo, and aspergillus glaucus. 

Five gallons of air were aspirated later on 
from a sewer on Fourth street near Broad- 
way, New York ; a most offensive smell issued 
from the opening. After six days' cultivation, 
colonies and moulds formed, saccharomyces, yellowish-white, 
non-liquid, raised colonies ; cocci. The moulds were penicil- 




A smaller form of the yeast 
plant in the same sewer. 



936 



DISEASE GERMS. 



Hum glaucum. A large number of micrococci, mixed with the 
aspergillus glaucus. 






\ 








Saccharomyces liquefaciens, magnified looc, 
from sewer air. 



,fi),r^-:"i 




Air aspirated from a sewer connected with a 
brewery. Deposit under ttie microscope 
filaments of various microbes (bacillus), 
which produce disease; young microbes 
in an ever active state ; others incrusted 
in acids. 



-cf*^^ 







Air aspirated from sewer in 
Greenwich avenue. New York, 
near a brewery. After six 
days' cultivation it shows lactic 
ferments of ale, putrid wort, 
chaplets of mycoderma aceti. 



^* 



Putrid Blood Serum. — Ttie 
evolution of numerous ba- 
cilli, all factors of disease 
from aspirated air, as well 
as the liquid contents of 
the sewer. 



Asperated air from a sewer in 
close proximity to a vinegar 
factory. Deposite seen on 
the microscope Mycoder- 
ma aceti still young, and 
older ones. 







Air aspirated near a beer 
brewery, showing microbes 
which produce disease. 





Young Bacillus Anthrax, 
muigling with the young 
broods of the malarial 
germ in a sewer. 



Bacilus of Typhoid Fever, aspirated 
<rom a sewer; cultivated, injected 
into animals, reproduced the original 
disease (pathogenic typhoid fever). 



Various other micro-organisms which the inhabitants of all 
our large cities are compelled to breathe. 



^BACTERICIDES. 



937 



Sanitary science says most emphatically, that typhoid fever is 
becoming more prevalent, being epidemic and endemic all over 
the world. 

By the light of modern investigation, and with our modern 
knowledge of the influence of bacteria in the production of vari- 
ous forms of disease, it is not at all difficult to ^ • .-• %^~ - 
understand the way in which the surface water ' '- :;^^^. .^' 
in its rise and fall may influence the spread of a *s%^,&|J^v^ 
disease of this nature. As we have seen by the ^^^0-S:^S^ 
considerations to which we have drawn atten- ^-^* " " 
tion, the excreta from typhoid patients find comma-BaciUus in 

. . • 1 • , ^ r .• 1 • sewage water. 

their w^ay mto cesspools or mto detective drains, 
and are thus dispersed into the surrounding damp soil. Both 
the rise and fall of the surface water, with the amount of air 
which it must necessarily displace from the interstices of 
the soil, must be a potent factor in the circulation of typhoid 
germs. In the one case, w^hen the water falls, air enters the soil 
to a greater depth, from which it can be sucked into the low^er 
floors of dwelling-houses, whilst the rise of the water in the soil 
displaces the air upwards, which taking with it the typhoid germ, 
distributes it over certain, localities. It seems probable that a 
wdder study of the phenomena of this nature would afford a very 
adequate explanation of how it is that at certain periods of the 
year typhoid fev^er is so much more prevalent than it is at others. 

Furthermore, the infection process requires special conditions. 
The germs will not flourish in every human being. They re- 
quire a soil suitable to their growth. And such a suitable soil, 
such specially favorable conditions are found in nearly all per- 
sons who have been exposed to insanitary influences, such as bad 
drainage, foul air, or unwholesome surroundings of 'any sort, or 
who are in poor health or have suffered from any complaint of a 
weakening character. All these things tend to depress the 
strength and lower the vitality, and thus a fertile soil for the pro- 
pagation of typhoid germs is at once produced. There is no 
doubt that the typhoid poison may enter many healthy and well- 
nourished bodies, and pass harmlessly away. But let the vitality 
be lowered by the inhalation of sewer gas or other foul air, by 
exposure to any insanitary conditions, or by any other cause, and 
then the entrance of the poison into the system is almost certain 
to involve the communication of the actual disease. 

Every fresh patient is a new source of further danger. Yet 
the peril may be reduced to a minimum by the thorough disin- 
fection of the evacuations before these are thrown away. This 
ought to be an invariable rule. Supposing, however, that some 
germs nevertheless escape, then the risk of contagion may fur- 



938 



DISEASE GERMS. 



ther be minimized by good drainage, by rigid care as to drink- 
ing-water and milk, and by the observance of sanitary rules 
generally. All water and milk as to which the slightest suspi- 
cion can exist should be boiled before being used, and a strict 
inspection of dairies is imperative. If typhoid fever is to be 
arrested or abolished in this or any other part of the world the 
greatest care must be taken to avoid all exciting, as well as pre- 
disposing causes, and to study the way in which it is introduced 
and in which it spreads in every part of a locality. 

The terms endemic and epidemic are used in connection with 
preventible diseases, the former to imply that the disease is re- 
stricted within certain areas and depends on local or localized 
causes, and has a tendency to persist in the district ; the latter to- 
describe a disease which suddenly appears and spreads widely 
and rapidly, but its prevalence is usually of limited duration. 
The two conditions, however, may pass into one another, e. g.^. 
plague, yellow fever. 

The term sporadic is applied to diseases which occur in isolated 
cases, and appear sometimes as if of spontaneous origin, as 
typhus fever. Such cases are to be explained either by the sud- 
den development of spores which have been waiting for a favor- 
able set of circumstances, or, possibly, it may be that those con- 
ditions of overcrowding and filth may so aggravate the virulence 
of some organism (existing usually in the body without danger),, 
that absorption of its products occurs and produces the symp- 
toms known as typhus fever. 

Action of the microbes in the body. — Microbes affect the body in- 
one or more of three ways: (i) By rapid development and 
aggregation in the blood vessels, producing embolism, as in 
anthrax. (2) By producing a ferment which acts on the tissues,, 
as, perhaps, in diphtheria. (3) By producing one or more defi- 
nite chemical poisons (toxines), as in tetanus. 

There is, for a longer or shorter time, a period of quiescence, 
latency, or incubation ; the period of iiivasion which follows is 
characterized by increased temperature, rigors, etc. When the 
distinctive features of the disease appear the stage of advance or 
eruption has begun ; these special features appear to be due to 
the fact that, after undergoing development in the invasion stage, 
the microbes and their products tend to accumulate in particular 
organs, as in the throat, bowels, nervous system, skin, etc. From 
these parts they are discharged from the body ready to propagate 
the disease, or they die out from causes unknown, produ'-ing the 
stage called decline, defervescence, or resolution, suddenly (crisis), 
or slowly (lysis). Various theories are suggested to explain 
why the microbes tend so often to die out in each case, as that 



BACTERICIDES. 



939 



the high temperature of the body kills them, that the multiplica- 
tion of the poison interferes with their growth. Convalescence 
is the period in which the body gets rid of the effete products, 
and restoration of the various functions is re established. 
SequelcBj however, sometimes occur after the disease appears ta 
have been cured ; these are probably due to the action on the 
tissues of poisonous products which have not been eliminated or 
destroyed — perhaps on account of their late production. Deaths 
however, may occur before a disease has run its course. 

The great aim of sanitary science is the prevention of disease. 
The infecting nature of the tubercular bacilli is causing consider- 
able alarm ; strenuous efforts are being put forth by the various 
health boards to disinfect all suspected localities, and radical pre- 
cautions so as to prevent its dissemination. 

Pulmonary tuberculosis (consumption) is directly communi- 
cated from one person to another. The germ of the disease ex- 
ists in the expectoration of persons afflicted with it. The follow- 
ing explains the means by which the disease may be transmitted : 
Tuberculosis is commonly produced in the lungs (which are the 
organs most frequently affected) by breathing air in which living 
germs are suspended as dust. The material which is coughed 
up, sometimes in large quantities, by persons suffering from con- 
sumption, contains these germs often in enormous numbers. 
This material when expectorated frequently lodges in places 
where it dries, as on the street, floors, carpets, handkerchiefs, 
etc. After drying in one way or another, it is very apt to become 
pulverized and float in the air as dust. By observing the follow- 
ing rules the danger of catching the disease will be reduced to a. 




V c ^X,'*-' ."; -^9 Pneumonia in 

' ■' ^•?<^N^o ' c r o u p o n s , 

;:.,*o'*i\v" ' magnified icco 

'■'' ^'--'"^ diam., found 

Tubercle Bacillus. Sputum of a tubercular from a and isolated 

In the sputum patient in a Pullman sleeper from the spu- 
found on the floor suffering from lung-syphilis. tum found in a 
of a Pullman sleep- Pullman sleep- 
ing-car. ing-car. 

minimum: i. Do not permit persons suspected to have con- 
sumption to spit on the floor, or on cloths, unless the latter be im- 
mediately burned. The spittle of persons suspected to have con- 



^40 'DISEASE GERMS. 

sumption should be caught in earthen or glass dishes, containing 
a solution of the sulphate of iron. 2. Do not sleep in a room 
occupied by a person suspected of having consumption. The 
living rooms of a consumptive patient should have as little furni- 
ture as practicable. Hangings should be especially avoided. 
The use of carpets, rugs, etc., ought always to be avoided. 3. 
Do not fail to wash thoroughly the eating utensils of a person 
suspected of having consumption as soon after eating as possible, 
using boiling water for the purpose. 4. Do not mingle the un- 
washed clothing of consumptive patients with similar clothing of 
other persons. 5. Do not fail to catch the bowel-discharges of 
consumptive patients, with diarrhea, in a vessel containing cor- 
rosive sublimate, i part; water, 1000. 6. Do not fail to consult 
the family physician regarding the social relations of persons 
auffering from suspected consumption. 7. Do not permit mothers 
suspected of having consumption to nurse their offspring. 8. 
Household pets (animals or birds) are quite susceptible to tuber- 
culosis ; therefore, do not expose them to persons afflicted with 
consumption ; also do not keep, but destroy at once, all house- 
hold pets suspected of having consum.ption, otherwise, they may 
give it to human beings. 9. Do not fail to thoroughly cleanse 
the floors, walls and ceilings ot the living and sleeping rooms of 
persons suffering from consumption at least once in two weeks. 

Sanitary science has demonstrated beyond all dispute that 
pathogenic micro-organisms do exist in distinct and definite 
entity, that they show themselves as distinct, specific germs, 
begetting special disease. The micrococci of measles is the same 
to-day as it existed thousands of years ago ; the same period of 
incubation, the same prodromata, the same eruption, the same 
complications and terminations. 

That the essential nature of a pathogenic microbe is not 
changed by an alteration in the soil or other surroundings. 
The microbe may be shrivelled, dwarfed, or reproduction 
checked by lack of oxygen, unsuitable nutrition, improper tem- 
perature, but never changed in nature. 

Up to the present time it has been found impossible to deprive 
pathogenic microbes of^tHeir pathogenic properties. 

We lack as yet a sufficient or satisfactory explanation of the 
immunity conferred, though three plausible hypotheses have 
been proposed. The first is the theory of exhaustion, which 
assumes that the germs of the disease exhaust the elements in 
the blood necessary to their nutrition. Something analogous to 
this is seen in vegetation of higher structure, which cannot be 
made to grow indefinitely in the same soil. The second is the 



BACTERICIDES. ^41 

antidote theory, or the theory of antagonism, which supposes 
that certain products evolved frorri the soil in the multiplication 
or growth of germs react upon them fatally. The analogy here 
is found in the process of fermentation, whereby the torulae cease 
to produce themselves, become quiescent and sink to the bottom 
of the vessel as soon as the proportion of alcohol reaches 
twenty per-cent. There is reason to think that the fever evoked 
by micro-organisms is in some cases fatal to their growth and 
life. The third is the theory of accommodation, which main- 
tains that the tissues in their first struggle with the micro-organ- 
isms acquire a higher degree of energy or vitality, whereby they 
are enabled to endure or resist future attacks. Perhaps a simile 
may be found for this hypothesis in the process known as accli- 
matization. 

The question now arises. How do Pathogenic Micro-organisms 
produce the Phenomena of Disease? From the rapidity of their 
multiplications it might be inferred that the symptoms and 
lesions of the infectious maladies were caused by the mere pres- 
ence of these organisms as foreign bodies. But it has been ob- 
served that the bacilli of milzbrand alone multiply in the body 
in such number as to produce extensive occlusions of vessels. 
Further, it has been shown that no mere mechanical presence, no 
mere foreign bodies, aniline particles, or granules of cinnabar, 
ever induce the signs of fever or toxicemia. The micro-organ- 
isms of disease live in the body, and must therefore be nourished 
at its expense, whereby they withdraw from the blood or tissues 
elements essential for their nutrition. Pathogenic micro-organ- 
isms require oxygen. In processes of fermentation, outside air 
is excluded, that the germs of fermentation may be compelled to 
withdraw oxygen from its soil. Pathogenic micro-organisms 
multiplying in great abundance seize upon the oxygen of the 
blood with such avidity as to develop in fulminant forms the 
symptoms simulated by prussic acid poisoning. But the other 
symptoms mentioned do not correspond either to deficient oxy- 
genation or carbonic acid poisoning. 

These symptoms indicate toxica^mia, and since the injections 
of fluids from which bacteria have been separated by porcelain 
filters remain innocuous, it follows that the toxic agent inheres 
with the bacteria. Then, inasmuch as blood-corpuscles show 
their reaction against bacteria on simple contact, it follows that 
tbe poison must lie upon or issue from their surface. 

The only hitherto known poisons which may in such minute 
quantities induce such grave toxic signs are the poisons result- 
ing from the action of the bacteria of decomposition upon 
organic matter. As these intensely virulent poisons were first 



942 



DISEASE GERMS. 



observed only in dead organic matter, they were called ptomaines. 
These matters, the ptomaines, though so newly known, Have re- 
ceived so much attention in the past year as to form a subject in 
themselves. It may be said here that some cadavers develop no 
ptomaines, that ptomaines are developed as putrefaction advances 
in the course of weeks, next that they are also found sometimes 
in animal products, as in cheese, urine, faeces, etc., and lastly, 
that many ptomaines are perfectly innocent. Then it might be 
added that many phenomena attributed to their action have been 
found due to simpler causes. 

Sanitary science teaches us that sewage should not run into our 
lakes and rivers, as the microbial product is a factor of disease 
and tends to poison all the fish in those waters. Take for 
example the shell-fish and others in all our bays and rivers where 
sewage enters, there is to be observed with an ordinary glass a 
red-dotted discoloration, in which there is a bacillus of a deadly 



1^ 




;\ 



Bacilli found in fish and oysters which are cul- 
tivated in rivers, bays, creeks, into which 
sewage enters, found at thirty miles from the 
opening. 




Vibrios and comma-baciilus in water 
contaminated with sewage on which 
our modern fish and oysters subsist. 



character. In order to test whether this bacillus is toxical, eating 
a few of the infected oysters or clams, or some fish, give rise to 
bowel spasms, or inject into the tissue from the red spots, into 
some animal, a condition of disease analogous to cholera was 
produced, and the comrna-bacillus found in the stools, together 
with other organisms of a virulent type. 

Sanitary science teaches us that the air we breathe at all sea- 
sons of the year is highly impregnated with disease germs or 
their spores. 

In the summer season especially, we, in addition to microbes, 
breathe <-he pollen from grasses, flowers, vines, and trees, which 



BACTERICIDES. g.^ 

give rise to different forms of hay fever, or summer catarrh. 
Fungoid spores are more abundant in the atmosphere in hot 
weather than cold. Cities being comparatively destitute of ozone 






^ 00 



^a. 




^0 /'^/^jfTf/i^ 

^^ 

Bacillus Alvei as found in honey, young Bacillus Alvei, showing stages of transition 

broods, passing into a higher grade, as seen between rod and fully developed spores, 

in next diagram. ^°^^ brood on bees giving rise to flower, 

clover and buckwheat rot. Another transi- 
tion converts the microbe into the bacillus 
subtilis of hay fever. 

and loaded with the living organisms of sewers, have an atmo- 
sphere loaded with bacteria ; at an altitude of 2000 feet no 
microbes are found. The largest 
percentage of microbes are to be 
found in the atmospheres of hospi- 
tals, or adjacent to them, whereas 
the reverse condition exists in the 
air of the country. 

In this country the presence of 
microbes in houses, schools, etc., 
has been demonstrated by actual 
experiment of eminent bacteriolo- 
gists ; and they have shown the im- 
provement that can be produced by 
proper ventilation. In houses the 

mimh^rc nf mirrnhpc: inrrf-ac/^^c in Bacillus Alvei as found in honey, which, 

numoerS 01 miCrOOeS mCreaSeS m if eaten by individuals, give rise to in. 

proportion as the living rooms de- ^estinal irritation; and the transition of 

ir r ^ o ^ the microbe in the body gives rise to 

crease in size, and accordmg to how the fungus of diabetes. 
many rooms constitute a house; 

thus, a one-roomed house contains more microbes than a two- 
roomed house, and sickness and mortality go pari passu. 

That the following diseases attack the person through the 
medium of the air cannot be doubted, viz., scarlet fever, small- 
pox, measles, typhus, enteric fever, plague, pertussis, yellow 
fever, diphtheria, influenza, purulent and granular ophthalmia, 
erysipelas, hospital gangrene. 



feo<^ 





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m^^M^ 


s 


ir.y 




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s- 


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%;«» 


i a, 




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^ t 




>.' 


,!$«« 


'-X 




Q44 DISEASE GERMS. 

Sanitary science teaches us that the prevention of endemic ma- 
laria by extensive drainage is a sanitary fact. The mortality 
caused by the malarial germ does not indicate the amount of 
misery caused by it. It usually takes from twenty to thirty at- 
tacks before the germ, with attendant fever, produces a fatal re- 
^'^:::<^ suit, and then its sequelae, its anaemia, 
leucocythemia, diabetes, dropsy, enlarge- 
ment of spleen and liver, and other 
conditions which ultimately terminate 
the existence of the patient. In malarial 
sections, the number of yellow, sallow 
A bacillus found in stagnant water; wrctchcs, inhabitants of sucli districts, 
'?::tuy^^L'::t^^oL':^&::^x with their Umbs shrunken, their muscles 
g""^' wasted, nervous and physical wrecks, 

can have the microbe of all their ills blotted out by a drainage 
of the soil;, a perfect system of drainage will get rid of this 
microbe, and localities decimated with ague become perfectly 
healthy. 

Sanitary scie7ice teaches its that nearly all our domestic animals 
in and near our large cities are saturated with the bacillus an- 
thrax and actinomycosis ; that milk and meat poisoning are very 
common, cases being daily recorded. The inhibition of these 
microbes often cause immediate death from the reflex presence 
of the microbe, or from its spore, or the toxical effect of the pto- 
maine. So prevalent and fatal are those cases becoming, that 
efforts are being made to stem the evil, but with poor results. 

Death before these germs can enter the blood is deplorable, 
and worse still when pustules, abscess in lymphatic, and pyaemia 
occur. 

The microbe actinomycosis is a denizen, in its early stages, of 
the jaws; just how far it has spread among the human family 
cannot be correctly stated, but its prevalence is in a great measure 
due to the imperfect cleansing of the dentist's hands, forceps and 
other tools. We cannot always tell, until the microscope reveals 
its presence or absence. 

That pus from an alveolar abscess is necessarily septic we 
cannot be sure ; but there are three facts worthy of notice: 

1. Pus from an alveolar abscess is often of foul odor. 

2. As a consequence of alveolar abscess, necrosis of a por- 
tion of the jaw-bone is not at all uncommon. 

3. There are cases recorded of patients who have died from 
pyaemia and septicaemia, as the result of alveolar abscess, with or 
without the actinomycosis. 

In a case of anthrax, from eating diseased meat from an infected 
animal, the pus from the lymphatics was extremely fetid, and 



BACTERICIDES. 



945 



when examined showed abundant presence of micrococci. 
Agar-agar plate cultiv^ations were made on two consecutive days, 
but no development ensued. Thus, while the microscope re- 
vealed the presence of crowds of micro-organisms, the cultiva- 
tion experiment showed that they were all dead. It would seem 
as if the microbes had been the 
cause of their own death; that is 
to say, they had multiplied so 
rapidly as to exliaust the soil upon 
which they had to live, and had 
produced products which were poi- 
sonous to themselves. The result 
of the investigation struck one with 
some little surprise. It is, perhaps, 
hardly what one would expect, 
that a patient should survive with 
such a quantity of putrid material 
in his body, in which even mi- 
crobes were unable to live. 

Sanitary science teaches its that 
from our drinking water we are suf- 
fering unconscious suicide, and this 
exists all over the land. 

A number of cemeteries drain 
into Brooklyn's sources of water 
supply. 

Long Island City pumps its 
water out of an underground frog 
pond. 

Jersey City, Newark, Elizabeth 
and Hoboken secure their water 
from the dirty Passaic river. 

Albany and Kingston have 
muddy supplies of water. 

Phi.adelphia pumps up Schuylkill 
graveyards. 

St. Louis is burdened with mud and filth from the Mississippi, 
which has rotted its water pipes. The same is true of cities de- 
riving their water supplies from the Mississippi, Missouri and 
Ohio to an alarming extent, such as Louisville, Memphis and 
New Orleans. 

Boston's water system is polluted by a poisonous vegetable 
growth. 

Chicago sewage so completely invests lower Lake Michigan 
that in summer time the hydrant water actually smells of the 
60 




Section through a Kidney of a Case 

THAT DIED AFTER MeATPoISO-MNG. 

The figure represents part of a glomerulus of 
a Mai jighian corpuscle, in which some of 
the cap-llary blood-vessels are filled with 
the bacilli Magnifying power 700. i. 
Capsule of Malpighian corpuscle. 2 Ca 
pillaries filled with bacilli. 3 Capillaries 
empty. 4. Bacilli contained between ca- 
pillaries. 

sewage and drainage of 



946 



DISEASE GERMS. 



filth. In winter, the water, being taken from a considerable 
depth, is void of oxygen, the h'fe-giving gas, and under the high 
pressure of the pumps, remains a dead liquid, injurious to the 
health and productive of malaria and winter cholera. 

New York might have tapped Lake George for less money 
than the total expense attending Croton water, which has cost 





Ophidormnas sanguinea of stag- 
nant water ('^lightly magnified), 
often present in our drinking 
water of all our large cities. 



Crenothrix Kuhniana. — This 
micro-organism, magnified 
600, is taken from water 
pipes, rendering drinking 
water very foul. 



Comma-Bacilla — Spirillum as 
found in sewage, as it enters 
the river. 



The Comma Bacillus as sten in 
river water into which sewers 
enter. The drinking of such 
water, even five miles below 
whtrc the sewers enter, gives 
rise to diarrhoea. 



Upward of ^80,000,000. Croton water, politically and physically, 
is probably the most corrupt supply extant. Mineral matter is 
always visible in it ; in the summer it is impregnated with a green 
and poisonous vegetable matter. 

Grand Rapids, Michigan ; Waukesha, Wisconsin, and a few 
other and small places are probably the only ones known having 
perfectly pure water supplies. At Grand 
Rapids, the Hydraulic Company's works, 
and those at Waukesha, are fed by enormous 
springs, cases exceptional and singular in the 
water-works history of this continent. 

Nearly all farm wells in the rural districts 
receive the drainage of the barns. 
Not long ago, nearly all the wells and water-works supplies 
in our State were found laden with germs, which if corrected, 
would decrease the mortality of our country. 

As a general rule, the water which supplies all our large cities 
contains a large number of microbes in a perfect state of vitality. 
The rivers and lakes receive most of them directly from sewers 

even most of the wells in the rural 



i^, - 



Spirillum volitans which 
•met with in marshes. 



which discharge into them 



BACTERICIDES. 



947 



-districts receive them by infiltration through the soil. During 
epidemics of measles, scarlet fever, variola, typhoid fever, 
cholera, etc., the microbes of each of those diseases are to be 
found in all running and stagnant water, in close proximity, and 
therefore they often become sources of contagion and infection. 
Well-water near a barn, a cess-pool close to a dwelling, owing to 
its stagnant nature, and to the infiltration of microbial matter, is 
much more dangerous than running water. 




Bacteria magnified 1500 diameters 
found in the vom<ted products 
of those patients suffering from 
gastric ulcer It corresponds to 
the bacteria fouiid in surface 
water and drain pipes. It was 
vomited as a dense gelatinous 
or slimy mass. 




Aquatic saprophytes as found in marshes, 
wells, drains, stagnant pools, from decaying 
organic matter. Magnified 500 times. 



Germ-laden well-water used in bread-making is dangerous to 
health, because the internal temperature of the loaf in the hot- 
test oven is seldom sufficient to destroy the microbe, far less its 
spores. In testing well-water, we almost invariably find ova of a 
large number of parasites, spores of disease germs, and bacteria 
-innumerable. As a general rule, well-water should be con- 
demned for drinking purposes and making bread. 

Rain, spring, or river water is more free from microbes than 
-^veil-water. It is true boiling water will destroy all the disease 



948 



DISEASE GERMS. 



germs it may contain, but in the act of boiling, the natural gases 
of the water are destroyed, it is rendered heavy, indigestible. 

Filtering, if correctly performed, seems tD be the only method 
of clearing it of the ova of ascarides, and larger germs. 

Mineral waters, such as apoUinaris, vichy, if genuine, are ex- 
cellent table waters, but their use is costly. Ice yields its mi- 
crobes to any fluid or solid with which it is brought in contact, 
besides the use of iced waters, arid other drinks is highly detri- 
mental to digestion and productive of a tubercular habit. 

Sanitary science teaches us that the modern methods of pre- 
serving meat and vegetables are erroneous — productive of bac- 
terial evolution and disease — factors which increase the mortality 
of the nation. 

To prevent chemical change, the evolution of fungi and mi- 
crobes, in organic substances ; to preserve them fit for alimentary 
use and the nourishment of the body for an indefinite period of 
time, they must be protected from the microbes and germs of 
the air, and germicides, as chloride of sodium, aromatic spices 
and salines; and when smoked, the aromatic principle of carbolic 
acid and creosote, contained in the smoke destroys the microbes 
and prevents all chemical change. 






Bacillus megatherium as 

seen in decaying cab p^^ ; ^^ Moulds, found Moulds, or Fungi, found 

bage, canned tomatoes, -^^ hermetically sealed in hermetically sealed 

peas, etc. ^^^^ ^H^^ ^jtj^ ^^l. ^^^^ 

mon. 

The preservation of meat, fish, fruit, vegetables, in hermeti- 
cally sealed cans, with or without certain fluids, heated to a tem- 
perature of iio° Fahr., to insure the destruction of germs, ap- 
pears to be correct in principle, but most pernicious, nay toxical, 
to the user. 

The preservation of meat in fat, or by drying, or evaporation 
by heat, refrigeration by ice, is extensively used to preserve beef, 
mutton, poultry, fish, etc. 

When congelation occurs in the fluids of the subcutaneous 
tissue, important cadaveric changes begin; these changes con- 
sist in the formation of the most deadly poisons, which may be 
held in perfect abeyance so long as the freezing point is main- 





BACTERICIDES. 



949 



tained, but let the temperature rise, putrefactive changes occur in 
which ptomaines appear. As the temperature rises, and these 
changes occur, the meat becomes soft and mucky, and if cooked 
at this point has a sweetish taste. All animal food kept on ice, 
in the process of thawing, evolves toxical agents. 

Cream or milk, acted upon by ice, so as to perfectly freeze it, 
if freezing be maintained, all is well, but. let a thawing take place, 
and again freezing the same can, ptomaines or tyrotoxicon are 
evolved. 

Sanitary science teaches us that all cooked meats, cold articles 
of food which have been cooked some time before eating, pro- 
duce toxic properties, ptomaines or alkaloids, which are indestruc- 
tible ; these dangerous poisons are generated in cabbage, pies, 
hams, and all canned meat or vegetables. That re-heating or 
cooking over does not destroy them. 

These poisons are known as ptomaines when formed by the 
decomposition of albumen by the microbes of putrefaction in the 
dead body ; the more poisonous bases produced by pathogenic 
germs have been named toxines, while those formed in the 




i^acillus Figurans found 
in garden earth and 
on green vegetables, 
parsley , salads, which 
gives rise to choleraic 
symptoms. 




Bacil us Megatherium found on cab- 
bage, after standing one hour, being 
productive of intestinal irritation. 
The microbe effects a transition In 
the bowels, and becomes a patho- 
genic bacteria. 



healthy living body by the breaking down of albuminous matter 
in the course of functional activity are called leucomaines. Fa- 
tigue-fever may be explained by the production of leucomaines 
being more rapid than the excretory organs of the body can 
keep up with ; a similar explanation may also serve for uraemia. 
Microbes in order to produce disease must obtain admission 
into the body, and when they gain an entrance there must be a 
lowered vital force, so as to enable them to grow. For with a 
high graded vital force no microbes can grow — the body is 
insusceptible. 



950 



DISEASE GERMS. 



Insusceptibility is a condition which is due to the absence of a 
proper soil, in which the microbes can grow. As it is believed 
that epithelial cells have normally the power to resist the attacks 
of bacteria, which may then be destroyed by the white blood- 
corpuscles ; a lowered vitality, either hereditary or acquired^ 
would, therefore, constitute a predisposition to infectious disease. 
As age advances this power of the cells probably increases, so 
that the susceptibility is greatest in infancy and childhood. (See 
article, Disease Germs.) Moreover it appears that germs 
will not develop in the blood unless it contains at first suitable 
food in the shape of effete matter. Another important cause of 
insusceptibility to some diseases is the (in a measure) protective 
influence of a previous attack. In the cultiv^ation of micro- 
organisms in artificial media, it has been found that the presence 
or absence of very minute quantities of certain salts was essen- 
tial for growth ; this suggests that the first attack of a disease 
may use up some essential body which may not be reproducible, 
or only so after a long interval, or some product may be left 
behind which would be inimical to a second successful growth 
of the germ. 

Microbes in their passage from race to race, from one animal 
to another, increase, diminish, or destroy their pathogenic proper- 
ties. See the remarkable increase in virulence of all microbial 
disease in the passage of the germ from one race to another. 

Sanitary science is strongly in favor of contagious or micro- 
bial disease hospitals, for diphtheria, small-pox, typhoid and 
other fevers. 

That priceless object, human health, is best secured by an iso- 
lation of any case of germ disease; that bacterial- smitten pa- 
tients in the ordinary currents of life do not receive the care so 
indispensable to their welfare, that no ordinary dwelling can be of 
utility as a means of stamping out germs ; that a poor man's 
house does not afford the means of properly isolating a case of 
infectious sickness, neither can the natural affection of the pa- 
tient's relatives provide all that is needed for the recovery of the 
sufferer. In a well-ordered hospital, however, the patient is sure 
to receive careful nursing, good treatment, and proper food. 
Recovery is thus much facihtated, and if the hospital is, as it 
should be, free for the use of the inhabitants of the district, no 
expense whatever is imposed on the patient or his family. More- 
over, the other members of the family are relieved from the risk 
of contracting the disease, and are left free to pursue their ordi- 
nary avocations without endangering the public health. . It is 
satisfactory to find from the reports of medical officers of health 



BACTERICIDES 



951 



and others that there is a growing inclination on the part of the 
pubHc, both rich and poor, to avail themselves of the benefits of 
the sanitary hospital where the local authorities have been suffi- 
ciently far-sighted to provide such a building. Without a 
proper infectious disease hospital a district is without one of the 
most effective defences against epidemics. 

Sanitary science has clearly demonstrated that the activity, 
growth and virulence of microbes are greatly intensified by their 
entrance into sewers ; that the germs in sewers are most conta- 
gious, giving rise to the disease of which they are pathogenic, 
but more virulent ; all fevers, cholera, pneumonia, dysentery are 
apt to be commxunicated through fewer air. 

The symptoms of chronic sewer-air poisoning are of two kinds 
— the specific and the non-specific. The specific symptoms are 
those which result from pathogenic micro-organisms of various 
kinds suspended in the sewer air, and causing the various infec- 
tious diseases described. 

Among the symptoms, where no specific disease-germs are at 
work, are malaise, headache, loss of appetite, with dyspeptic 
symptoms, drowsiness, and slight feverishness. There is a 
marked tendency to anaemia and general debility. These symp- 
toms are frequently grouped under the name of " malaria." In 
children, to these phenomena may be added a smooth or glazed, 
broad, flabby tongue, with a marked tendency to digestive 
trouble, as vomiting, diarrhea, dysentery, and attacks of gastric 
catarrh and catarrhal tonsillitis. 

The tendency of sewer-air poisoning is to derange the organs 
of primary assimilation rather than the lungs ; as, for example, 
gastric catarrh, duodenitis, hepatitis, splenitis, diarrhea, enteritis, 
and colitis. Besides these effects, the debilitating influences of 
the polluted air render the persons so affected an easy prey to an 
intercurrent malady. Sewer air is more like to affect weakly 
and anaemic persons. 

Sanitary science teaches its that diarrhea is a prominent symp- 
tom of different complaints, and is frequently due to the presence 
of some irritant in the intestinal canal. Children are specially 
liable to be attacked with diarrhea, when changes are made in 
regard to diet, as at the time of weaning, or when improper food 
is given, but in summer this tendency is so greatly increased 
(adults also being affected) that such names as epidemic, chol- 
eraic or infantile diarrhea have been given it. While this disease 
prevails quite as much (if not more so) among adults as among 
young children, yet the mortality is almost exclusively confined 
to the latter, and equals one-tenth of all other causes put together. 



952 



DISEASE GERMS. 



While it is true that improper feeding of children, and putre- 
factive changes occur more rapidly in food in warm than in cold 
weather, and might be sufficient to set up diarrhea, yet it is now 
believed to be chiefly due to bacteria, and it is probable that they 
act in this as well as in epidemic cholera by producing poisons in 
the intestine. 

Probably much of the diarrhea which occurs, especially in 
•children, after the use of milk, is due to the formation of tyro- 
toxin, or other more or less poisonous products by decomposi- 
tion of the milk in the intestine itself; and as milk appears to be 
an excellent breeding ground for septic and other organisms, it 
is easy to explain the reason why infants, who are breast-fed, 
have a much greater chance of escaping diarrhea than those who 
are fed by hand. That the risk of bacterial inoculation is prac- 
tically small in the former. 

That the essential cause of diarrhea resides ordinarily in the 
superficial layers of the earth, where it is intimately associated 
with the life processes of some micro-organism not yet detected, 
captured or isolated. 

That the vital manifestations of such organism are dependent, 
among other things, perhaps principally, upon conditions of sea- 
son, and on the presence of dead organic matter, which is its 
pabulum. That, on occasion, such micro-organism is capable of 
getting abroad from its primary habitat, the earth, and having 
become air-borne, obtains opportunity for fastening on non-living 
organic material, and of using such organic material both as 
nidus and as pabulum in undergoing various phases of its life 
history. 

That in food, inside of as well as outside of the human body, 
such micro-organism finds, especially at certain seasons, nidus 
and pabulum convenient for its development, multiplication, or 
evolution. 

That from food, as also from the contained organic matter of 
particular soils, such micro-organism can manufacture, by the 
chemical changes wrought therein through certain of its life pro- 
cesses, a substance which is a virulent chemical poison ; and that 
this chemical substance is in the human body the material cause 
of epidemic diarrhea. 

Certain factors have been noted as having an important bear- 
ing upon the development of diarrhea, the chief of these being 
the nature and temperature of the soil. 

I. Nature of the soil : — A high mortality occurs on loose soils, 
such as those composed of sand, gravel, marl, or marl with clay, 
which are easily permeated by water and air, and especially 
when such soils are contaminated with organic animal matter. 



BACTERICIDES. 



953 



Excessive dryness or wetness of the soil is unfavorable to 
diarrhea. 

2. Temperature of the soil : — The atmospheric temperature 
has very great influence, but it is exerted indirectly, as the mor- 
tality does not increase until the mean temperature recorded by 
an earth thermometer at a depth of four feet from the surface has 
attained to about 56° F. — no matter what the temperature pre- 
viously attained by the atmosphere, or recorded by a thermome- 
ter at a depth of only one foot from the surface, may have been. 
The mortality rises and falls with the four-foot thermometer. It 
usually begins to rise rapidly in the middle of June, attains a 
maximum towards the beginning of August, the fall begins 
slowly in August, becomes more rapid in September, and re- 
covers its ordinary rate by the end of October. 

Minor influence on the mortality is exerted by the amount of 
rainfall, rise or fall of ground-water, wind or comparative calm, 
and by elevation abov^e sea-level according to the way in which 
they hasten or retard the rise of temperature, or affect the wet or 
dry condition of the soil. 

3. Density of population. 

4. Density of buildings upon any given area. 

5. Restricted circulation of air about or within dwellings. 

6. Domestic darkness, and general dirtiness and mustiness of 
dwellings. 

7. Emanations from sewers, cesspools, privies, and dust bins. 

8. Filthy accumulations. 

9. Polluted drinking water and food supplies, especially milk, 
and everything about a house which tends to lower health and 
vitality, exert a baneful influence, and should be remedied. We 
recommend subsoil drainage, concreted sites for dwellings, free 
ventilation, daily scavenging, proper drainage, and special pre- 
cautions to protect the milk supplies from contamination, aerial 
or otherwise, both before and after it reaches the consumer. 

Sanitary science has clearly demonstrated that the disease 
germ which induces the greatest mortality among the human 
race is the tubercle bacillus. This is the most important of all 
microbes. A nation tainted to its core with this micro-organism 
would quickly cease to be a nation at all. The presence of this 
disease germ entails sickness, infirmity, an actual, definite, national 
loss, in consequence of which we are weaker and poorer. 

We do not properly appreciate the influence of disease germs 
on national prosperity, although we realize it in the individual. 
If our national rulers could only realize the extent to which it is 
impoverished by preventible disease, rendered poorer by the loss 



954 



DISEASE GERMS. 



of that wealth of which money is the token, they would soon devise 
means to wipe out glaring insanitary conditions and take meas- 
ures to instruct the masses in sanitary science, so that each one 
would have a sound mind in a sound body. 

The greatest possible amount of money spent by our govern- 
ment for efficient sanitary measures will always prove an actual 
and great economy, and result in a saving of human life and an 
increase of national wealth. 

Nothing is so costly as disease, excepting death ; no \vaste is 
so extravagant as the waste of human life. 

I. Tuberculosis is the most important of diseases. As it 
affords the highest percentage of deaths, it is the most important 
from an economical point- of view, as the sufferers from it gener- 
ally die after prolonged illness with diminished or altogether 
abolished power of production. 2. The war against tuberculosis 
is to be carried on vigorously by the state, the profession and 
the community; it promises very considerable diminution, if not 
total stamping out. 3. The cause of tuberculosis is the bacillus ; 
its existence outside the animal economy is not yet proved, but, 
it has the power of long preserving its infective qualities. 4. 
The bacillus of tuberculosis is obtained (a) by heredity — this is 
of slight importance ; (b), by direct or indirect transmission from 
other tuberculous individuals ; (c), by direct or indirect transmis- 
sion from tuberculous animals, particularly by their milk and the 
parts serving as food. 5. Measures against the spread of tuber- 
culosis — ad 4A, certain regulations impracticable; ad 4 b, school 
hygiene (disinfection of the expectoration of teachers and children, 
regular wet cleansing and frequent disinfection of school-rooms) ; 
erection of disinfecting offices by the community, and the instruc- 
tion of people in the technique of disinfection ; repeated disinfection 
of dwellings and articles used by tuberculous individuals, obliga- 
tory disinfection of the dwellings and utensils of persons dying of 
tuberculosis ; supervision of the health of nursemaids, midwives 
and hospital attendants ; supervision of persons engaged in the 
preparation and sale of foods, exclusive of such as are coughing. 
Careful hygiene of hospitals, prisons, orphanages and similar in- 
stitutions. Ad 4c, instruction of the people, strict compulsory 
meat inspection. Determination of all animals found to be tuber- 
culous as regards breed. Veterinary superintendence of shippons 
from which tuberculous animals have come. Destruction ot 
animals found to be tuberculous (with at most partial compensa- 
tion), super\ision of the milk trade. 



BACTERICIDES. 



955- 



A most complex disease of the blood in which 

Scurvy, the essential elements of anaemia, purpura are 
prominent factors, with a deficiency of the alkaline 
salts in the blood. 

Monotony, sameness, -isolation, together with the use of 
food deficient in the salts of potash, as fresh meat, fruit, 
vegetables, are the usual causes. 

Symptoms. — The earliest and best marked symptoms are 
observed in the countenance ; the face is pale, and may be 
bloated; the eyes and lips have a dirty hue; the features are 
somewhat depressed ; the gums are spongy, livid, and bleed when 
slightly irritated ; teeth loose, breath very offensive. There is 
great lassitude and debility, pains in the legs, limbs very feeble, 
joints stiff, unable for any exertion. There is great difficulty of 
breathing, skin dry and harsh, sometimes rough and scaly, espe- 
cially around joints, oftentimes puckered ; although more gen- 
erally it is shining, with patches or spots of brown, blue, black or 
livid blue. These patches are first seen on the legs or thighs, but 
generally extend over the entire body, except the face, and the 
disease continuing, the feet and legs become oedematous. 

If not arrested at this point, the symptoms increase in severity, 
the gums become more livid and swollen, the breath more offen- 
sive, the pains more severe, and so with the other symptoms. In- 
the latter stages there is often hemorrhage from the mucous 
canals, and the loss of blood is often so great as to prostrate the 
vital power of the patient. 

In these stages, the evacuations from the bowels are often fre- 
quent and offensive, and we often have scorbutic dysentery, albu- 
men in urine. The pulse is jerking, appetite impaired, intellectual 
faculties slightly affected. 

In nearly all cases there is a tendency to faint on the slightest 
motion or exercise, which is often fatal. 

In distinguishing purpura from scurvy, to ascertain the cause- 
is of the first importance. The latter disease can always be 
traced to hardships and the absence of fresh meat, fruit and vege- 
tables ; and it is readily amenable to treatment by proper diet 
and lemon juice. Purpura, on the other hand, never depends, 
on the above-mentioned causes, and does not yield to treat- 
ment. The following additional points of distinction may be 
mentioned : 

1. Scurvy does not usually appear in isolated cases ; all those 
exposed to the unfavorable influences above indicated suffer from 
it more or less. 

2. Debility, want of energy, depression of spirits and pains in 
the limbs are always present as an early symptom in scurvy,. 



956 DISEASE GERMS. 

while in purpura these symptoms are generally absent, especially 
at the commencement of the disease. 

3. In scurvy painful swelHngs and ulcerations are apt to occur, 
especially in the legs ; these are not present in purpura. 

4. In purpura Jieinorrhagica the bleeding is more general, 
copious and continuous than in scurvy. 

5. There is generally a high temperature in the later stages of 
purpura hemorrhagica. 

Treatment. — Rest in the recumbent posture ; attention to liver, 
skin, kidneys, fresh air, generous diet, wholesome animal' and 
vegetable food ; fresh meat and boiled fish ; juicy, rare meat ; all 
kinds of vegetables, with fresh fruit in abundance. Precisely the 
same treatment as for purpura, with the exception that five grains 
of chlorate of potassa in water should be given three times a day, 
in order to supply the deficiency of alkalies in the blood. Cin- 
chona and mineral acids are of great efficacy. 

In land-scurvy, change of diet -is of the greatest importance, 
and an avoidance of salted meats and fish. 

More recently scurvy has appeared among the ill-fed children 
•of large cities who reside in crowded insanitary localities. 

It yields readily to fresh air, meat-juice and abundance of food. 

Pellagra, or scurvy of the hills, used to be confined exclusively 
to the Alps, but several well-marked cases have taken place in 
Montana and Arizona. It is a species of scurvy ; blood disease, 
with an altered state of skin, the eruption being symptomatic of 
the blood disease. The cause is a want of variated food, or in- 
sufficient nourishment. 

It ends in mania, imbecility and slow death with softening of 
brain and spinal cord. 

When first seen patient should be removed to better quarters 
and have a variated diet, because when once established all reme- 
dies fail. 

The best success has attended the use of a highly animalized 
diet, with vegetables. The glycerite of ozone and kephaline 
operate most favorably in aiding blood formation, their use being 
-pre-eminently constructional to brain and blood. 



Or motion sickness, as it may be termed, 
Sea-Sickness, for it occurs on lakes, rivers, or other turbu- 
lent motions, and by riding backwards, is a 
disturbance of a special sense, whose function is to deterrrine the 
position of the head of man in space, and to govern and direct 
"the mechanism by which the body is maintained in the erect 
posture and in equilibrium. This special sence is highly devel- 



1-iACTERICIDES. 957 

oped in the highly civiHzed Caucasian, and is his pecuhar pre- 
rogative ; by it the grandeur of the heavens, the beauties of 
nature, are reahzed ; by it, man's mind is endiwed with divine 
energy, and he can better appreciate his divine origin. This 
faculty of equilibrium is connected or seated in the brain, the 
optic lobes, the nervo-vital fluid or bed-plate of cerebrum and 
cerebellum, and other parts of the nervous organism, but its 
principal seat is in the semi-circular canals of the internal ear, 
which may be called the sense of equilibrium. 

Motion produces sickness by disturbing the endo-lymph in 
those semi-circular canals, the viscera of the abdomen, the bed- 
plate of brain, or the nervo-vital fluid upon which the brain rests. 
The motion may be either backward, forward, downward or os- 
cillating, and should be continued for a certain length of time. 
A combination of these conditions is the most effective, espe- 
cially if there be an element of irregularity or uncertainty. 

There are three varieties or forms of sea-sickness, which can 
be clearly distinguished from each other, and each of which is 
susceptible of relief by appropriate treatment. Nausea and 
vomiting is a prominent feature of all the forms. They may be 
classed as follows : 

I. The Endo-lymph, flowing freely in the semi-circular canals 
of the inner ear, is subject to all the laws of fluids, inertia, gravi- 
tation, friction. It flows in a straight horizontal current, follows 
the motion of head and ship. The plane of the canals corre- 
sponds most nearly to the direction ot the motion, face forwards ; 
reverse the motion, and the endo-lymph continues to- flow on, 
until it is arrested by friction, this causes undue pressure in one 
or more of the ampullae which causes a wrong impression to be 
carried to the sensorium, and insubordination and giddiness is 
the result ; the fluid in the canals is agitated, rocked or washed 
about, the finer nerve filaments are irritated and abused, and 
when this process is repeated a number of times, nausea and 
vomiting take place. 

In the recumbent position, head low, feet to the stern of boat, 
in which position nature has some beautiful anatomical contriv- 
ances to prevent sickness. She has made provision for the 
equilibrium of the body in the horizontal position, by the change 
in position of the fluid at the base of the brain into the spinal 
cavity, in the position of the semi-circular canals on their present 
extremities. In consequence of these, when the body is recum- 
bent or thrown back, the endo-lymph gravitates to the least 
sensitive part, and disturbance of them will not have that tend- 
ency to alter pressure. This explains why the backward motion 
in carriages causes nausea. In auditory vertigo we have pre- 



•958 



DISEASE GERiMS. 



cisely the same condition by pressure within the inner ear, de- 
cided vertigo, headache, nausea, etc. Motion sickness is a semi- 
physiological prototype of sea-sickness. All authorities are 
agreed on the point that a reversion of the movement in the 
semi-circular canals is a cause of nausea, vomiting. This form 
is most common in all steamships, with sea motion and vibration 
of the engine. 

Second class. — Visceral vomiting, due to mechanical disturb- 
-ance of the viscera; contusion of the abdominal viscera, pro- 
duced by the violent heaving of the ship in a heavy sea, has a 
tendency to cause mechanical disturbance. Here, again, we are 
compelled to go back to the brain. The endo-lymph in canals 
follows the motion of the head, and after that motion is stopped, 
continues on its course for a second or two, and then moves on 
in its original direction. During this change erroneous impres- 
sions are conveyed to the brain, v.'hich in turn sends a mistaken 
message to the abdominal muscles and viscera, and they are 
brought into action, and complete abdominal contusion is the 
result. This is of the greatest importance to the viscera, altering 
their basis of support, and causes them to thump on each other. 
Besides, there can be little doubt, as the viscera are all covered 
by the sympathetic and the pacinian corpuscles, that their move- 
ment causes a disturbance of the centre of equilibrium. In this 
form vomiting is very violent. 

Third class. — A mechanical disturbance of the fluid contents 
of the stomach gives rise to paleness, goneness and vomiting. 
Sea-sickness exists independent of visual impression, although it 
may exercise an important influence in some cases. Visual ver- 
tigo depends upon an exhaustion of the optic mechanism ; but 
in the visual vertigo of sea-sickness there is a discord between 
the immediate impressions and a visceral sense of the fitness of 
things, which passes into a feeling of uncertainty, dizziness and 
nausea. 

All the phenom.ena of sea-sickness have a rapid tendency to 
pass away. Nature has so constructed the organ of equilibrium 
that it is eminently fitted to receive impressions through the 
, physical behavior of the contents and habit taught that organ, to 
convey to the sensorium within, correct information of the ex- 
perience of those impressions. The ocean habit teaches the 
canals to adapt themselves to the new condition of things, and 
to pass over erroneous impressions unheeded, which were noticed 
at first. In fact, the new habit becomes so strong that a disturb- 
ance of it by return to land will be marked by a peculiar phe- 
nomenon, as is witnessed in the unsteady gait of a sailor, and 
■others. 



BACTERICIDES. g-^g 

Sea-sickness teaches us that there is within us a sense of pas- 
sive motion. We see it in the child being lulled to sleep in the 
rocking-horse, rocking-chair ; horseback exercise, vehicular mo- 
tion of all kinds, passi\'e movements of the body. It is agreeable, 
when mild, and when in a line with the semi-circular canals; 
disagreeable, when the natural harmony is broken. The feeling 
of goneness is due in a great measure to the subsidence of the 
abdominal visceia in the erect posture, and irritation of the nerve 
centres by ceaseless movement of the ship. 

Best remedies to act on canals, sulphate quinine, nitrite of 
amyl, pills of nitroglycerine, bromohydric acid, cocaine tablets, 
or coca wine. 

Bandage round abdomen, recumbent posture, and, when about, 
face to the front of ship, etc. 



The vesiculae seminales are two mem- 
Seminal Vesicles, branous receptacles, situated one on 
each side, beneath the base of the blad- 
der between it and the rectum. Their length is usually about two 
-inches, and their greatest breadth from four to six lines ; but they 
vary both in size and shape in different individuals. Their poste- 
rior extremities are separated widely from each other, but ante- 
riorly they converge so as to approach the two vasa deferentia, 
which run forwards to the prostate between them. With the 
vasa deferentia thus interposed, they occupy the two diverging 
sides of the triangular portion of the base of the bladder, which 
lies upon the rectum, and is bounded behind by the line of re- 
flection of the recto-vesical fold of the peritonaeum. The semi- 
nal vesicles themselves rest upon the rectum, but are separated 
from it by a layer of the recto-vesical fascia which attaches them 
to the base of the bladder. Their posterior ends lie beneath the 
openings of the ureters. 

The common seminal or ejaculatory ducts, two in number, are 
formed on each side by the junction of the narrowed extremities 
of the corresponding vas deferens and vesicula seminalis, close to 
the base of the prostate. From this point they pass side by side 
through the prostate between its middle and lateral lobes. After 
a course of nearly an inch they end in the floor of the prostatic 
portion of the urethra by two valve-like slits placed in the veru- 
montanum. one on each prominent margin of the opening of the 
prostatic sinus. 

Seminal vesiculitis is usually secondary to mischief in the 
urethra. It is a common accompaniment of gonorrheal epididy- 
mitis, and originates in a precisely similar manner. When the 



960 



DISEASE GERMS. 



inflammatory process has crept from the urethra along the com- 
mon ejaculatory duct to its termination, it is as likely to proceed 
along the short seminal tube to the vesicle as along the twenty- 
four inch vas deferens to the epididymis. I believe' it commonly 
extends along both these structures. 

I have seen the vesicles inflame secondarily to urethritis, set up 
by the passage of a bougie, by the presence of a stricture, by 
masturbation after coitus with a leucorrheal woman, and by the 
elongated front of a bicycle saddle. I have seen both vesicles 
suppurate in one case where their inflammation appeared to be 
primary ; at least there was no antecedent cause discoverable in 
the urethra. 

When acute inflammation attacks a vesicle it gives rise to a 
swelling at the side of the base of the bladder, the greater part 
of which is due rather to eff'usion of inflammatory products into 
the perivesicular connective tissue than into the cavity of the 
vesicle itself, just as we see that in epididymitis the bulk of the 
enlargement depends upon inflammatory infiltration into the con- 
nective tissue between the tubules of the epididymis. 

Seminal vesiculitis, like acute epididymitis, most frequently 
terminates in resolution. It sometimes ends, however, in suppu- 
ration, and, when this occurs, pus may make its way laterally 
into the ischio-rectal fossa, or may diffuse itself deeply around 
the rectum (constituting one of the varieties of peri-rectal suppu- 
ration), or may discharge itself by the ejaculatory duct, or may 
open either into the bladder or rectum, but never into both cavi- 
ties together. 

Some cases pursue a chronic course, distend the cavity of the 
vesicle, cause permanent choking of the ejaculatory duct, giving 
rise to a cystic swelling behind and beneath the bladder and 
blighting the spermatozoa. 

._ The symptoms of vesicular 

f ' y ' — ^ff' c.~> disease are essentially those of 



J * v-s - ^ ^ -^ ^ about th( 



j> • •^ "^z* Jj^ \ vesical irritability, resemble 
^ '^ ' " ^ '^ ^ ^^..ofo.(-;f;s^ consist in uneasiness 

e perinaeum, painful de- 



'N ) r\^ -A ^OJS^ v^'.. fecation, frequent painful mic- 

"^ ^.^ r -» ^- turition or retention, nocturnal 

Perfect Spermatozca. Imperfect Spermatozoa, emissionS, pCrslstent moisture Or 
Sprightly, active. as^^seej. injnflamma- ^gCping pCnis, with SOmC priap- 

vesicies. opaque, mo- Jsm. All the symptoms are easily 

explained: The distended vesicle 

produces a degree of pressure upon the back of the bladder in 

the neighborhood of the trigone, and this gives the frequent 

desire to urinate. Pain or uneasiness increases as the bladder 



BACTERICIDES. 



961 



fills : nocturnal emissions, undue erections are always present, 
owing to the irritation or hypersemia produced by the distended 
vesicle, and reflected irritation to the deep urethra and its 
connections. 

Prolonged or ill-treated gonorrhea, masturbation, perversion of 
the sexual act, bicycle riding, etc., are frequent common origina- 
tors of this malady, which is affecting a very large proportion of 
our male population. 

Modern therapeutics, which rests upon a scientific basis, has 
crystallized a treatment of infinite value, one in which definite 
results are obtained. 

In all cases an efficient alterative and tonic course, with atten- 
tion to secretions, bathing, diet, etc., should be pursued. 

Specially the green-root tincture of gelsemium in doses rang- 
ing from five to fifty drops, three times daily is a genital sedative 
of the highest order ; alternated with the ozonized extract of the 
black willow in doses of from a half to one teaspoonful thrice 
daily, acts as a true sedative, astringent and vitalizer of the ejacu- 
latory ducts, and the entire reproductive area. 

In the entire materia medica there are no two things which 
can excel these in allaying irritation of the seminal vesicles — 
directly sedative, nay, anaesthetic to this part of the organism. 
They not only control inflammatory action, but effectually check 
all leakages and emissions.' 

Their activity can also be greatly increased, and the deep- 
seated urethra entirely rejuvenated, by the introduction every- 
other night into the urethra, well up to the prostate, of a bougie 
prepared from the glucoside of the salix niger. 

Still further, a cocaine suppository could be introduced into 
the rectum, to render treatment still more effective. 



There is a great variation of sight among the dif- 
Sight. ferent races of men ; the sense of sight, like that of 
hearing, is much greater and keener among all colored 
races than the white. 

Vision, or sight, is performed by the brain, through the most 
perfect optical apparatus, the eye, by or through which the brain 
looks at the exterior world. 

In normal vision in the Caucasian, between fifteen and forty^ 
five, with a healthy brain and eye, he can distinguish an object 
the six-one hundreth part of an inch in size, at a distance of six 
inches. 

Myopia, short or near-sightedness, may be said to exist when 
the distance at which ordinary type can be read is less than 
61 



962 



DISEASE GERMS. 



twelve inches, and when near objects can be seen distinctly, 
bright light aggravating the condition. 

Near vision may be hereditary, a typical type of conformation ; 
usually too great a convexity of the cornea or crystalline lens, or 
both. It may also be due to lengthening of the eye-ball, to an 
undue density of its refractive media. The rays of light from 
objects at usual distances are brought to a focus before reaching 
the retina, instead of being concentrated upon it. 

Overcrowding in our public schools in large cities is most pro- 
ductive of myopia. It is brought about by a low form of puru- 
lent ophthalmia, which is always present where density of popu- 
lation, insanitary conditions prevail. Want of phosphates in 
children's food is a common cause. This is often caused by the 
introduction into bread of alum, to whiten, but which destroys 
the elements of brain and bone nutrition. Adulterated food 
(cerebral starvation) and overcrowded schools are manufacturing 
a myopic race of children. 

Masturbation in both sexes is a cause. Permitting lights in 
sleeping apartments deprives the eye of its natural rest in dark- 
ness, hence this is a common cause. Overwork, excesses, read- 
ing by gas-light and oil lamps, etc., are causes. 

Long-sigJitcdness ; an alteration in the refractive power of the 
eye, producing presbyopia. It is always associated with weak- 
ness of vision, an indication of cerebral atrophy, of approaching 
old age, often a precursor of glaucoma, vision imperfect for near 
objects ; distant ones clearly seen. 

Weakness of vision, asthenopia^ eyes weak, but appear normal ; 
inability to read or write for any length of time, usually asso- 
ciated with headache and muscse volitantes. 

Color-blindness, an inability to discriminate between certain 
colors, an affection of vision of the greatest interest to the gen- 
eral public, as regards the exclusion of affected individuals from 
the position of engineers on railroads, signal-men, pilots. 

Quakers and Jews are- most affected with it ; in the former it is 
brought about by a marked characteristic, a general coalescence 
of the typical fissures of the brain, induced by monotony, same- 
ness, isolation ; a condition often present in insanity, epilepsy and 
other low types of the human brain ; in the latter class relation- 
ship or consanguinity wipes out the mental characteristics and 
obliterates the convolutions. This in-and-in breeding, as well 
as solitariness, predisposes to suicidal mania and causes color- 
blindness. 

The average per cent, of color-blindness among any given peo- 
ple will depend upon the preponderance among them of Friends 
and Jews, or persons who possess the same characteristics. It 



BACTERICIDES. 



963 



always diminishes as we ascend the social or educational scale. 
Among deaf mutes the percentage is even greater than the two 
classes mentioned. Intermarriage is not only a great factor, but 
the same law extends to temperament and races. Intermarriage 
not only creates the defect, but aggravates it, causing the most 
intractable form, which is red blindness. There is also to be 
found an unusually high average of color defects among the 
children of either fathers or mothers who work among colors. 
Trades requiring great concentration of sight, as engraving and 
watchmaking, seem to bring it about. Women are equally 
affected with m^en. The average percentage in people of low 
civilization or culture is great ; among deaf mutes, ten per cent, 
and among Friends and Jews, about six per cent. 

Color-blindness is a defect which is quite compatible with 
perfect vision in other respects. Color-blindness is found to exist 
in three forms : 

1. Inability to distinguish any color, properly so called ; black 
or white, or light and shade. 

2. Inability to distinguish between nicer shades of more com- 
posite colors, as brown, gray and neutral tints. 

3. Inability to distinguish between primary colors ; red, 
blue, yellow; or secondary and tertiary colors, as green, pur- 
ple, orange. 

In the latter form there is a defective appreciation of all 
colors. Little good results from any treatment ; and as there 
is about one per cent, of the entire population affected, care 
should be exercised by railroad officials, pilot boards, etc., that no 
affected person be employed, so as to avoid serious accidents. 

Convexity of the cornea from above downwards, or from side 
to side, gives rise to an inequality of the refractive power of the 
several meridians of the eye (astigmatism). It is often con- 
siderable, and interferes with the sharpness of sight. 

Oversight ; a condition in which the refractive power of the 
eye is too low, or the optic axis too short ; consequently when 
the eye is in a state of rest, parallel rays are united upon the 
retina, but behind it, and only convergent rays are brought to a 
focus upon the latter. Distant objects are not seen clearly ; 
eyes look smaller and flatter than in health ; likely to be head- 
ache, dull pains in the eyes, with heat and fulness ; when reading 
words run into each other. 

There are a very large variety of drugs which affect the brain 
disastrously, and cause weakness of the optic nerve, ''amblyopia," 
such as morphia, tobacco, chloral, and the long list of hair washes 
and dyes. 

Double vision may be due to the use of drugs, such as gelse- 



964 



DISEASE GERMS. 



mium, or to some irregularity of density, or paralysis of the 
muscles of the eye-ball. 

Night blindness, or day vision, hemeralopia, is common among 
travellers, soldiers, sailors, in tropical countries, brought about 
by long exposure to intense sunlight, or to the reflection of the 
sun's rays on the white sand of the desert ; this exhausts the 
sensibility of the retina. It is occasionally a symptom of scurvy, 
of sexual excesses, masturbation, and organic changes in the brain. 

Intolerance of light, photophobia, is a constant prevailing symp- 
tom of all inflammatory conditions of the eye and brain. 

A dilated pupil^ mydriasis, is invariably present in all states of 
cerebral anaemia, and gives rise to imperfect vision. It may be 
induced by the use of acro-narcotic drugs, especially belladonna. 

A contracted state of the pupil is present in all states of conges- 
tion of the brain (myosis), and it can also be induced by the use 
of calabar bean. Certain trades, in which they are compelled to 
look at minute objects, as watchmakers, wood engravers, acquire 
it. Great obscurity of vision in a weak light. 

Vision is often most powerful or acute during twilight, myc- 
talopia. 

Specks or spots before the eyes — muscce volita7ites are present. 
When the vital integrity of the brain is lowered or depressed, 
and either anaemia or hyperaemia is present, the nerve filaments 
that supply the aqueous humor and vessels of choroid are re- 
laxed. If the debility be great, vessels take on varicosity ; and 
when the brain looks through the eye at the external world, it 
sees the varicose vessels, tortuous, and anastomosing in every 
conceivable form, and it then compares them with objects seen 
or described in the external world ; if depression be not very 
great they will be compared to small objects, as flies, specks^ 
spots ; if depression be great, the vessels are greatly engorged ; 
then the patient will compare them to large objects, as men, 
devils ; they are real, no hallucination, as the patient sees them 
in his own eye. It indicates brain exhaustion, in a mild or 
aggravated form. 

Protuberant eye-balls are present as a symptom in tuberculosis, 
in all its varied forms. 



Why we sleep, and how we sleep, are questions 
Sleep, still awaiting solution. The periodic suspension of 
the activity of the superior nerve centres is the domi- 
nant character of sleep ; even the automatic centres for the re- 
spiration and circulation are less energetic, so that the breathing 
is slower, pulse quieter. 



BACTERICIDES. 



965 



The variations of the cerebral circulation present a certain re- 
lation with the alternation of sleep and wakefulness, but these 
variations require an explanation, they do not suffice for any 
theory of sleep. The great, nay vital, importance of oxygen in 
keeping up the activity of the tissues once recognized, its less 
absorption, giving rise to anaemic states of the brain. 

An active state of the brain cells necessarily gives rise to 
waste, a sensation of fatigue ; and those fatigue substances ope- 
rate by monopolizing the oxygen, sleep follows by default of 
this agent. The products of exhaustion are continually forming 
within the brain when active ; that their accumulation brings on 
sleep, and that during that process they are eliminated by the 
blood which passes through that organ. 

All organic activity gives rise to products of exhaustion, to 
the formation of a substance termed ^' ponegenes,'^ which accu- 
mulates in the brain during wakefulness, and being very oxidiz- 
able, terminate, by diverting to their own profit, the oxygen 
destined to keep up the activity of the different glands, muscles 
and brain, in such a fashion as that the mental acts and voluntary 
movements are depressed, the organism falls asleep. 

Among the ponogenic substances are lactic and uric acid, and 
a group of bodies closely allied to them. 

In would thus appear that there is a sort of self-regulating 
mechanism in the body, by which sleeping and waking are made 
to alternate. During the waking hours soporific products are 
formed, and these, gradually accumulating, will by-and-by induce 
sleep, while during sleep stimulating products are formed which, 
after a certain number of hours, will stimulate the brain to wake- 
fulness. 



Microbes in the throat are common in all 
Sore-Throat, diseases. 

From breathing microbe-laden air, from re- 
laxing and damp weather, or living badly and working hard, 
will in the end produce a relaxed condition of the throat. 
For this, pure air, better food, and swabbing or garghng 
the throat with a solution of tannic acid and chlorate of potassa, 
to which a few drops of peroxide of hydrogen is added, is the 
best remedy. Sore throat is common among those exposed to 
the vicissitudes of weather. It is a common, universal symptom 
or indication of the presence of the micrococci of scarlet fever or 
the streptococcus of diphtheria ; it may follow a shock from 
cold, damp, or excessive talking. It is common in 99 cases 
out of TOO in all persons who have had syphiHs or tubercle; in 



966 



DISEASE GERMS. 



all individuals who are close to or near by any syphilitic or 
tubercular individuals. 

The hoarseness, or soreness, or the ulceration are due to the 
inroad or deposit of those two bacilli. 

It is preposterous in this microbial age to look for anything- 
else. 

Look for the brown copper-colored mucous membrane, with 
yellow flakes of pus ; the impress, the stamp of syphilis ; or the 
pale mjottled mucous membrane, with cheesy specks or particles, 
the insignia of the tubercle bacilli. Those microbes work 
silently, there is neither pain, nor rawness, nor redness. 

hilialations of glucozone are most effectual in killing and root- 
ing out those microbes. Its daily use sterilizes the mucous 
membrane, renders it unfit for their deposit and growth. 



Convulsions in young children, subject to laryn- 

Spaisms. gitis (spasmodic laryngitis) ; they are respiratory 
convulsions, but may become universal. I suggest 
that the age of the patients, the fact that there is a manifest im- 
pediment to respiration at the gateway of the respiratory appa- 
ratus, and the occurrence of the attacks mostly at night (in 
sleep), point to an over-stimulation of the respiratory centres by 
too great venosity. If so, the hypothesis that attacks of laryn- 
gismus are similarly caused is favored. " Spasmodic '^ laryngitis 
usually occurs in children under two or three years of age ; the 
attacks usually occur suddenly during sleep, and the next day 
the child maybe seemingly well, except for a little hoarseness 
and cough ; the attacks are sometimes mistaken for laryngitis. 

Treatment of Imvard Fits. — Let us now see if the results of 
treatment favor the hypothesis put forward. It is good practice 
not to let the child who is the subject of laryngitis sleep too long 
at a time ; not to let it remain too long in a condition favoring 
venosity ; I suppose the same applies to laryngismus stridulus, 
to which morbid affection I confine further remarks on treat- 
ment. 

It is understood, of course, that attention is given to diet, di- 
gestion, and state of the bowels. No one fails to treat the rick- 
ets, the approved medicine being kephaline. The good effect 
of the highly valued remedy, cold sponging, favors my hypo- 
thesis ; manifestly it will stimulate the respiratory centres. So do 
the good results of carrying the child out, even in cold weather, 
and change from town to country air. The several remedies 
will tend to reduce venosity. 

Now for drugs, more especially in the treatment of what we 



BACTERICIDES. 



967 



call laryngismus itself. The best remedies should, on the hy- 
pothesis, be those which stimulate the respiratory centres. Of 
special drugs fl. ext. musk-root and belladonna are most useful 
in laryngismus stridulus. The former can be given to a child 
of twelve months old in doses of one-half teaspoonful every six 
hours, and will be found to have a powerful influence in check- 
ing the tendency to spasm. Belladonna, to be of service, must 
be given in sufficient doses. The comp. tincture of lobelia is a 
never-failing remedy ; it should be administered in small doses, 
frequently repeated ; con. ozone applied to the throat and chest is 
good. Musk is a stimulant to the respiratory centres, as is also 
belladonna. It is well known that children tolerate large doses 
of belladonna ; bearing in mind Soltmann's researches, this may 
be because in them it acts more as a stimulant, or rather that the 
parts it can render negative (inhibitory and secretory nervous 
arrangements) are not largely present in the infant to be para- 
lyzed. 

Chloral is a remedy for fits of laryngismus lauded by high 
authorities. It is the best remedy for a rapid succession of fits 
of any kind ; for putting an end to the seizures, that is. It is 
not, I presume, actually curative of the morbid condition induc- 
ing them. It may be given when fits of laryngismus are frequent. 

Now for treatment after the paroxysm. When the fit is over, 
the child usually comes round spontaneously. But supposing 
that after a severe attack respiration.no longer goes on. The 
respiratory centres are exhausted, or what remains of them un- 
exhausted is not enough to produce respiratory movements ; 
the child is seemingly dead. There is paralysis of the respiratory 
apparatus after respiratory convulsions, just as there may be of a 
limb after an epileptiform convulsion which had affected that 
limb first and most. Here we must bear in mind that after 
asphyxia fits produced in lower animals, the heart, as a rule, con- 
tinues to beat for a short time after respiration has stopped. 
Hence if luckily present when a child is seemingly dead after a 
fit, we should give him a chance of recovery by artificial respir- 
ation. We should not waste time to see whether the heart has 
or has not stopped. 



means the violent and uncontrollable action 
Spasm of the of some particular set of muscles. Spasms 
Bladder are generally described as of two sorts, viz., 

tonic and clonic. In tonic spasms the 
muscles of a part contract violently, and remain rigid and im- 
movable by the will of the patient for a greater or less length of 



968 DISEASE GERMS. 

time. Such contractions occur in tetanus and in ordinary 
cramp. Clonic spasms again consist in sudden contraction and 
relaxations regularly alternating. The jumping of the legs and 
arms, which occur under certain conditions, are examples of this. 

All muscular structures are liable to attacks of spasmodic 
action ; the bladder having such a coat is frequently affected 
with spasm. Spasmodic attacks are accompanied with great 
pain, as well as contraction. 

Causes. — The presence of a stone in the bladder ; disease of 
the rectum or uterus; abscess of kidney ; an inordinated amount 
of uric acid; ulceration of the walls of bladder; disease of pros- 
tate gland ; excessive sexual congress ; hysteria ; the use of 
drastic diuretics or emmenagogues, as oil of turpentine, juniper, 
cantharides, savin. 

Sympto7ns. — Severe pain in the lower part of the abdomen, 
extending to urethra. There is either continence or inconti- 
nence, or dribbling of urine. The difficulty is not so great when 
the urine flows involuntary; when there is retention, with 
urgent desire to micturate, and tenesmus, with inability to do 
so, suffering is great. If allowed to continue, may terminate 
fatally. 

Treatment. — If patient is seen during the attack, hot baths, 
enemata of warm water and lobelia ; fomentations or poultices, 
with belladonna, linseed poultices, with lobelia and belladonna ; 
suppositories of opium and belladonna. 

Internally, mucilaginous drinks, with cream of tartar and 
nitrate of potass; either the compound of lobelia, valerian and 
capsicum, or else sumbul and tincture of green root gelsemium. 

When attack is over, removal of cause, alteratives and tonics, 
iodide potass and sulphate of quinine. 

Diet regulated, an avoidance of all stimulants ; tea, coffee, 
warm clothing ; forbid horseback exercise, or sexual intercourse; 
use appropriate remedies as to cause. 



Spasm of the rectum ; contraction of the 
Spasm of sphincter muscle accompanies ulcer of the mucous 
Rectum. membrane that cov^ers it. 

The spasmodic condition is distinguished by the 
absence of pain after defecation, and an examination of the bowel 
will show no stricture. 

The treatment of spasmodic contraction of the bowel is best 
effected by a general course of nerve tonics to remove the nerv- 
ous irritability of the system, and the use of the cocaine sup- 
positories. 



BACTERICIDES. 



969 



There is very frequently met with in highly developed and 
intellectual ladies and in neurasthenic males a neurosis of the 
nerves of the rectum, which gives rise to frequent spasm, with 
painful defecation, and constipation ; a state which is either 
brought about or aggravated by emotional states, without any 
ulcer or breach of surface. This state yields to alteratives and 
tonics with the use of the cocaine suppository. 

If this treatment fail, seclusion, rest, forced feeding, massage 
^nd electricity. 

Some of those cases are very troublesome. Lack of nervous 
co-ordination of the sphincters and irritable bladder; painful 
coition, asthma, difficulty of breathing, aphonia. In strict neu- 
rosis the sphincter develops chronic spasm as well as neuralgia, 
which gives rise to great exhaustion after any motion of the 
l)Owels. 

This term is applied to the flowing away 
Spermatorrhoea, of the seminal fluid, and designates all 
varieties and forms of spermatic losses, 
which occur beyond the limits of health. 

True spermatorrhoea, or seminal incontinence, the flowing away 
of the spermatic fluid, is primarily dependent upon weakness, 
or exhaustion, or neurasthenia, with increased impressibility, 
mobility, or excitability of the genito-urinary spinal centre, phe- 
nomena usually induced and perpetuated by hyperaesthenia of 
the nerves which supply the prostatic portion of the urethra, 
induced in nine cases of out of ten by masturbation. 

In seminal incontinence there are three conditions which may 
exist separately or be blended together. 

1. Nocturnal emissions, which occur during sleep, attended 
with an Qv^cXXon, pleasurable sensation, erotic dream. 

2. Emissions during the day, excited by slight mechanical or 
physical causes ; incomplete erections, diminished sensation, 
and no erection. 

3. Spermatorrhea proper, in which there is a continual flow of 
semen from the urethra, without erection, sensation, or during 
urination or defecation. 

In the first form, namely, involuntarily nocturnal seminal dis- 
charges, we have the bulk of the affection. This is common to 
all men after the epoch of puberty, especially if they lead a 
chaste and virtuous life. Their frequency may vary with the con- 
dition of life, age, climate, habits, constitution, temperament, diet, 
precocity. 

Their frequency varies greatly. Single men, who live a moral 
life of contentment and possess an inherent vitality, sound 



970 



DISEASE GERM 



nervous system, healthy occupation, mental and physical, strictly 
avoiding all the unhealthy literature and debasing amusements, 
may have no emissions, no leakages of any kind, still, if he had 
an emission not more frequent than one every two or three 
weeks, it might not be inconsistent with a high standard of 
health. If such were the case, it would merely exhibit a slight 
weakness, or merely a reflex sign of fulness or distension of the 
seminal ducts. 

Ungratified sexual instinct in those whose nervous systems are 
slightly impaired is apt to be followed by emissions, but if these 
are not any more frequent than what has been stated and are not 
followed by languor, headache, backache, dimness of vision, and 
noises in the ears, with . mental depression, etc., they are not 
regarded as very materially wrong, although we see in them a 
precursor or indication g( an impairment of the sexual appetite 
at the base of the brain. 

In the second form, where the afflicted individual has emis- 
sions, or ejaculations, or leakages during the day, we have a 
clear case of nervous bankruptcy, combined with weakness of 
the genital organs and of the reflex nerve centres. In such 
cases, the slightest degree of peripheral irritation, as the friction 
of the clothes, the crossing of the legs, horse-back or bicycle 
riding, driving on rough roads, reading libidinous dime novels, 
attending variety theatres ; looking at indecent pictures ; or the 
fu// bust of a beautiful zvoman excites in their mind lascivious 
ideas, and emissions. In such a case, if there is an erection, it 
is but partial, as the penis is flabby and flaccid. 

In the third form there is a true condition of seminal incon- 
tinence ; there is a moisture, or leakage all the time, a passive 
loss, without the concurrence of the organism, and this oozing, 
leakage or partial ejaculation is associated with positive physical 
symptoms, such as a dilatation of the orifices of the ejaculatory 
ducts, from atony of their muscular fibres ; great and unconscious 
discharge of semen at stool and in urinating ; an irritable weak- 
ness of the seminal vessels and dilatation, with atony of the ejac- 
ulatory ducts. Spermatic fluid escaping all the time, and the 
spermatozoa are so feeble, so infertile, that they die in their 
escape, and we have azoospermorrhagia, or the passive loss of 
barren semen. 

Inflammation of the prostate urethra invariably exists, which 
leaves the mouths of the ejaculatory ducts open, patulous ; this 
is very frequently a result of masturbation, or chronic inflamma- 
tion from gonorrhea, or bicycle riding, or from lifting heavy 
weights, the seminal vesicles are injured, and the semen oozes out. 

Any of those three forms may exist separately, or they may be 



BACTERICIDES. 



971 



blended together, or the one pass into the other, beginning with 
the mild form and proceeding from bad to worse, giving rise to 
a general train of symptoms. 

Emissions increase in frequency and severity, erections become 
most feeble, ejaculation on coition is precipitate, general nervous 
debility, pain in the back of the head, dilated pupils, muscular 
languor, mental incapacity, slight paresis of the brain, dulness of 
perception ; impairment of memory ; vertigo, mental dejection ; 
weakness of vision ; trembling of the limbs ; palpitation of the 
heart ; shortness of breath ; a sense of oppression in the chest ; 
flatulence, constipation, dyspeptic symptoms. Daily losses, due 
to mechanical or psychical causes, are soon followed with leak- 
ages all the time, with no erections, no pleasurable sensations 
whatever, sexual intercourse is impossible, being impracticable 
either from the flabby or feeble premature erection ; or the wasted 
state of the parts, or the general nervous bankruptcy present. 

The patient becomes progressively worse, he broods over his 
lost virility, great mental depression, which passes into hypo- 
chondriasis. His gait becomes unsteady, he is erratic, he suffers 
from neuralgic, rheumatic pains; headache; hands and feet 
habitually cold and clammy ; insomnia ; shuns society ; fears 
to look any one in the face ; utterly incapacitated for mental and 
physical exertion ; thinks of nothing but his genital organs, 
dejected, vertigo, noises in the ears, specks and spots before the 
eyes, muscular weakness, trembling of the limbs, crackling of 
the joints, chilliness, indigestion. There is increased irritability 
of the prostate urethra, and brain and spinal cord ; these suffer 
fearful exhaustion from the persistent and constant oozing, which 
daily becomes augmented. His mental status merges silently 
into epilepsy, chorea, ataxia, insanity, or other nervous disorders. 

Spermatorrhea then or the flowing away of semen, however, 
induced, terminates in a functional derangement of the nervous 
system, which is apparent from the increased sensibility of the 
brain and cord, or feebleness of the powers of life. No one can 
shut their eyes to the fact that our literature, amusements, exciting 
erotic ideas, are powerful factors in the production of an irritable 
state of the genital organs. Seminal incontinence is usually ac- 
quired by those erotic ideas, superadded to which masturbation, 
sexual excesses, or unsatisfied sexual decire, produced by toying 
with females, or sexual perversion if the act of coition can be 
consummated, and like conditions, give rise to exaggerated irri- 
tability of the genital organs, which is soon followed by inflam- 
mation of the prostate, patulous, dilated, or relaxed state of the 
ejaculatory ducts, with the nerves of the part morbidly sensitive, 
and out of gear. 



972 



DISEASE GERMS. 



In addition there are numerous local exciting causes, as phy- 
mosis, retention of the sebaceous secretion around the corona 
glandis, tetter, narrowness of the meatus, diseases of the rectum, 
especially ascarides, or fissure, or pruritus, or piles. 

The rectum being supplied with the same nerves there is the 
finest degree of sympathy between it and the seminal vesicles. 

Promiscuous sexual intercourse debilitates the sexual organs 
and inevitably brings about an oozing of semen. Certain trades, 
as photographers. 

The only correct method of diagnosis in all cases of sperma- 
torrhea is to make a microscopical examination of the discharge 
which constantly oozes from the urethra. A microscope of five 

hundred diameters is sufficient. Their 
urine, if there is no moisture appafrent, 
will demonstrate or exhibit a class of 
objects devoid of living spermatozoa, 
but will show numerous dead or vari- 
ously deformed small, motionless bodies, 
incapable of fertilizing any ovum, how- 
ever vigorous that may be, or a No. 12 
catheter could be inserted up to the 
prostate urethra^ and enough of fluid 
obtained to exhibit an exhausted, watery 
fluid, devoid of living elements. If not 
cured insanity is the termination. 

A chemical examination of his urine 
will demonstrate the state of his brain, 
and very likely show that instead of 
there being six per cent, of vitalized phosphates that it is reduced 
to two and a half, a state of things which exist only in incur- 
able cases of insanity.* 

Self-abuse is an etiological factor in a large number of cases of 
insanity, but only those cases should be designated as insanity of 
masturbation in which the connection between the excesses and 
the symptoms is direct. Self-abuse, to produce insanity, must 
have been carried very far, or the subject must be predisposed. 
Often onanism can be traced in other members of the family, and 
very often it is found that the maternal ancestry is a weak one. 
Mania, melancholia and epilepsy occasionally occur in young 
masturbators, the former two usually having a favorable prog- 
nosis. Stuporous insanity and katatonia are both common, and 
the former presents good prospects. The forms thus far men- 

"^The chemical constituents of the average brain of man, in health, is in one hun- 
dred parts : Water, seventy-tive and a half; albumen, seven; fat, eleven and a half; 
various salts containing phosphoric acid, six. 




Spermatozoa as seen in the urine 
of patients suffering from seminal 
weakness. 



BACTERICIDES. q7-> 

tioned when occurring in masturbators present no essential differ- 
ence from the typical psychoses. They should therefore be desig- 
nated as mania, melancholia, stupor, etc., from masturbation, and 
not as masturbational insanity. There is a chronic delusion of in- 
sanity in grown persons who have been devotees of self-abuse, and 
it is usually a hypochondriachal paranoia. Clinically, it is very 
like typical paranoia, and etiologically it is not the direct result of 
self-abuse, but rather of an intermediate neurosi.^, a cerebro- 
spinal irritation which is due to self-abuse. Finally, there is a 
form of insanity developing about or after the period of puberty 
which does merit the name " masturbational insanity ;" it is 
chronic, has a tendency to agitated dementia, is characterized in 
its early period by anxiety, timidity, suspicion, fear and a cow- 
ardly, mean disposition. Later there are confusion, meddlesome, 
aggressive behavior, vague delusions, loss of memory and de- 
terioration. After these are observed spells of fury or destruc- 
tiveness. This form is never due to any other cause, and 
resembles no other form of insanity than the one already 
alluded to. 

In forming an accurate prognosis of the case it is not by any 
means so unfavorable as many would think, as a rule they yield 
readily to treatment, provided the prostate is not hypertrophied, 
or there is no stricture, haemorrhoids or no chronic inflamma- 
tion of the seminal vesicles, or sexual hypochondriasis. Cases 
brought on by bicycle riding, the use of chemicals, as in pho- 
tography or gonorrhea, or sedentary habits ; any cause but mas- 
turbation. 

Spermatorrhoea from onanism, sexual perversion, are more 
intractable than from any other cause, as the brain waste is 
greater. 

We give a synopsis of the treatment of spermatorrhoea. In all 
cases of involuntary seminal emissions there are certain rules 
which must be observed, such as bathing the entire body daily, 
followed by brisk friction or massage, the shower bath ; the diet 
should be light but very nutritious and easily digested ; all stimu- 
lating articles of food carefully avoided, as well as alcoholic and 
malt liquors. Before retiring at night the bladder should be com- 
pletely emptied, and the patient should sleep upon the right side, 
on a hair or straw mattress with as little covering as possible. 
An alarm clock should be set, so as to awake the patient at an 
early hour, so as to empty his bladder, as a full bladder induces 
erections. Interdict sedentary habits, horse or bicycle riding, or 
driving over rough roads, or toying with ladies, or reading sex- 
ually exciting literature or shows. Everything calculated to 
excite erotic thoughts or dreams avoided, mind and body should 



gy^ DISEASE GERMS. 

be occupied with healthy exercise. Causes, as far as ascertained, 
should be removed, the corona glandis should be bathed two or 
three times a day, the anus and rectum should be be thoroughly 
syringed out with a solution of boroglyceride or infusion of Vir- 
ginia stciie crop. Remove all sorts of irritation ; even an elon- 
gated prepuce keeps the sensitive glands of the penis constantly 
moist, and favors the collection of sebaceous secretion. Herpes 
of the prepuce, stricture, piles and fissure, puritus, habitual con- 
stipation, variocele should if possible be speedily cured. True, 
of all the exciting causes, the most common is an inflamed or 
irritated prostate, urethra. 

In all cases of seminal incontinence the remedies to commence 
with are those which would be the most likely to overcome the 
sensibility of the mucous membrane of the urethra, the ejacula- 
tory ducts and seminal vesicles — to diminish the reflex excita- 
bility of the genito-urinary spinal centre. 

To accomplish this, a sitz-bath morning and night, drying the 
parts well and then bathing them with a distillation of hamame- 
lis, we*aring a suspensory during the day. 

The remedies which have a calming, sedative effect are to be 
selected from some of the following, which we arrange according 
to our idea of their efficacy : 

The green root tincture of gelsemium in doses from a (gw 
drops up to such a dose as will give its peculiar physiological 
action, administered on retiring, diminishes the sensibility, the 
reflex mobility of the genito-spinal centre, paralyzes the move- 
ments of the cells of the acinous glands, and checks their secre- 
tion, so it can on no account be dispensed with. It is an invaluable 
remedy. 

Numerous acro-narcotic drugs have a very similar action, such 
as digitalis, belladonna, hyoscyamus, coca erythroxylon. 

Another invaluable remedy for the cure of spermatorrhoea, and 
the arrest of diurnal or nocturnal emissions, is the salix nigra, or 
the fluid extract of black willow bark. This is a sexual sedative 
of the first order, superior in its action to the bromides, but with- 
out their depressing or deteriorating qualities. 

This drug is a tonic, carminative, stimulant and germicide, with 
a special action upon the sexual appetite in the brain, and when 
this centre of inhibition gets out of gear, it gives excellent results. 

It is a remedy of great value in all forms of prostration and 
spermatorrhoea, controls emissions most effectually. 

The appropriate dose is about half a teaspoonful thrice daily. 

The resinoid of the black willow bark is also made into a ure- 
thral bougie and applied, and into a suppository, and used with 
marked success. 



BACTERICIDES. gj ^^ 

The use of the ozonized extract of black willow bark is indi- 
cated in every case of spermatorrhea whatever other remedies 
are being used, a mixed treatment is always the most salutary. 

The cocaine suppository is a preparation especially adapted to 
weak, nervous debilitated men, who have suffered from those dis- 
charges for an indefinite time. 

The very celebrated spermatorrhoea pill which is composed of 
the following abstractse : Cocaina, jerubalum, hypophosphite of 
lime, gelsemium, and extracts of ignatia and leptandra. 

Tonics should follow the sedative plan of treatment. A gen- 
eral tonic course, embracing such as columbo, stone crop, cin- 
chona and mineral acids, coca. 

Oats in the form of a phosphated tincture is an admirable 
tonic for those cases ; alone its action is unsurpassed, but better 
still when alternated with damiana and ignatia. 

Of local remedies, the organized soluble gelatine bougies are 
the best ; they hold the first rank, especially if there is a limited 
or circumscribed area of infiammation and tenderness including 
the openings of the ejaculatory ducts. 

Those bougies have entirely superseded all the older methods 
of treatment — they are most efficient especially when prepared 
fresh, from thallin, beberine, brucine, arbutin. 

Under good management recovery is the rule, but in some few 
rare cases, it may happen that the reflex genital centre is still 
impressible, in which case a few doses of the ozonized sumbul 
will prove highly serviceable. 

If there is reason to suspect dilatation and atony of the ducts, 
the bougie should be run right up to the prostate-urethra and 
retained there, and permitted to dissolve and be absorbed. 

SpennatorrJuva, if not cured, will give rise to wasting, and 
atrophy of the generative organs ; to white softening of the 
spinal cord and brain ; to suicide, insanity, and death. 

A healthy man, who never masturbated, may have unnaturally 
small or atrophied organs of generation, and be able to perform 
the duties of married life, although rarely in a satisfactory man- 
ner. Very different however with the masturbator, he not only 
has seminal disease, or impotence with either dwarfed sperma- 
tozoa, or none at all, with wasting and stringiness of the testicles 
and smallness of the organs. 

It is true some cases of smallness of the genital organs may 
be congenital, but its common origin is the damaged inflicted by 
masturbation, by unnatural excitement without gratification ; by 
withdrawal, non-completion of the act ; by wearing condums ; 
mumps ; gleet ; stricture ; paralysis ; blows on the head and 
spine. These, and numerous like causes, produce wasting and 



976 



DISEASE GERMS. 



imperfect development. No one can be surprised that it is very- 
prevalent, as nine-tejiths of all patients suffering from sperma- 
torrhoea are its victims. This is an appalling truth, visible in 
marital infelicity, quarrels, dissension, desertion, suicide, or else 
a life of shame and disaster. 

Eminent chemists, scientific physicians of all schools, men of 
profound intellectual calibre, are earnestly and vigorously at 
work in the discovery of remedies to destroy the germs of dis- 
ease, and to some extent have succeeded in revolutionizing the 
art of medicine by their discoveries. 

The time is ripe for important discoveries in new remedies to 
vitalize the genito-urinary tract. 

Spermatorrhea and impotence are now being cured by eminent 
specialists, who bring to bear on their cases a class of powerful 
drugs which wipe out every symptom of lost vigor, and cause 
the weak, debilitated victim to become strong, healthy, and vig- 
orous. The vitalized principle of the brain, *' cercbrin " in keph- 
aline ; the " avena " in oats ; the vital element of thought ; the 
glucoside of the saw-palmetto and damiana are growth-fostering 
remedies to the genital system, to the ganglia and plexus of both 
penis and testicle, and do good work in sexual atrophy. Elec- 
tricity must not be despised. Cold water hip-baths, retracting 
the prepuce, and bathing the corona-glandis with castile soap, 
thrice daily, and then drying. After each bath, the following 
developing powder should be applied ; rubbed all over the penis 
and scrotum, and kept constantly in close approximation by 
means of a suspensory bandage. 

The formula for this developing powder is : Take the oil of 
saw-palmetto, and digest it in peroxide of hydrogen for two 
weeks, then evaporated to a resinoid, which is triturated in pul- 
verized boroglyceride until it makes a fine powder. 

How well, how efficiently this powder acts is proven by ex- 
perience in a large number of cases. It causes a determination 
of blood to the penis and testes ; promotes molecular growth in 
a large number of cases ; it is rapidly absorbed by the vessels, 
and would almost seem to furnish nourishment to the parts. 
Although it is a powder, the moment it touches the skin it is 
taken up by the absorbents, permeates every cell and fibre of the 
part, acts with increased force and rapidity on the wasted vessels 
and tissues ; fostering growth, imparting power and vigor, with 
acuteness of sensation ; in short, restoring the weak and wasted 
muscles to tone, vigor, strength and size. 

The practical application of this principle and the internal use 
of vitalized kephaline and oats, meet the wants of a large class of 
men, helpless and useless (sexually), and the attention of the mem- 
bers of our profession to this subject is a step in the right direction^ 



BACTERICIDES. 



977 



\M'>' 



Human semen (healthy), as seen in the 
Spermatozoa, field of the microscope, magnified 600 diame- 
{Healthy.) ters, five minutes after ejaculation. 

The seed of a Caucasian, the fertilizing 
agent secreted in the epithelial lining of the tortuous seminal 
tubes of the testes. 

At puberty in man, the seminal tubes 
are filled with cells, from which the sper- 
matozoa are developed, they are set free 
by the bursting of the cell walls, and 
arrange themselves in parcels, symmet- 
rically placed, with the so-called heads 
in one direction, and the tails in the 
opposite. The spermatozoa are clear 
hyaloid bodies, each of which consists 
of a dilated portion (the head or body), 
from which a long tail or filament issues. 
The head is flattened from side to side, Spermatozoa. 

and of a conical form, the pointed ex- 
tremity being anterior, terminating in a long tapering tail which 
is in rapid undulating motion, and which propels the head di- 
rectly forwards. 

These movements may continue for twelve hours or longer, 
after they are ejaculated into a healthy vagina, but if they are 
exposed to cold or acidity, they seldom live over thirty minutes. 






A, the bladder; B, B, the lower bowel; C, the spermatic chord which conveys the 
seminal fluid from the testicle to D, the vesiculse seminales or seminal reservoirs ; 
D, the vesiculge seminales ; E, the seminal ducts entering the urethra through the 
prostate gland ; F, the urethra; G, a part of the penis showing the urethra cut open; 
I, the prostate gland. Fig. i, shows the prostate gland and the seminal ducts in 
their healthy state. 

The recognition of different discharges from the urethra is of 
vital importance. 

Spermatorrhoea, or the flowing away of semen, is readily dis- 
tinguished, although complicated, by the general bankrupt state 
of the nervous system, the careworn, haggard appearance, the 
withered, wasted, pendulous state of the testicle, the indurated 
62 



978 



diseasp: germs. 



epididymis ; besides, there is always a slight, almost impercep- 
tible discharge from the urethra, most frequently seen after uri- 
nating, or defecating, or when in the society of females. 




A, the body of the testicle ; B, B, the tubuli testis ; C, the rete testis ; D, the vasa de- 
ferentia; E, E, the epididymis ; F, the vas deferens; G, the ducts which convey the 
seminal fluid to the prostatic portion of the urethra, and when open allow the 
seminal fluid to escape with the urine, and on going to stool ; H, the vesiculse 
seminales, showing the spermatozoa conveyed by the vas deferens from the testicles ; 
I, I. I, the rectum ; J, J, the division of the vertebrae; K, K, the skin divided; L, 
the bladder ; M, the bulbous portion of the urethra ; N, the corpus spongiosum ; O, 
O, the urethra ; P, P, the corpora cavernosa; Q, the body of the penis ; S, the sym- 
physis pubis ; T, the anus ; U, the epididymis indurated, which explains how impo- 
tency is produced by preventing the seminal fluid passing to the vesiculse seminales. 

Seminal discharges are frequently mistaken for gleet and pros- 
tatorrhoea, especially if the patient has had repeated attacks of 
gonorrhea, or indurated chancres in the urethra, whereby the 
urethra has become thickened, or if the prostate has lost its tone. 

It is a matter of great importance to know in all cases what 
we have to deal with, to distinguish the gonococcus of gonor- 
rhea ; the spermatozoa of the seminal secretion ; the discharge 
present in gleet, or that peculiar to catarrh of the prostate ; or 
to a concealed urethra chancre, as each requires a different mode 
of treatment. 

To the microscope we are indebted for the means of unequivo- 
cally being able to discriminate between the different discharges. 

It may, however, be remembered, that the gonococcus is never 
present in the urethra without some pain, heat, redness, swell- 
ing, due chiefly to the micrococci burrowing in the follicles of 
the mucous membrane ; when the discharge is chiefly spermatic, 
it is glairy, starchy, like the white of an ^^%y glueing the lips of 
the orifice of the urethra together; whereas, when from ulcer, 
either in the urethra or prostate, or stricture, usually greenish. 
As we have just stated, no reliable diagnosis can be effected, 
without the microscope, aided by urinary analysis. 



BACTERICIDES. 



979 



The annexed diagram shows the appearance and the location 
of the three principal 



discharges. 




A, C, and D, represent the appearance of the discharges in spermatorrhoea, gonor- 
rhea, and syphilis. The dotted Hnes on each side of F point to the seminal ducts. 

True, the spermatorrhoea are often mutilated and mixed with 
the other secretions, and are difficult to detect. 



This may be looked upon as a prolongation 
Spinal Cord, of the brain downwards. It lies within the 
spinal column in the vertebral canal safe from 
any external violence, unless the injury be very severe. It sends 
off on each side numerous nerves which supply every part of the 
body. Like the brain, it is covered by three membranes, and it 
consists of two portions, a gray matter, where various nerve-cells 
are met with, and a white portion, which is formed of nerve- 



980 



DISEASE GERMS. 



fibres, which convey motion and sensation. Any injury to the 
cord will cause more or less loss of motion and sensation in the 
parts below, and then paraplegia is said to occur. The cord is 
liable to inflammation, and the patient is said to have myelitis ; 
to chronic degeneration, causing progressive locomotor ataxy ; 
to cancerous and other tumors, causing paraplegia ; to destruc- 
tion, through fracture or dislocation of the vertebrae surrounding 
it ; to concussion, as in a railway accident, and to inflammation 
of its membranes, or spinal meningitis. 

The medulla oblongata, the seat of reflex action, is the con- 
necting link between the brain and the cord, and all nerves of the 
body, have more or less a common connection with the medulla, 
the bulb of which is the common centre or fountain of nerve 
supply, the spinal cord being but its prolongation, not so highly 
organized as the medulla, but nevertheless a reflex centre from 
bulb to sacrum. 

All irritations from organs are transmitted here by the gray 
or efferent nerves to the root or origin of the nerves that supply 
that organ, in other words, the same kind, quality, or intensity 
of irritation is transmitted to the origin of the nerve which sup- 
plies it ; the same irritation exists in the cord as is present in 
the periphery or terminal end ; that when the disease in an 
organ is removed, it is still necessary to wipe out the irritation 
at its central origin in the cord. 

Like the brain proper, the cord is covered with serous tissue 
which secretes a nervo-vital fluid for its protection, when the 
structures are so devitalized that they fail to secrete this fluid, 
and the brain and cord rest against their bony casement, there 
is trouble and often a puzzling problem to the physician. 

There are thousands of weak, nerveless men, who do not 
know what ails them ; thousands of invalids, whose physicians 
are puzzled and perplexed by their symptoms and cannot account 
for the rapid waste of strength, energy and vitality, much less 
check it; and thousands of others, on the street, in the pulpit, 
on the bench, in the counting room, whose nervo-vital troubles, 
illness and misery are due to losses of vital fluid. Some know 
it, many more do not. Some are being properly or improperly 
treated for it, many are being dosed and drugged for malaria, 
neurasthenia, consumption, overwork, brain troubles, paralysis, 
etc. They sicken, die, destroy themselves in hopeless despair of 
ever getting well and strong again, verge into hopeless idiocy or 
go raving mad, simply because their trouble is not understood ; 
because day by day and hour by hour there is draining from 
them in their urine, at stool and otherwise, that precious nervo- 
vital fluid that represents life, health and energy to them. 



BACTERICIDES. 



981 



And is it surprising that the continual losses do drain away 
strength and vitality ? This fluid is the most vital, intrinsically, 
the most valuable in all nature ; is the only one charged with life 
— actual life ; capable of producing life ; of creating offspring ; of 
impregnating and developing into perfect being with thinking 
and reasoning brain and mind, pulsating heart, expanding lungs, 
sentient nerves, motive muscle, and all that beautiful, minute, 
and co-ordinate mechanism that forms a perfect human being ; 
the only secretion in the body capable of propagating species ; 
carrying life within life. 

Surely this was not meant for waste. Surely the influence of 
its loss upon the system, especially of a boy or young man 
(growing and not fully developed) must be great, and it is. 
Many and many a young man thus wastes away before the eyes 
of his friends from no other cause. How much better if all this 
false modesty, social hypocrisy, and blundering medical dosing 
and drugging, without thorough examination and full under- 
standing, were wholly done away with, and the young men and 
old men too, were brought to understand two cardinal facts : 

The causes of spinal irritation, poverty of the nervo-vital fluid, 
spinal bankruptcy, are to be found in both sexes in irritation 
transmitted to the cord. 

The recognition of spinal irritation, or exhaustion, or neuras- 
thenia is, as we have said, often difficult. 

The acquisition of strong nervous temperament, with great 
prostration, persistent headache, dyspepsia, constipation, phos- 
phates and chlorides in the urine are significant. Then by pass- 
ing a sponge electrode from a good running battery, we are al- 
most invariably assured of the seat of the irritation. 

This may be complicated with neuralgia or spasmodic affection 
involving the organs supplied with spinal nerves. If the irrita- 
tion is on the dorsal portion it is generally referred to one side, 
frequently the left, and is only felt below the mammae, often 
complained of as a constriction, or tightness, or suffocation, with 
accelerated action of the heart, with spasmodic cough. If the 
irritation is in the lumbar, there will be spasmodic action of the 
viscera ; numbness, cramps and excessive tenderness, with im- 
paired motion and sensation in the lower extremities, with con- 
stipation, retention of urine, irritable bladder and uterus, with 
disturbed menstruation. 

It is not common in the cervical portion, still if it took place 
there it would give rise to neuralgic pains in the neck and face, 
difficulty of swallowing, loss or impairment of voice and affec- 
tion of speech, cough and altered sensibility; partial paralysis; 
coldness and numbness of both hands, or a pricking sensation. 



982 



DISEASE GERMS. 



In the treatment of spinal irritation, we must endeavor to ap- 
preciate the immensely destructive effects of an impairment of 
this nerve centre, it tells upon every organ, every secretion, so 
that the bowels are constipated, and require the action of the 
cascara sagrada lozenge ; daily bathing followed by brisk fric- 
tion ; massage ; gentle exercise in open air if strength permits, 
and when not exercising, rest in the recumbent position. Comp. 
tincture matricaria to stimulate the stomach, improve the appe- 
tite ; diet to be very generous, consisting of the elements of the 
blood. 

Local stimulation the entire length of the spine by keeping 
applied two strips of irritating plaster, or the application of the 
electrical brush, or some other convenient stimulant. 

The internal medicaments are of two classes, green-root 
tincture of gelsemium, belladonna; ozonized fl. ext. musk root, 
to induce sedation ; glycerite of kephaline, tincture of oats, 
cerebrin, to vitalize and reconstruct the cord. 

The materia medica affords an abundant class of remedies 
which operate directly on the cord, as rhus rad., ergot, nux, 
calabar bean, atropia, ignatia, etc. 



The simple stretching of parts is often attended 

Sprains, with much suffering. 

Of the back. — Commonly caused by a fall from 
a height, or from a weight coming down suddenly on neck and 
shoulders. 

The structures suffering are the fibrous ones generally, such 
as the muscular fascia, tendons and ligaments. There is con- 
siderable swelling in the loins soon after the accident, and great 
pain on any attempt at motion. The inconvenience arising from 
a severe sprain in the back lasts a long time; so that a person 
may be confined to his bed or sofa for a fortnight, and it may be 
many weeks or even months before he completely loses pain. 
There may be some transient effect produced on the kidneys, 
and blood may be found mixed with the urine for a few days, 
but rarely any bad effects ensue. 

The treatment consists in perfect rest in the recumbent pos- 
ture ; the application of either the arnica or marigold lotion, or 
ozonized iodine to the stretched muscles 

Pain must be relieved by large doses of hyoscyamus. 

Knee. — Sprains, or twists of the knee joint are very common, 
often setting up great irritation, inflammation, and the damaged 
part is slow in recovering. 

Having had considerable experience with the older methods 



BACTERICIDES. 



983 



of treatment, clay is now the favorite local remedy. The ozon- 
ized clay is simply mixed with water to form a paste of a thick 
and moist consistence. This is spread on muslin to the depth 
ot a quarter of an inch thick, and applied entirely around the 
part. Over this a rubber roller bandage, just light enough to 
keep the dressing from shifting, and to retain the peroxide. At 
the end of a few hours the joint and all its structures is com- 
pletely saturated with a powerful bactericide, microbe evolution 
prevented, resolution is perfect. Rest is all important. 

Ankle. — The lower extremity is the most frequent seat of 
sprain of all the limbs, and particularly the ankle joint, and the 
ridiculous fashion of wearing high-heeled boots, whereby the 
base of support for the body is diminished, is a frequent cause 
of the accident. In the slighter sprains of the ankle the liga- 
ments are stretched, or, perhaps, a little lacerated ; but in the 
severe ones they are completely torn. Severe sprains are often 
mistaken for fractures, and should the case be one, when from 
swelling and pain there be any doubt, it should be treated as a 
fracture, bearing in mind that proper treatment of fracture is the 
best that could be adopted for a sprain. 



Impediment of speech (stuttering) in nearly 

Stammering, all cases is a nervous affection ; having as its 
origin a want of equilibrium of the gray and 
white matter of the cervical portion of the cord, resembling 
chorea. The vocal apparatus is usually perfect. It may be con- 
genital, but more likely to be the result of some shock in a 
fright, blow, or reflex condition, or follow some fever, worms, 
masturbation. 

White skin, dilated pupils, soft muscles, debility, point to a 
neurasthenic condition of the nerve centres ; or when it appears 
as a sequel of microbial disease, the spores of the germ cause the 
difficulty. 

The treatment consists in the removal of the cause ; improv- 
ing the general health by bathing, clothing, frictions to the 
cervical portion of the spine, thus raising its standard of vitality. 

Same remedies as for chorea. Make the child speak slowly 
and distinctly. Let him fill his chest well before he articulates 
a word, and then enunciate one word after another. If unable 
to do that, let him beat time for every word he utters in talking 
or reading. A persistent course of measuring the words until 
the stammerer can read and talk straightforward for an hour, 
daily, will soon overcome the habit. Let the diet be brain-food, 
boiled fish, oatmeal porridge and massage. 



984 



DISEASE GERMS. 



By this term is meant an unnatural protru- 
Staphyloma. sion of the tunics of the eye-ball. It occurs 

in the cornea and sclerotic. 
Staphyloma of the Cornea. — Of this condition there are two 
varieties. In one the cornea, rendered soft and weak in conse- 
quence of a slow inflammatory process, yields to the pressure of 
the clear aqueous fluid collected in the anterior chamber of the 
eye, and forms a rounded or conical prominence in front of the 
globe which presses upon and, in some cases, protrudes between 
the eyelids. This condition is usually associated with more or 
less marked corneal opacity. In cases where the cornea remains 
clear the patient complains of impairment of vision and is often 
short-sighted. In the other variety of staphyloma a portion of 
the cornea has been destroyed by ulceration ; the gap thus 
formed is filled up by portions of protruded iris, which become 
adherent to its margins. The protruded and exposed iris is sub- 
sequently thickened by the formation of delicate scar tissue on 
its surface, but still yields to the pressure of the aqueous fluid 
and forms a projection in front of the globe. Tne most marked 
instances of this kind of staphyloma may be observed in patients 
who have had an attaek of purulent ophthalmia, which has 
caused sloughing, and removal of nearly the whole of the cornea. 
Patients afflicted with the latter form of staphyloma usually 
suffer from frequent attacks of ophthalmia, and of pains and in- 
flammation in the displaced iris. Distension of the staphyloma 
by accumulation causes much pain and irritation, which is gen- 
erally relieved for a time by rupture of the protruded membrane. 
This, however, is always followed by closing of the orifice and 
reaccumulation of the aqueous humor. Sympathetic inflamma- 
tion often attacks the opposite eye. The palliative treatment 
consists in guarding the eye against possible causes of irritation, 
and in applying the ordinary means of relief during the recurrent 
attacks of ophthalmia. When there is painful distension of the 
staphylomatous cornea and iris in consequence of a great accu- 
mulation of aqueous humor, considerable though temporary- 
relief may be effected by making a small puncture into the thin- 
nest and most prominent part of the projection. When the oppo- 
site eye is affected with sympathetic inflammation it become* 
necessary to remove a part or the whole of the damaged globe. 
Staphyloma of the Sclerotic. — This term is applied to protrusioH 
of a portion of the sclerotic, due either to thinning of the mem- 
brane itself, or to thinning or rupture of the subjacent tunics — 
the choroid and retina. This condition may be caused by 
wounds of the sclerotic, blows on the eye-ball, or slow inflam- 
matory changes, resulting in a loss of firmness and diminished 



BACTERICIDES. 



985 



resistance in the tunics of the eye. Staphyloma may affect the 
anterior, lateral, or posterior portions of the globe of the eye. In 
cases of anterior or ciliary staphyloma, may be perceived one or 
more bluish, small and irregular-shaped prominences, which con- 
trast strongly with the surrounding portions of white and smooth 
sound sclerotic. The cornea and the walls of the anterior 
chamber generally remain healthy. The same changes occur in 
staphyloma of the lateral portions of the sclerotic. This affec- 
tion, which is called equatorial staphyloma, is often associated 
with much impairment of vision and severe recurrent attacks of 
ophthalmia. Posterior staphyloma generally occurs at that part 
of the sclerotic which corresponds to the optic nerve and yellow 
spot. This is frequently a congenital condition, and is the cause 
of that defect of vision known as myopia, or short-sightedness. 



The generative act on the part of the male im- 

Sterility. plies the completion of sexual congress, with an 

ejaculation of fertile semen, and its deposit in the 

-upper part of the vagina. The capacity for copulation depends 

•upon the perfect erection of the penis, the failure of which renders 

man impotent. 

Sterility includes certain distinct states, or conditions : 

As one in which no semen tvhatever, or nnproductive or infertile 
^emen is secreted, termed, azoospermism. 

Another in which the spermatic fluid is secreted but not ejacu- 
lated, termed aspermatis7n ; 

Aud still another, in which there is a failure to deposit fertiU 
semen in the upper portioi of the vagina, called mis-emission. 

In the first form, intercourse and ejaculation are natural, but 
the essential elements of life, of fecundation, are dead ; in the 
second form, the power to ejaculate is prevented by an impedi- 
ment, and in the third variety, coition and emission are perfect, 
but fruitful semen, fails to reach its destination, in consequence 
of some congenital or acquired deficiencies of the urethra. 

I A man having no semen at all, or at the best unproduc- 
tive semen, may be due to maltormation or disease of the testes, 
obstruction of the vas deferentia, and abnormal conditions of the 
semen ; with no testes, and the accessory organs rudimentary, is 
unable to ejaculate a drop of semen. If the parts are mutilated 
in early life, the individual may have an erection but is absolutely 
impotent and sterile. When the testes are retained in the abdo- 
men, that is have not descended in intra-uterine life, they may 
have erections and perform the sexual act but they emit a fluid, 
thin, watery, devoid of spermatozoa ; other abnormal deficiencies 



986 



DISEASE GERMS. 



which obstruct secretion, as atrophy of the seminal vesicles, vari- 
cocele and morbid states of the blood in which disease germs are 
present, more especially the microbe of syphilis, or the bacilli of 
tuberculae; the lithiate of soda of gout and the like, are prone to 
set up iit the testes a process of interstitial disorganization and 
degeneration, which destroys the secreting cells, causes oblitera- 
tion of the excretory ducts of the testes, and abrogates their func- 
tional activity. 

Besides, the quantity, quality and composition of the ejaculated 
semen, may be altered or poverty-struck by sexual excesses,, 
masturbation, exhausting diseases, inflammation of the seminal 
vesicles, and prostate urethra. 

There may be an entire absence of spermatozoa in the ejacu- 
lated fluid, induced by grief, worry, struggle, excesses, nervous 
bankruptcy. Neurasthenic masturbators suffer from emissions, 
seminal and prostatic discharges, the result of their violation of 

divine law, venereal excesses, 
or ungratified desires, with no 
spermatozoa, or if any be pres- 
ent they are motionless. The 
vitality of the spermatozoa is 
dependent up a healthy secre- 
tion of the prostate, when ex- 
cess or pollutions damage that 
gland, overstep a natural limit,, 
the spermatozoa are liable to 
suffer, become few, small, and 
their place is usurped by sper- 
matic crystals. 

Among our physically 
drained young men various 
diseases of the spermatozoa 
are met with, such as fatty degeneration, abnormal density of the 
semen or purulent state of that fluid, watery or colloid. 

In masturbators, or men who have committed excesses, or prac- 
ticed sexual perversion, the semen is thin, watery, and the sper- 
matozoa few and motionless, incapable of impregnating the ovum. 
When their semen is permitted to dry and placed under a 300 
diameter power a considerable number of transparent, variously 
modified, rhombic prisms, with their bases in apposition, the ends 
of these terminating in fine points, composed of ammonio-mag- 
nesium phosphate. 

The more numerous those crystals are they denote a diminu- 
tion of the spermatozoa or their entire absence. 

Among the same class of patients the semen is often watery,. 




Spermatic crystals. 



BACTERICIDES. 



987 



having a whey-like appearance, destitute of all spermatozoa, except 
a few deformed and motionless, but a few spermatic crystals, 
lymph corpuscles. 

Disease, acute or chronic, impairs the vitality of the semen, 
renders the spermatozoa scarce, small, motionless, infertile. 

The semen of men, after fifty years of age, becomes gradually 
less and less charged with spermatozoa, until about eighty, when 
few are visible, hence their inability to procreate arises more from 
impotence than sterility. 

Sterility in the male is far more frequently the cause of barren 
marriage than is generally "believed to be the case. Asper- 
matism is associated with complete impotence, but azoospermia 
or absence of spermatozoa in the semen, a condition by no means 
rare, may exist with perfect potency, and on that account is very 
easily overlooked. With few exceptions, azoospermia is caused 
by obliteration of part of the seminal ducts. This condition is 
generally caused by double gonorrheal epididymitis, or inflam- 
mation of the vas. After that malady, the chances are nine to 
one that azoospermia will follow. Prognosis appears to be hope- 
less when the condition in question is not discovered until three 
or four months after the onset of the local inflammation. The chief 
importance of the management of the case lies in accurate diag- 
nosis. True aspermatism is traced to arrested development of 
the ejaculatory ducts. In several cases of sterile marriages under 
our own observation the unfortunate wife had been sent from 
physician to physician, or from hospital to hospital, and her 
cervix divided, or her endometrium scraped, until a glance at the 
microscope proved that nothing was wanting to insure the bless- 
ing of children, except spermatozoa. No doubt the increase of 
intemperance involves the relatively greater frequency of those 
forms of gonorrhea where the earlier symptoms are very mild. 
Hence the first stages may now be as much neglected by patients 
as they have ever been wont to neglect later stages. The more a 
case of gonorrhea is neglected the greater will be the chance of 
serious secondary complications. 

Of all germ diseases that of syphilis is the most destructive to 
spermatozoa. Of all drugs which will annihilate it, the use of 
morphia and bromide of potassa stand pre-eminent ; of all morbid 
states, catarrh of the prostate; the micrococci and cryptococci of 
fever kills the most vigorous semen. 

TJie correct diagnosis of sterility must in all cases be made by 
the microscope, or by a bulbous sound. It must always be borne 
in mind that sterility does not include impotence, but is often met 
with in vigorous subjects, who ejaculate a fluid which presents 
all the visible properties of normal semen, hence it is difficult for 
them to realize that they are the result of a barren marriage. 



988 DISEASE GERMS. 

Semen is the mixed product of the secretion of the testes, 
vasa deferentia, seminal vesicles, sinus pocularis, prostate, Cowper's 
glands, mucous follicles of the urethra, etc., presided over by 
the brain. 

The thick, white, pasty secretion of the seminiferous tubes con- 
sist mainly of seminal cells, out of which the spermatozoa or 
fertilizing elements are developed ; but the spermatozoa first make 
their appearance in the rete testis and constitute nine-tenths of 
the glutinous mass. 

In the epididymus and vasa deferentia, the zoosperms are per- 
fectly motionless, from the density of the medium in which they 
are contained, but when they reach the seminal vesicles they are 
in active undulating motion. 

2. When sexual intercourse is not finished by the ejaculation 
of semen, that is, does not enter the urethra, because its ex- 
pulsion is prevented by some obstruction, or obstacle in the 
ejaculatory ducts ; or perverted sexual appetite in the brain, or 
deficient excitation of the spinal centre, or a blunting of the 
nerves of the glans, congenital occlusion of the ejaculatory ducts 
is rare, but a damaged condition of these ducts, brought about 
by wearing condums, or the act of withdrawal during ejaculation 
to avoid impregnation, retards an emission ; acts most disas- 
trously on the entire force of erection and ejaculation. 

Tight or adherent foreskin, stricture, induration of the corpus 
spongiosum. 

Lethargy, loss of passion through fear, disgust, suspicion of 
infidelity. 

3. A failure to deposit fertile semen in the upper portion of the 
vagina may be due to mechanical obstruction, owing to which it 
regurgitates into the bladder, or slowly oozes away from the 
urethra as the erection subsides. Ejaculation may have a faulty 
direction, owing to malformation of the urethra, although de- 
formity does not always involve sterility. Fistulous openings 
above or below, congenital or acquired, malposition of the 
urethra, or its orifice located far back, will prevent the ejaculated 
semen from reaching its destination. 

Again, all depressing emotions, desires, affections, passions ; 
all acro-narcotic drugs ; alcohol, gout, syphilis, impair the ejacu- 
latory power. 

What is meant here by " atonic sterility" is a state of prostra- 
tion of the nerve-centres which preside over the genital functions, 
so that the sexual act is not performed naturally and completely. 
There may not be an absence of spermatozoa in the testicles or 
the fluid ejected, but they fail, on account of the incomplete 
sexual act to reach their destination. 



BACTERICIDES. 



989 



Now, assuming that an inflamed prostate urethra will produce 
the class of symptoms described above, and finally atonic sterility^ 
it is well to look for the cause of the local inflammation and irri- 
tation of that portion of the urethra. The cause that I have 
usually found was stricture ; often not a close one, but a con- 
striction sufficient to retain behind it a few drops of urine at each 
time the bladder is emptied. These few drops of urine decom- 
pose and act as an irritant. This irritation constantly kept up' 
soon excites an inflammation which extends to, and often into, 
the bladder. This inflammation of the bladder is often the first 
symptom that calls the attention of the patient to his urinary ap- 
paratus. Constant excitement of the genitals by over-indulgence 
in sexual intercourse or masturbation may cause a state of 
hyperaesthesia of the urethra. No doubt that strictures are often 
caused by masturbation, an inflammation being excited and kept 
up by free indulgence, and eventually the same results are 
obtained as arise from a gonorrheal inflammation. Sometimes 
congenital discrepancies serve as an exciting cause. 

The treatment of the first form is as a rule most unsatisfactory.. 
Nevertheless, much can often be accomplished if the cause can be 
removed and the patient placed upon a prolonged alterative and 
tonic course, together with daily massage, followed by faradiza- 
tion of the entire body, and the administration of the glycerite 
of kephaline and tincture of avena sativa. 

The treatment of the second form is much more hopeful ; in- 
variably good is to be derived from the use of alteratives and 
tonics, massage, baths. 

If the ejaculatory ducts are obstructed, a No. 12 silver catheter 
may be introduced into the bladder, and retained there for ten 
days, so as to excite a dissolution and effusion of the lymph in. 
their mouths. Add to this introduction a No. 12 rectal silver 
bougie, its presence may possibly squeeze out the coagulated 
lymph. 

If stricture be a cause, then it must be dilated and absorbed. 

If the chemical secretion of the prostate be changed through 
inflammation, or the prostate urethra sensitive, then urethral 
bougies of thallin. 

The cocaine suppository per rectum, and internally such drugs 
as nux, saw palmetto, damiana, should have a trial. 

The treatment of the third form is chiefly by surgical proce- 
dure ; faulty or mal-formed states of the urethra ; fistulous open- 
ings above and below, adherent prepuce, all admit of prompt 
relief. 

Even atrophy of the organ admits of a cure by judicious- 
management. 



ggQ DISEASE GERMS. 

Sterility is rapidly increasing and it is important that a clear 
idea of the physiology of reproduction should be disseminated. 

AU the factors concerned in the process of conception must 
operate in harmony, the woman must produce healthy ovules 
and the man normal spermatozoa. These products must unite ; 
there must be no abnormal condition that will destroy their vi- 
tality before or after they come in contact, nor after fixation to 
the uterine mucous membrane. 

Many women are potentially fertile, yet practically sterile, as* 
a result of the prevention of conception ; a practice common in 
all stations of society which is undermining the health, morals, 
and our very national existence. 

All means of prevention are prejudicial to the mental and phy- 
sical health of husband and wife, and the moral effect of with- 
drawal before emission is nearly identical with that of masturba- 
tion, and the physical disturbance may be greater, as the vasa 
deferentia remain partially filled, producing an irritation that 
causes a more frequent desired for sexual connection than is 
healthful. When the semen is not deposited in the vagina, and 
the connection is imperfect or unfinished, the active congestion 
of the female pelvic organs finally become passive, resulting in 
engorgement, hyperplasia, displacement, etc., entaiUng various 
local and reflex disturbances, or even insanity. Women in 
so-ca/led refined, religious, and cultivated society, being controlled 
by a desire for social pleasure, and for position and wealth for 
their children, practice prevention more than women in the ob- 
scure walks of life. Their daughters are taught nothing about 
the anatomy or the physiology of their generative organs, but 
are trained to abhor offspring, and are told how to avoid becom- 
ing pregnant. The higher education or dram-cramming; of girls 
nowadays, with the absence of exercise, and other hygienic 
measures, and the reading of sensational or love novels, destroy 
their power to bear well-developed and healthy children, or to 
supply them with enough nutritious milk for the natural period. 

As woman ascends in the scale of education and refinement, 
child-bearing becomes more difficult. She is more sensitive to 
pain, and bears children with greater cranial development. Her 
mode of dress distorts or displaces her thoracic, abdominal and 
pelvic viscera, and so weakens the abdominal muscles that the 
auxiliary forces in parturition are very much impaired. 

Sterility may be absolute or relative, congenital or acquired. 
In absolute or congenital sterility, the ovule is not impregnated, 
or if impregnated, conception does not follow, the ovule being 
destroyed in the tubes or uterus ; or conception may occur, but 
the woman aborts before the child is viable. In relative or ac- 



BACTERICIDES. ^q I 

quired sterility, the woman has had one or more living children, 
but in number not according to the duration of married life. A 
woman may marry successively, two or more men, and have 
children by only one of them ; or a man may marry two or more 
childless widows, and have children by each of them. This is 
sterility from incompatibility, these women being potentially fer- 
tile. One-child sterility exists in one out of thirteen marriages. 
The average time from marriage to the birth of the first child is 
seventeen months, and between the birth of children nineteen 
months, and women, upon an average, bear children from twenty- 
five to thirty-eight years of age ; less than fifteen years. As one 
in thirteen women bear their first child after having been married 
three years, no woman should be considered sterile until the 
fourth year of married life. 

Sterility may result from mechanical obstruction, from uterine 
or pelvic diseases, or from constitutional disturbances, or from 
some defect in the husband. The spermatozoa may be prevented 
from entering into the uterus by any congenital or acquired de- 
fect that interferes with sexual connection, such as imperforate 
hymen, vaginismus, atresia vaginae, etc., or by constriction or 
obliteration by stenoses or flexure of any part of the cervical 
canal, or by an elongated cervix. The vitality of the spermato- 
zoa may be destroyed by secretions from diseased mucous mem- 
branes of the vagina, cervical canal or uterus, but the most 
poisonous secretions result from glandular cervical endometritis, 
and from latent gonorrhea. Tumors connected to the uterus, 
and in the parenchyma of the uterus, or any disease of the mu- 
cous membrane and walls of the vagina. 



Difficult breathing may be due to 
Stertorous Breathing, a number of causes, as inflammation 

of the fauces and tonsils ; from the 
presence of the microbes of croup, diphtheria, tubercle, syphilis, 
cancer, irritating the nerves of the larynx; also from the presence 
of foreign bodies ; growths in the same locality ; to ulceration ; 
narrowing or pressure of the trachea; to bronchitis ; asthma, 
emphysema, and consolidation of the lung ; to organic disease of 
the heart; to the presence of ptomaines in tetanus, cholera, 
typhoid, whereas, stertor, or stertorous breathing is due to one 
or other of three states : 

Nasal or Palatine Stertor, when the air is rushing through the 
nose or mouth, causing a vibration of the soft palate. 

Pharyngeal Stertor, when the air passes through the narrowed 
interval between the base of the tongue and the posterior wall of 
the pharynx. 



pQ2 DISEASE GERMS. 

Muais Stertor, when there is mucus in the air tubes, and the 
air in breathing bubbles through it. 

Stertorous breathing is a mere mechanical condition, and in a 
large number of cases can be got rid of. 

Mucus stertor, when unaccompanied or unconnected by living 
engorgement, may occur in serious cases, when the nutritive 
process of the lungs are interfered with by some injury to the 
seat of life in the medulla oblongatata, injuries to the brain, con- 
vulsions, poisoning with opium, drowning, epilepsy, apoplexy, 
and the so-called death rattles of profound prostration, whether 
there be fluids in the bronchi or not. Snoring in these and 
other states shows that there is an impediment to the ingress of 
air, so that the blood and tissues fail to be oxygenized ; a condi^ 
tion of non-aeration of blood and embolism ; a failure of the 
hearths action and death. It is very doubtful whether a large 
percentage of death does not really occur from this cause, and 
most of those mysterious deaths that occur during sleep. When 
snoring or stertor forms a symptom it should be treated by 
placing the patient on either side, and keeping him there. This 
seldom fails to give instant relief to this distressing and danger- 
ous symptom with its consequences, and death in many cases 
can often be obviated. 



Squinting, or strabismus, is a want of har- 
Strabismus. mony in the muscles of the eye. The common 
form met with in young persons is where the 
eye is turned inward, or, convergent ; the other form, in which 
the eye is turned outward, or divergent, is more rare, and is 
chiefly met with in elderly persons, from paralysis of the internal 
muscles. Both eyes may be affected, but this is not common. 

The causes of squinting are very numerous. It may be con- 
genital, or induced by bad habits, by imitation, by looking at 
pimples on the nose ; or it may come on from a stye, which 
often interferes with the motion of the eye ; by the use of one 
eye to the neglect of the other, or by shading one ; it may also 
result from slight opacities of the cornea ; from a variety of 
nervous causes, and it is often the result of reflex irritation in 
morbid conditions of the stomach, worms, teething and constipa- 
tion; disorders of the sympathetic system, as fright, passion, etc., 
and also to disorders of the brain, as convulsions, congestion, 
effusion, hydrocephalus, etc. 

Treatment. — If it be recent, that is, not over a few weeks' 
standing, the difficulty can be frequently overcome by the re- 
moval of the causes, as teething, worms, disorders of the stom- 



BACTERICIDES. gg^ 

ach and bowels, by the proper remedies ; b}' avoidance of study 
and reading; by proper exercise to the eyes, and by wearing 
glasses for the purpose. But if the squint be of long standing, 
and is habitual, and above all, if there is the slightest disparity 
in vision of the two eyes, very little good can be effected, unless 
the internal rectus muscle be divided. This is a very simple pro- 
ceeding, consisting in placing the patient under chloroform and 
placing a blunt hook under the muscle and raising it, and then 
dividing it. If the squint depends on some opacity of the cornea, 
or organic disease of the brain, no interference should be per- 
mitted. 

The orthopoedic treatment of paralyzed muscles has been re- 
cently tried in strabismus with marked success ; this treatment 
consists in seizing the conjunctiva over the affected muscles by a 
pair of forceps, the eye being under cocaine, and moving the 
globe in the line of action of the paralyzed muscle and its antag- 
onist. 

Protrusion of the eye-ball is a general symptom of wasting 
disease, as consumption, anaemia, but it maybe due to aneurisms, 
tumors, fatty deposits, osseous and encysted growths. The 
danger of tumors are twofold : destruction of the eye from con- 
tinued pressure ; and protrusion through the roof of the orbit 
into the cavity of the skull, with compression of the brain. The 
diagnosis is most important. 



This may be met with in either a spasmodic 
Stricture or organic form. In the former it comes and 
of the goes ; in the latter there is effusion of lymph, 

(Esophagus. which forms a permanent obstruction. The 
oesophagus being made up of circular muscu- 
lar fibres, or rings, each of which is supplied with both sensient 
and motor nerves, renders it susceptible of the slightest irritation, 
which gives rise to contraction, and repeated contractions give 
rise to effusion of lymph ; thickening. 

Spasmodic stricture is that which is not permanent, but comes 
and goes away. This may originate in two ways. There may 
be some weakness or irritation of the cervical nerves, issuing 
from the spinal cord, which supply the circular muscular fibres 
of the oesophagus, a sortof neurosis, or extreme sensibility, when 
in hastily swallowing a cold fluid, like ice water or beer, it acts as 
an instantaneous depressant to the weakened nerves, which 
causes contraction of the circular muscular, a sort of spasm, 
which prevents deglutition. It is more apt to come on in swal- 
lowing a cold fluid than otherwise, for fluids are much more diffi- 

63 



994 



DISEASE GERMS. 



cult to swallow than solids. In the act of swallowing a liquid all 
the rings of the oesophagus are brought into active exercise; 
whereas in swallowing a well masticated solid, it will slip down 
without a movement. In the other class of cases the integrity of 
the nerves are normal, no neurosis, no nervous irritation, but it 
may come on from decided carelessness in the hurried drinking 
or suddenly gulping down large draughts of ice water, cold beer 
and other cold drinks in hot weather. The pungent coldness 
and haste produces the shock, followed by contraction, which 
once induced is liable to be repeated, if the same cause is brought 
to bear on it. It is most generally met 
with in beer drinkers and among young 
ladies who bolt large quantities of ice- 
cream. 

Symptoms. — Difficulty in swallowing ; at 
first confined to fluids, usually cold; then it 
extends to warm drinks and solid food ; 
but the difficulty is not always; it comes 
on by spells ; often a sense of fulness and 
choking under the influence of excitement. 
It cannot be confounded with permanent 
stricture, because the difficulty of swallow- 
ing is only now and again, and a bougie 
will pass down without a particle of obstruc- 
tion. 

In the treatment of spasmodic stricture 
the greatest possible care should be exer- 
cised in eating and drinking; food should 
be bland, soft, nutritious ; well masticated 
and swallowed slowly. All liquids taken 
should be warm and sipped with caution. 
Forbid strictly cold or iced drinks, iced 
lemonade, beer, ice-cream. 

The medical treatment should consist in 
daily baths, massage, electricity, sumbul, 
kephaline, avena, matricaria. 
Organic stricture is a condition in which lymph is effused in 
or on the circular muscular fibres of the oesophagus ; thickening 
produced ; it m.ay involve the entire ring clear round, or only 
a part, and forms a permanent obstruction to the descent of 
solids, and often liquids. The effusion may be mere lymph, or 
even cartilage. 

The cause is some irritation, as spasmodic stricture or the 
swallowing of some irritant, which gives rise to the effusion of 
lymph. 




Stricture of the oesophagus 
and human alimentary 
canal: /, oesophagus; b. 
stomach ; c, cardiac orifice ; 
d, pylorus ; e, small intes- 
tine ;/, biliary duct; ^, pan- 
creatic duct; A, ascending 
colon ; i, transverse colon ; 
J, descending colon ; k, rec- 
tum. 



BACTERICIDES. qqc 

Symptoms. — Vomiting after taking food which descends to a 
point, and apparently sticks, and is thus rejected ; or if the diet is 
very bland or soft, or the drink mucilaginous, it may pass through 
the obstruction. If case is seen here, and proper treatment in- 
culcated, a cure may be effected. But if neglected, after the end 
of six or eight months the inability to swallow becomes greater, 
until little can be swallowed. Then emaciation, debility, takes 
place, and increases rapidly. The stricture can be felt, its size 
and shape well made out by bougie. If not cured, starvation 
takes place in spite of nutrient enemata. 

In the treatment of organic stricture there must be great care 
exercised, in order to m.aintain the nutrition of the patient. The 
diet should be of the most nutritious and blandest character, 
such as the juice of meat, raw eggs, cream, with enemata of the 
same. 

The seat or location of the stricture can be easily made out by 
the introduction of a bougie and feeling for the stricture. Once 
its location is determined, put an irritating plaster four inches 
square over the seat of stricture on sternum, another on the 
spine ; spread fresh every morning and applied. 

The patient must be placed upon an alterative and tonic course of 
treatment, such as compound saxifraga and phytolacca, alternated 
with matricaria. Three times a week the patient should swallow a 
bolus of thirty grains of papoid, large enough to be stopped by 
the obstruction ; while so obstructed a bougie should be intro- 
duced which should push the papoid closely against the obstruc- 
tion of the effused lymph. On this the papoid acts as a solvent, 
a digestive agent. 



By this is meant a narrowing, or a dimin- 
Stricture of the ished calibre of the canal. It may be so 
Rectum. slight as not to attract attention, or do ap- 

preciable harm, or it may be so complete 
as to close the canal and prevent the passage of any substance 
whatever. It may involve the entire ring, or a half, or a part 
of it. 

Causes. — Usually an effect of acute or chronic inflammation ; 
lymph is effused, generally about two and a half inches from the 
verge of the anus, or more properly speaking, at the spot where 
the tenesmus is experienced. It rarely exists without ulceration, 
and this alone may cause stricture. Congestion around an ulcer- 
ating surface, and the constant effusion of lymph in attempts to 
heal the ulcer, very soon form an undue deposit of lymph in the 
rectal walls, whereby they become thickened and hardened. In 



996 



DISEASE GERMS. 



patients of feeble health this process goes on till the elasticity 
and contractility of the muscular coat is lost, and the rectum be- 
comes passive, a steadily narrowing tube through which faeces 
pass when liquefied or semi-liquefied, forced through by the 
stimulus of cathartics and spasmodic effort of the intestines. 

Symptoms. — These vary considerably in the early stage, but, 
as the stricture becomes more marked, there is constipation often 
alternated with diarrhea. Stools if solid are passed with great 
difficulty, in small, flattened, chopped pieces, usually about two 
and a half inches in length; in other cases they are long, slim 

and cord like ; severe straining efforts 
in voiding the motions if solid ; pain 
in the loins and sacrum ; flatulence ; 
often mucous discharges stained with 
blood ; if there is ulceration above 
the stricture, burning pain and ten- 
derness about sacrum and funda- 
ment ; discharges of blood and pus. 
' The reflex symptoms are often very 
decided and severe, languor, lassi- 
tude, debility, headache, constitu- 
tional disturbance, burning; in hands 



and feet, brain disorder, vertigo, fits, 



impairment of the general health, 
depression of spirits, hypochon- 
driasis. 

TJie diagnosis is easy, the history 
of the case, the constriction of the 
bowel can be felt by the finger about 
two and a half inches from the anus, 
so that it cannot be confounded with spasmodic constriction 
caused by spinal irritation. 

Treatment. — This necessarily varies according to the state of 
the stricture, the condition and circumstances of the patient. In 
all cases one thing is essential, every possible means should be 
resorted to to build up, im^prove and maintain the highest standard 
of health possible ; to effect this the patient should resort to 
daily bathing, flannel clothing, a most generous diet, an alterative 
and tonic course of remedies. The most appropriate alterative 
is the saxifraga comp. ; as a tonic no remedy can excel the Vir- 
ginia stone crop, coUinsonia, mineral acids. 

The stools should be kept soft and liquid by a dose of kola- 
tina ; or olive oil and glycerine; or juglandine before retiring at 
night. 

Then an absorbent action must be excited in and around the 




Stricture of the rectum, usually found 2 J^ 
inches fiom the verge of the anus; the 
effusion of lymph may be all round or 
only partial. 



BACTERICIDES. ^^7 

stricture by some one or more of the following methods : The 
introduction of a metallic bougie, well warmed and gelatinized, 
with belladonna and salicylate soda, a size that will pass easily 
through the stricture should be inserted first, and permitted to 
remain at least a half an hour. These bougies should in length 
be twelve inches long, and inserted gently up for eight inches. 
From week to week they should be gradually increased in diam- 
eter, until the largest size pass easily. This method will take 
from three to four months. To aid this treatment, various sup- 
positories should be used, as the cocaine ; belladonna and opium ; 
salol. 

The idea which must be rigidly carried out is absorption of 
the effused lymph, which constitutes the stricture, never dilata- 
tion. 

It is useless to experiment with sponge tents, sea tangle, or to 
torture the patient by cauterization, incisions, forcible rupture or 
tearing, for they may be for a week or two of utility, but the 
stricture returns under those methods. 

We might enumerate other methods by which absorption of 
the lymph can with some degree of success be effected, such 
as electroysis ; suppositories or bougies six inches long, in which 
papoid, trypsin, boroglyceride, salicylate soda, salol, creolin, are 
incorporated. 



The development of blenorrhagia takes 
Stricture of the place in the following order : The micro- 
Urethra, coccus deposited on the anterior portion 
of the mucous membrane of the urethra 
encounter there a very thick epithelium, upon which they fer- 
tilize. Perhaps here we have an explanation of the theory of 
incubation, for the micrococcus only develops well in the globules 
of pus. The epithelial cells desquamate, allowing the germ to 
penetrate into the chorion and thence into the lymphatics ; then 
true suppuration commences, propagating itself little by little to 
the deep parts of the urethra, always following the course of the 
lymphatics. At the close of the malady, either because the soil 
is exhausted or the pathological modifications of the tissues ren- 
der them unsuitable to the growth of the germ, the latter returns 
to the superficial parts of the mucous membrane, and locaUzes 
itself on the surface. 

This is found to be done in nests, on the inferior aspect of the 
canal, and signalize the points where lymph is effused to form 
stricture. 

Stricture in the urethra is essentially due to rapid microbe 



DISEASE GERMS. 

evolution, in points with foliaceous colonies, which present them- 
selves in the form of diplococci, forming masses of greater or less 
extent, render the canal narrower than what it is by nature, and 
incapable of resuming its ordinary capacity. When the urethra 
contains the micro-organisms of morbid action, they produce 
one or other of three conditions, either a weakness of some of 
the circular rings, which give rise to spasmodic contraction, or 
when the germs are freely elaborated in urethral pus ; inflamma- 
tory or when the cultures have given rise to a permanent effusion 
of lymph. All forms of stricture, whether they be spasmodic, 
inflammatory or permanent, arise either from microbe growth, a 
specific cause, and capable of being removed by one uniform and 
easy treatment. 

As a rule, few persons take little notice of a stricture till some 
inconvenience arises therefrom. A man may have a slight 
moisture, or gleety discharge, ar a diminished flow of urine, 
from which he experiences little or no inconvenience, he may not 
even suspect the existence of any other complaint, and therefore 
gives the matter no thought, till at length prostatitis, inability to 
micturate drives him to seek professional advice, and an exami- 
nation of the urethra being submitted to, the presence of a stric- 
ture is detected, which may have existed for a length of time. 

Spasmodic stricture arises from the circular muscular fibres of 
of the urethra being weakened in times gone by or by the sapro- 
phylic bacteria of masturbation or the gonococcus, the slightest 
stimulus will cause the weakened part to contract, and thus cause 
the stream of urine to be suddenly obstructed, or if able to pass 
it, it will be spiral, corkscrew, or split ; cold, damp, exposure, 
microbes in the canal may act as exciting causes. The difficulty 
micturition comes on suddenly. 

In, or during inflammation, nests of micrococci weaken the 
nerves and circular fibres by burrowing in the follicles and 
lacuna. 

Permanent strictures are always due to effusion of lymph, and 
its organization either into a band across the inferior aspect of the 
canal, or a flattened exudation. The cause of this effusion is due 
to a microbial nest, and effusion of lymph over the germ colony, 
which gradually diminishes the calibre of the canal. 

Among the earliest symptoms of permanent stricture is the 
retention of a few drops of urine in the urethra, which drops 
soon escape and slightly wet the linen ; the bladder becomes 
irritable, necessitates frequent efforts to urinate, as the lymph in- 
filtration increases^ there is a discharge of mucous from the 
urethra, attended with a sensation of itching, heat and pain in 
making water; the steam of urine becomes forked, spiral, flat- 



BACTERICIDES. 



999 



tened, or scattered, which, if let alone, eventually grows worse, 
until the urine is voided drop by drop. At this period the 
slightest irritation, cold or wet, intemperance in diet or otherwise, 
may be immediately followed by a complete stoppage of urine. 

Stricture of the urethra may arise from any form of irritation, 
but ninety-nine cases out of one hundred are due to the micro- 
organisms of gonorrhea. 

Independent of the symptoms enumerated, the stricture must 
be felt by a metallic bougie. 





Two urethral strictures, the posterior 
one in the deep urethra. 



Three urethal strictures. 



Treatment. — The general treatment should consist in placing 
the patient upon a general alterative and tonic course, saxifraga 
in alternation with cinchona. The local management of the 
stricture is somewhat varied; some believe in burning them out; 
others in cutting them with the stilleto ; while another class ad- 
vocate forcible dilatation ; some are believers in their dissolution 
by electrolysis ; while others again believe in the old and best 
method, exciting absorption in them by the persistent introduc- 
tion and retention of graded metallic medicated bougies ; three 
days in the week for ten or twelve weeks. 

The merits and demerits of all other methods, it is unneces- 
sary to discuss, suffice it to say, that after its removal by those 
methods, they invariably return. 

This method is the best as there is no recurrence ; by the 
other methods, the disposition to recur after removal, originates 
in the stricture itself; thence to the bladder and contiguous parts 



1000 DISEASE GERMS. 

and anteriorly in a less degree in the urethra ; smearing the 
bougie, or using bougies of thallin, belladonna, papoid, trypsin, 
operates like a charm. 

In the management of the case, the simple bougie should be 
increased in size weekly, according to the facility with which it is 
absorbed. A little and little is gained by its passage every other 
day or twice a week. Following the use of the bougie, an iodol 
gelatinized bougie should be inserted and permitted to dissolve. 

The good effects of frequently and gently stretching a con- 
stricted part, is the true successful method of cure ; a perfect 
cure can be effected, without pain or inconvenience; and no re- 
currence demonstrates the superiority of the simple metallic 
overall other forms of treatment. 

The treatment of stricture of the urethra by electrolysis has, 
within the last few years, been brought before the profession, and 
from its success, we may fairly conclude that in the near future, 
it will occupy an important place. In the application of 
electrolysis to the urethra, a battery of thirty cells, and a gal- 
vanometer to measure the strength of the current, together with 
filiform bougies and electrodes of various shapes and sizes, are 
required. The bougie electrode used for passage into the urethra 
has a metal point, usually of olive shape ; its stem is covered 
with isolating material, and is connected with the negative pole 
of the battery. The other electrode, connected with the positive 
pole, is of a convenient shape to hold in the hand or apply to the 
back. In all cases it is absolutely essential that a galvanometer 
should be in the circuit of the electrical current, so that its 
strength may be known and regulated. The usual current 
strength employed is five milliamperes, though it may sometimes 
be increased to ten milliamperes without the patient feeling any 
discomfort. The time occupied at a sitting varies from about 
five minutes to half an hour. The modus operaitdi of electrolysis 
on the stricture does not seem to be clear ; hydrogen gas is dis- 
engaged during the operation, and a thick, granulous discharge 
comes from the urethra. That electrolysis produces a change 
on the tissue forming the stricture, seems to be proved without 
doubt, from the alteration which is found to occur after the elec- 
trode has passed through the stricture, as compared to what ob- 
tains after the passage of an ordinary metallic bougie. If a metal 
instrument be pushed through a stricture which grasps it tightly, 
and is immediately withdrawn, it will be found that about the 
same amount of force is required to withdraw the instrument as 
was required to pass it. With the electrode the case is different. 
Although a considerable time may have been taken and some 
pressure needed to pass through the stricture, it can always be 



BACTERICIDES. lOOI 

withdrawn with ease, being no longer grasped firmly like the 
metallic instrument. With it, with care, a permanent cure can be 
effected, but too often it is neglected, and the stricture will re- 
turn, unless an instrument is passed and retained for some time. 
By weekly electrolysis, resiliant or non-dilatable stricture, or 
those which are impassable, can be successfully got rid of 



Follicular irritation, efTuslon of lymph, with sup- 
Styes, puration in one or more of the sebaceous follicles, at 

edge of eyelids. 
The cause is invariably mal-assimilation, perversion of nutri- 
tion, which gives rise to the same micrococci that we have in 
boils. 

In hordeolum or stye, there is great fetor of the breath, brown- 
coated tongue, constipation, slight pyrexia. 

These cases are benefited by an emetic, opening the bowels, 
and administering some germicide. 

Locally, to the lids, if it is just about to appear, painting the 
lids with saturated solution of boroglyceride ; if it has progressed 
to near the point of suppuration, pack the lids with the same. 
Boroglyceride solution is death to the microbe in all cases and 
under all conditions. 



Suicidal mania is a peculiar morbid state of the 
Suicide, brain of civilized man in which its typical fissures coa- 
lesce. A deviation from the normal type takes place, 
termed atypic, which is present in hereditary insanity, and in the 
boy children of mothers who have exhausted their mental powers 
in literary pursuits, over-stimulating their nerve-power a-^d thus 
causing a defective power of brain assimilation in their offspring. 
It is a low state of human brain in which the facial angle is 
lowered. 

Maternal impressions also give rise to it, as the witnessing of 
the slaughtering of cattle and killing of fowls ; the insatiable 
desire of some mothers during pregnancy to have criminal abor- 
tion performed, or in taking emmenagogue drugs to destroy and 
evacuate the contents of the uterus, thus impressing a suicidal 
disposition in her child. The true influence of our present trashy, 
demoralizing literature can scarcely be adequately appreciated as 
a prolific cause; besides, we have most important factors in isola- 
tion, solitary confinement, masturbation and supposed loss of 
sexual power. The worry, the struggle for existence, is supposed 
to be a prominent cause ; but this is not correct, because suicide 



1002 DISEASE GERMS. 

is more prevalent among the unmarried and the widowed than 
among the married, in whom the struggle is greatest. The 
anaemia of the brain and cord induced by excess of study and 
sexual losses is an important factor. Infidelity, Darwinism have 
an important bearing in its production. 

It is also to be regarded as epidemic. There is a singular 
regularity of the law which governs the return of suicides. The 
regularity is conclusive. There is a perfect uniformity with which 
the numbers of suicides are repeated from year to year in each 
country, especially in those countries in which the rate of suicides 
is high, such as France, Germany, England, the United States. 
Side by side with this remarkable regularity is a progressive in- 
crease of this morbid condition during recent years in the above- 
named countries. 

It has, besides, a seasonal distribution, the first months of the 
year, being few, but a steady increase to June, when it is at its 
height, and from its maximum there is a steady decline to the end 
of the year. The variations in the prevalence of suicide in dif- 
ferent localities depends a good deal on their moral, social and 
religious status and absence of monotony. The influence of 
sound, honest Christianity (no sham) retards it. In Scotland, 
where the rigid Presbyterian has a hold ; in Ireland, Spain and 
Portugal, where Catholicism is pure, the affection is rare. The 
number of suicides increase in countries where religion is a mere 
show or trade-mark. The proportion of suicides to the popula- 
tion is less where the tenets of the Bible are absolute, whereas 
the largest proportion occur where infidelity is rampant, as in 
Germany and the United States. In Europe the pure Germanic 
race shows the highest proportion of suicides, followed closely by 
the Scandinavian races ; whereas, among the Latin race, all except 
France, the rate is low, in Russia seldom known. 

In the present state of pathological anatomy, the old theory 
of suicide being the effect of the struggle for existence and of 
human selection, which works according to the laws of evolution 
among civilized people, will not stand good. The proportionate 
relation between male and female suicides is pretty constantly 
from three to four males to one female. The proportion of 
suicides is largest between forty-five and fifty-five, very few taking 
place later in life. 

The humanizing effects of an implicit faith in God, of man 
being part and parcel of that immortal existence, and of endless 
immortality well grounded into a people, seems to be the best 
prophylactic. 

When the malady is suspected, rest to the brain, freedom from 
care, worry ; liberal administration of cerebral tonics of great utility. 



BACTERICIDES. 



1003 




Micrographic germs are to be found in both the 

Sweat, insensible as well as the sensible perspiration of the 
skin, probably most numerous when the sweat glands 
are devitalized, as in — 

Hyperidrosis, in which we have an excessive effusion of sweat. 
In this we make no reference to normal sweat, the physiological 
result of active exercise or excessive heat, but to general or par- 
tial pathological sweating. 

The latter is common in the adipose, the feeble, the victims of 
microbial disease, as in the tubercular, S3/philitic rheumatism, 
fevers, etc. ; partial sweating in hands and feet due to neuras- 
thenia, or where it may follow the course of a special class of 
nerves, and may or may not be accompanied with foetor. In all 
cases the integument is weakened, its nu- _ ....'..-.-, 

trition impaired, being constantly mace- 
rated, it becomes painful, tender, exfoliates 
and becomes loaded with disease germs. 

Sudamina, confluent or discrete, superfi- 
cially seated, of the size of a millet seed, or 
larger, translucent vesicles, each one contain- 
ing a droplet of sweat, with a germ lurking 
in the serum, often due to the same causes. ^""^ '^^"^"^ of feet-sweat. 

No localized centre in the brain for excito-sudoral or inhibi- 
tory effects has yet been recognized, although we have very posi- 
tive evidence that a bankrupt, nervous system, especially the 
sympathetic branches, give rise to it. 

When the sv/eat centre is weakened, sweating all over is 
usually mitigated by either the tincture of oats, or mineral acids, 
or nux vomica, matricaria, quinine, belladonna, agaric, ergot, 
jaborandi. 

Localized sweating, in which a pathogenic microbe is present, 
such germicides as lycopodium, boroglyceride, quinine lotion, 
ichthyol, naphthol, microbe powder in socks, etc. 

Anidrosis, a state in which there is no sweat secreted, owing to 
some pathological condition of special nerves, or to destructive 
changes in the skin, produced by burns, blisters, cicatrices, keloid 
and other growths. 

Bromidrosis ,itt\d or stinking sweat is invariably due to microbes, 
as the brood of syphilitic germs in an ulcer, or swarms of the 
micrococci in small-pox, but in a sweaty foot, the odor of which 
is so offensive, there is a specific microbe which is pathogenic. 
It consists chiefly of short rods, which are aerobic, and anaero- 
bic, develop rapidly in beef tea or broth ; will retain its offensive 
odor even after numerous cultivations and inoculations. 

Any one of one of the following germicides brought in con- 



I004 



DISEASE GERMS. 



tact with the microbe will cause its instant death : Solutions of 
boroglyceride, peroxide of hydrogen, ozone ointment, microbe 
powder, resorcin jelly. 

Other antiseptic precautions are bathing the feet, twice daily, 
with solution of boroglycide, washing the socks, saturating them 
before drying with some germicide. 

Chromidrosis. — Sweat of an abnormal color, is often attributed 
to the presence of drugs, as antifebrin, antipyrine, indican, pre- 
parations of phosphorous and of iron, vegetable parasites or 
vegetations. 

The red, malodorous, sweat of the arm-pit is due to the presence 
which is found in the sweat, or massed in the form of zoogloea and 
adherent to the hair of. the skin, which it causes to become 
brittle. This microbe bears cultivation well at blood heat, on 
white of ^gg. In its growth it retains its original color, odor and 
microscopic appearance. 

In excessive and odorous perspiration of the feet and axillae, 
a variety of remedies will either sterilize or kill the microbe, 
almost incredible relief is at once experienced, and both the odor 
and sweating gradually disappear by bathing the parts with boro- 
glyceride solution, or a wash of peroxide of hydrogen. 



Sudden prostration from some shock ; a partial 

Syncope, suspension of vital power. 

{Faintmg.) Best treatment recumbent posture, one-drop 

doses of nitro-glycerine on tongue, head low, 

cold air; cold water dashed over the face and chest; smart 

beating hands, feet ; friction ; mustard plasters over the region of 

heart ; aromatic spirits of ammonia or brandy. 

If the syncope be due to or associated with anaemia or chlo- 
rosis it must be cautiously treated with brandy, ammonia and 
beef-juice, administered both by mouth and rectum. The recum- 
bent posture should be maintained until the action of the heart 
is nearly normal. 



consists of water, albumen, soda, chloride of sodium. 

Synovia phosphate of lime, a fluid to lubricate the joints, 

but one of the very best culture fluids for very many 

disease germs, especially the micrococci of scarlatina ; amylo- 

bacta of rheumatism ; bacillus of tubercle ; the syphilitic germ, 

and others. 

This joint-fluid is a most nutritious pasture field for those 
germs, affording them all elements suitable for growth and repro- 
duction. 



BACTERICIDES. IO05 

The micrococci of scarlet fever, when oxygen is deficient in the 
blood, take to the joint water, where they can receive nourishment 
and protection more frequently than is generally supposed ; it 
goes there alone and has neither identity nor affinity for any 
other microbe ; it may possess eccentricities, but it alone is the 
cause of the joint-lesion. It is impossible to describe or state 
the time of migration, or joints affected, but smaller joints, as the 
fingers, wrists, etc., in which the synovia is richest, and pink 
marrow abundant, are those generally affected. 

The synovitis caused by the presence of the micrococcus of 
scarlatina in the synovial sacs, and other white fibrous tissue, in 
which it breeds, evolve spores and ptomaines, should invariably 
be treated by the local application of bactericides, as concentrated 
ozone, sulphur, ozonized tincture of iodine, iodoform, iodized oil, 
or some of the essential oils, menthol, thymol, etc. 

The bacillus amylobacta of rheumatism germinates most actively 
in the larger joints ; it is an active germ, leads to an accumula- 
tion of effete material in the system. Occupies joints in which 
pink marrow is not so abundant, therefore in its immediate results 
is not so productive of anaemia ; the excretion of ptomaines are 
considerable, hence the joint pain is usually great. 

The treatment same as rheumatism, with local bactericides. 

Uie favorite location of the tubercular bacilli in joints is 
around the cartilaginous ends of the bones, and the joints selected 
are the knee, hip, wrist. (See Tuberculosis?) 

The syphilitic and other germs often localize in the joints. 



A term used to distinguish peculiar or- 
Temperaments. ganizations of the body in different indi- 
viduals. 
It is customary to arrange them in four principle groups. 

1. The sanguine temperament, characterized by plumpness of 
body, fair or red hair, blue eyes, a soft, thin skin, active circula- 
tion, and a full, quick pulse. 

2. The phlegmatic temperament is distinguished by a round 
body, soft muscles, fair hair, pallid skin, and slow, languid circu- 
lation and pulse. All the functions, mentally and bodily, are 
torpid. 

3. The bilious temperament, known by firmness of muscle and 
flesh, defined sharp features, black hair and dark complexion, a 
full, firm, and moderately quick pulse. 

4. The nervous temperament, characterized by a small spare 
frame, quick, impulsive movements, and a delicate constitution ; 
the pulse is small and weak, and easily excited ; the whole nerv- 



IOo6 DISEASE GERMS. 

ous system is susceptible, the thoughts quick and imagination 
lively. 

Some physicians place great reliance on the indications of 
temperament in the treatment of disease, and find that those who 
possess a sanguine temperament are m©st liable to acute inflam- 
matory diseases ; the phlegmatic inclining to scrofulous com- 
plaints; the bilious to affections of the liver and digestive organs; 
and the nervous to mental disorders and diseases of the nervous 
system generally. 



A microbial disease of great intensity, capable of 

Tetanus, destroying .life in either a few hours or from three 
to five days, patient conscious but in a state of rigid 
spasm, said to be idiopathic or traumatic, whichever it is a spe- 
cific contagious disease, due to the action of a specific virus, 
which exists in the tissues at the seat of infection in the blood 
and in the central cerebro-spinal nervous system. 

The conclusions arrived at with reference to the origin of 
tetanus, is that it is an earth poison, or microbe. 

I. Tetanus is transmissible, not only between animals of the 
same or different species, but also from man to man and from 
man to animals, and vice versa. 2. The demonstration is estab- 
lished as regards solipedes. 3. The contagion from horse to 
man may be made directly or indirectly, the latter being most 
frequent. 4. Intermediate agencies, whether in prolonged or 
slight contact with a tetanic horse, receive without destroying the 
poisonous element, consequently enlarging the sphere of infec- 
tion. 5. Living beings may serve as the means of transmission 
without being themselves affected, but are constantly in danger 
of traumatic auto-inoculation. 6. A wounded man may receive 
infection of tetanus from surrounding objects, but of all these 
the horse and all his belongings are the most dangerous. Next 
in order is cultivated ground and its products. 7. The earth case 
acquires tetanic virus when contaminated by a tetanic horse. 8. 
Statistics show that tetanus occurs most frequently among those 
persons whose calling brings them in contact with horses — that 
human tetanus is parallel with equine. 9. The equine theory is 
confirmed by a majority of facts. 

In view of the experimental evidence which we possess at 
present and of numerous unassailable observations of many sur- 
geons and veterinarians, there seems to be ample warrant for the 
admission that not infrequently tetanus in man is acquired di- 
rectly and indirectly from some of the domestic animals which 
surround him, notably the horse, and also from newly cultivated 
ground. 



BACTERICIDES. jqq-t 

When this microbe enters the body, it is by the nerves, and 
makes directly, as if by magic, for the medulla oblongata and its 
membranes, where it breeds with amazing rapidity. The germ is 
contained in the medulla and spinal marrow, and spreads along 
the cord, being strengthened in its progress, and grows more 
intense all the time. 

Such an active microbe breeding freely, with a deadly ptomaine 
excreta, even greater than rabies, runs along and implicates all 
nerves in connection with the medulla and cord ; first the micro- 
bial chain traverses the nerves that supply the muscles of the 
jaws and throat, they become rigid, fixed with the mouth firmly 
closed, giving what is termed trismus^ or lock-jaw. As the 
microbial colony spreads, descends the spinal cord, the muscles 
of the face, throat trunk and extremities become involved in the 
spasmodic contraction. Angles of mouth drawn outward and 
upward ; muscles of neck, back and abdomen, hard, tense, con- 
tracted, and from time to time violent contractions occur. Spasms 
never entirely cease, except in some cases during sleep ; aggra- 
vated every quarter of an hour or so, increased, cramps lasting 
for a few minutes and then partially subsiding. When the nerves 
that supply the strong muscles of the back are most implicated 
or affected, they draw or bind the body in the shape of an arch, 
the patient resting on the occiput and heels, which is called opis- 
thotonos. If the nerves that supply the anterior or front muscles 
of the body are weakened by any cause, the irritation may ex- 
hibit or spend itself there and thus bend the body forward by 
strong contractions of the muscles of the neck and abdomen ; 
this is called emprosthotonos. If the nerves that supply the mus- 
cles on either side be affected or weakened, the irritation may 
spend itself there and the body be drawn sideways, which has 
been designated pleurosthotonos. By and by, the nerves that 
supply the involuntary muscles become affected. Frightful suf- 
fering, caused by tetanic spasms ; face pale or as white as snow ; 
brows contracted ; skin covering forehead corrugated ; eyes fixed 
and prominent, sometimes suffused with tears ; nostrils dilated ; 
corners of mouth drawn back ; teeth exposed and features fixed 
in a grin — ristis sardonicus. Respiration performed with diffi- 
culty and anguish ; severe pain at the sternum or pit of the 
stomach ; great thirst, but agony increased by attempts at deglu- 
tition; pulse feeble and frequent; temperature very slightly 
raised ; skin covered with perspiration ; patient cannot sleep, or 
ii he does, it is only for a few minutes at a'time. In spite of all 
the suffering the patient's intellect remains clear and unaffected. 
It terminates either in death or recovery, or by a breaking up of 
the spasm into chronic, from which, with proper management, 
recovery is almost certain. 



IOo8 DISEASE GERMS. 

The duration of an acute attack is usually between three and 
five days, death taking place partly from suffocation, partly from 
exhaustion. It is very easily recognized by its history and 
symptoms, the absence of fever, the clearness of intellect and the 
continued spasm. No other disease like it. The appearances 
after death are great serous effusion in ventricles of brain, around 
the spinal cord ; the whiteness of skin and laceration of muscles 
by the spasm is also present. 

In the serous effusion around the medulla oblongata and 
spinal are to be found the bacillus of tetanus. 

Rods, very fine, like thread forms, mostly collected in irregular 
masses, with characteristic spore formation. 

Inoculation of garden earth subcutaneously into rabbits in- 
duces tetanus. The baciUi found in their blood is Identical with 
the microbe in man. 

The germ is pathogenic of the disease, bears cultivation well, 
and is as active after several generations of culture as in its primi- 
tive state. Pre-eminently contagious and in- 
fectious, it has an uncertain period of incuba- 
tion, depending upon the status of vital force 
of the inoculated. Cases occurring twenty- 
four, thirty-six or forty-eight hours after injury 
rarely survive the third day, but comparatively 
few are lost when it comes on the ninth or 
eleventh day. 

The excretion of ptomaines is most active in and around the 
medulla, decth often takes place from them before they have 
time to enter the blood. 

As tetanus has thus been clearly shown to be a disease due to 
the presence Of a pathogenic bacillus, its curative treatment de- 
pends almost exclusively upon the administration of bacteri- 
cides, but before any drugs can be given the spasm must be 
relaxed. For this purpose move the bowels freely with com- 
pound powder of jalap and senna with one drop of croton oil. 
Apply at once the galvanic cautery at a white heat every three 
quarters of an inch on both sides of the spine, from the nape of 
the neck down about ten inches. After its thorough application, 
poultices, composed of equal par<-s of flaxseed meal, pulverized 
lobelia and stramonium should be applied as hot as can be borne 
and changed every three hours. While this is being done, an 
effort must be made to relax the spasm, as the recovery of the 
patient depends upon that. For that purpose, take one heaped 
teaspoonful of lobelia seed, fresh crushed, one teaspoonful of the 




BACTERICIDES. lOOQ 

fresh plant of lobelia, one tablespoonful of American valerian, 
and one tablespoonful of pulverized capsicum ; place all in half 
a pint of brandy, shake well, let it settle a few minutes, then 
begin to give a teaspoonful every few minutes until the spasm 
relaxes. If there is a hot bath handy, put the patient in it (97° 
Fahr.) Throw in the bath a pound of lobelia, and while in the 
bath enemas of a strong infusion of lobelia should be given. The 
lobelia, by the stomach, bath and rectum should be pushed to 
thorough relaxation of spasm, avoiding emesis if possible. If 
there are no facilities for a hot bath, then cloths wrung out of a 
decoction of lobelia should be applied to chest, abdomen, thighs. 
Half an hour is sufficient for the bath, but if cloths are applied 
they should be constantly used, keeping them hot and moist. If 
spasm breaks, the case may be considered pretty safe, if well 
managed, and the proper bactericide administered. 

The dioxide of hydrogen is the germicide combined and 
alternated with sumbul and bromide of potassa. Other germi- 
cides might the tried, as resorcin, sozoiodol, concentrated ozone, 
etc. ; sulphur water ozoned ; par-aldehyd, etc. 

The lobelia, antispasmodic, must be still persevered with in 
small does, and small doses of calabar bean added to it. 

If there be a wound, a scratch, an abrasion, or laceration, from 
a rusty nail, with the microbe from the earth or from something 
in use near a horse, it should be attended to ; all irritating parti- 
cles should be removed and the wound sterilized ; the nerve, if 
lacerated or torn, might be divided, and poultices of either creoline 
or naphthaline, or ozonized jequirity applied. Otherwise, treat on 
general principles. It is folly to think either of dividing the 
nerve high up in the limb, or amputation, for once the microbe 
reaches the medulla (vital force slightly impaired) it will breed in 
the nervo-vital fluid and cause the disease. 

Spasm well broken, and microbicides administered, acro-nar- 
cotics, like belladonna, conium, might be tried. 

Inhalation of ether, chloroform, hypodermic injections, alka- 
loids of opium, chloral, are decidedly hurtful and likely to cause 
death. 

Infantile tetanus, or as they are sometimes termed, nine-day 
fits, occur in infants after birth, from cutting of the cord with 
scissors which had been on the ground or earth, or old linen 
rags, trichinous lard, etc. Great care is necessary to guard the 
new-born from cold, foul air, poisoned lard to skin, imperfect 
cleaning of sebaceous secretion, retention of the meconium. Cord 
should in all cases be properly cared for, never left in the hands 
of an ignorant nurse. 

Puerperal tetanus often makes its appearance during and subse- 

64 



10 lO DISEASE GERMS. 

quent to labor. Pressure of the fcetal head on the sacral plexus 
of nerves is said to be the common cause, true of an irritation 
transmitted to the medulla oblongata, but the disease is most 
common in spring and fall, when the accoucheur for pleasure is 
occasionally working in his garden or with his horse. Here we 
have all the symptoms of the disease; the peculiar germ-laden 
medulla ; the germ excreting ptomaines, the tetanine irritating 
motor nerves, which supply the muscles, causing rigid spasm. 

In our diagnosis it must not be confounded with ansemia or 
hyperaemia of the brain, which are very common. 

The mode of management here is to deliver quickly and pur- 
sue precisely the same treatment as one of general tetanus. 



The coagulation of blood in the heart or 

Thrombosis, blood vessels during life, is predisposed to 
by malaria, carbonaceous food and drinks, in- 
door life, sedentary habits, non-aeration of the blood, breathing 
deleterious gases, germ-laden air with sewage, pregnancy ; such 
drugs as ergot. 

The blood thick, clotty, is prone to attach itself to some neo- 
plasm, some calcareous body on its inner lining of the vessel, 
some atheroma, or some weakened or inflamed patch, or dilated 
vessel ; agents that will slow the heart's action, hasten the co- 
agulation. 

The nature of the clot is most variable ; the coagulated fibrine 
may fill the vessel, and the thrombosis may be uniform ; the 
blood may coagulate along the inner walls of the vessel only, 
flowing freely in its centre. 

When once formed it may organize or undergo shrinking, 
softening or suppuration. 

The symptoms will depend upon its location, the size of the 
vessel and the amount of clot ; for example, when the blood in 
the femoral vein is clotted it gives rise to phlegmasia dolens ; 
thrombosis of the cerebral vessels gives rise to special phrenic 
symptoms ; clotting of the blood in the vessels of the lower ex- 
tremities gives rise to anaemia, necrosis, hemorrhagic infarction, 
dry or moist gangrene. 

IVi the treatment of thrombosis, rest, abundance of fresh air, 
alkaline bathing, friction or massage, with stimulating liniments ; 
internally a judicious use of alkalies in alternation with belladonna 
and general treatment for embolism. 

Precautions. — As nearly all the new coal tar preparations, as 
exalgine, antipyrine, antifebrin, salol, etc., cause thrombosis, 
great care must be exercised in their administration. 



BACTERICIDES. 



[Oil 



In structure the tongue consists essentially of 
Tongue, muscular tissue covered by mucous membrane. The 
muscular fibres, omitting those of muscles inserted 
into the organ, are arranged in two horizontal and several verti- 
cal layers, the former set lying immediately underneath the mu- 
cous membrane, and the latter passing vertically from between 
the horizontal layers, leaving intervals which are occupied by 
gland structure. The mucous membrane is furnished with pa- 
pillae. I. The circumvallate, which are a dozen or so in number, 
and are arranged at the base of the tongue like an inverted V; 
these papillae are greatly concerned in taste, and are supplied by 
the glosso-pharyngeal nerve. 2. The fungiform ; these are scat- 
tered over the tongue, and are specially observed at the sides and 
tip. 3. The conical or filiform, are distributed all over the 



tongue. 



The tongue is divided into two 



symmetrical halves by a fibrous septum, 
the existence of which is marked by a 
raphe in the median line. 

Diseases, — Tongue-tie is a condition in 
which the fraenum, or fold, seen on the 
under surface, extends to the tip, and ap- 
pears to tie the organ down to the un- 
derlying structures ; its division, by means 
of a pair of blunt-pointed scissors, readily 
remedies the defect. 

Inflammation of the tongue (glossitis) may 
be caused by wounds, or stings, or by the 
application of some acrid substance ; occa- 
sionally it comes on without any apparent 
cause. If the symptoms are not peculiarly 
urgent — i. e., if there be no great pain or 
swelling, or threatening of occlusion of the 
fauces, a leech or two under the jaw, and a 
smart purgative, usually afford relief If 
the inflammation be very sudden, its pro- 
gress rapid, and suffocation threaten, then a few longitudinal 
incisions should be made on its surface to allow of the escape 
of fluids. In very severe cases, where these measures afford no 
relief, and the symptoms are very urgent, tracheotomy must be 
performed. Glossitis is sometimes brought on by the excessive 
use of mercury; the treatment in such cases consists of purga- 
tives, astringent lotions, and careful bandaging of the organ, and 
full doses of chlorate of potash internally. 

Ulceration. Ulcers of the tongue may have their origin from 
several causes, either from local irritation, such as decayed teeth, 




The upper surface of the 
tongue showing the papilla, 
and the dorsum on which 
disease germs localize. 



IQJ2 DISEASE GERMS. 

or from some derangement of the digestive organs, in fevers, or 
from syphilis, or from the prolonged and mal-administration of 
mercury. In all cases there is a marked foulness of breath. The 
constitutional treatment of course varies with the case, and re- 
moval of all obvious irritation, attention to the bowels, and lo- 
cally the application of a solid stick of lunar caustic, the sucking 
a few crystals of chlorate of potash, and in syphilitic ulceration, 
the application of a little calomel powder diluted with flour, are 
about the best remedies. Those connected with microbe of syph- 
ilis are the most intractable, and frequently defy all treatment. 
Malignant ulcers of the tongue are epithelial in their character, 
and their development is frequently ascribed to local irritation, 
such as a sharp stump of a tooth, the habit of smoking short clay 
pipes, etc., but such causes are very questionable. The margins 
of such ulcers are composed of hard granulating masses, impli- 
cating the substance of the tongue, and ultimately involving the 
glands at its base ; under the jaw and in the neck they are at- 
tended with great pain, and are usually deeply excavated. The 
prognosis in these cases is very unfavorable. The treatment is 

very unsatisfactory, and consists in 
removal as the only chance for the 
sufferer. 

Enlargement (hypertrophy) occurs 
in young persons, and is nearly 
always congenital. The tongue pro- 

Organisms found in the human mouth, trudcS frOm the mOUth, bcCOmCS 
almost invariably present. _ • i i i 

ulcerated from contact with the lower 
teeth, and there is a constant dribbling of saliva. The treatment 
consists in attention to the state of the digestive system, ban- 
daging the organ, and astringent lotions. In cases where this 
'-reatment is of no use, removal of a portion, or the whole of the 
protruded part, must be performed. 

Tumors in connection with the tongue are sometimes met 
with. Of the most frequent occurrence is ranula, to which a 
special article is devoted. (See Raniila.) Encysted tumors, 
closely resembling ranula, fatty tumors, and naevi. 

The ducts of the salivary glands, the parotid, and submaxil- 
lary, are sometimes the seats of concretions composed of phos- 
phate of lime and animal matter, oval in shape, of a brownish or 
yellowish color, and of variable size, sometimes being as large as 
a small ^^^. Occasionally they come away of their own accord 
by ulcerating through their confines, but their treatment consists 
in their removal by the knife and forceps. 

Wo?mds of the tongue almost always bleed very freely ; in slight 
cases, iced water, or styptics, will arrest the hemorrhage or occa- 




BACTERICIDES. 



013 



sionally a vessel may be tied, or pressure may be kept up by a 
pair of common forceps, the blades of which are kept together 
by an elastic band. The edges of a severe cut or laceration 
should be approximated with sutures. All pain, swelling, etc., 
should be allayed by iced drinks, and astringent and disinfecting 
gargles or washes. 

The tongue is a most valuable index of the state of the stom- 
ach, bowels, liver, kidneys, etc. 

In the mouth, but especially on the tongue, are to be found al- 
most every pathogenic microbe. 

By taking the mucus, or coat, and placing it under a micro- 
scope, we see the sarcincs ventriculi of gastric catarrh ; the 
bacillus of typhoid fever; the micrococcus of measles, scarlet 
fever and variola, are all 'to be found on 
the tongue. The bacillus of tubercle 
and amylobacta of rheumatic syphilis, 
cancer, are invariably found on the dor- 
sum or root of the organ. Even simple 
mal-assimilation can be detected in the 
myriads of bacteria and oidium albicans 
present. 

The physician of the future will not 
only tell that transverse cracks and fis- 
sures mean intestinal irritation from Different forms of the baciiius 

. , - , amylobacta found in the 

microbes or parasites, but what those momh and tongue in rheu- 

really are ; that elongated papillse at matism. 
root or edge, are the starved-out crepta syphilitica seeking nu- 
trition. 

The frequency with which bullous erythema and hydroa at- 
tack the mucous membrane of the mouth, especially the lower 
lip and cheek, is one of the characteristics of these diseases ; 
whether they ever also attack the mucous membrane of other 
parts of the alimentary canal is, I think, doubtful. No doubt, 
however, exists on this point with regard to pemphigus, for the 
disease not only attacks the mouth and vagina, but also the 
whole of the large bowel except the lower part of the rectum ; 
this has been placed beyond doubt, not only by general symp- 
toms and dysenteric diarrhea, but also by the results of post- 
mortem examination. (See Pemphigus). 

Urticaria is especially liable to attack the mucous membrane 
of the throat, producing sometimes most alarming symptoms, 
with great dyspnoea and difficulty in swallowing. Violent 
symptoms of gastric irritation are also not very uncommon in 
cases of acute urticaria. 

In our present state of microbial surroundings, the human 




I0I4 DISEASE GERMS. 

mouth should be kept aseptic by .washing it out with a few drops 
of the tincture of the soap tree bark, and dioxide of hydrogen ; 
or some anti-microbe powder, added to a little water; boro- 
glyceride also is excellent mouth wash. A very favorite anti- 
septic gargle consists of thymol ; benzoic acid ; eucalyptus, 
added to water. 



In quinsy, so called in various 
Tonsils, the forms of irritation of the tonsils, from 

abode of Pathogeniq inflammation to hypertrophy, there 
Microbes. is found in addition to the ordinary 

bacteria of mal-nutrition, the bacillus 
of tubercle and syphilis, the streptococcus of diphtheria, the mi- 
crococci of scarlatina and variola, a special pathogenic microbe 
of quinsy. Requires bactericides ; exalgine for fever. 

Chlorate of potash alone, or in combination with hydrochloric 
acid in the form of gargles, or taken internally, is so often disap- 
pointing in the treatment of enlarged tonsils that better means 
are desirable. The disease is of parasitic origin. Whilst the 
harmless, if not very active boroglyceride has pretty well dis- 
placed the chlorate in domestic practice. Then salicylic acid 
was used, and with excellent results when appHed judiciously. 
In the form of gargle it is least satisfactory, and often fails to 
reach the affected surface ; a spray of glucozone is better, but to 
use that effectually trained hands are needed. 

The best and simplest rnode is to apply the powdered acid 
directly by means of a rather large camel's hair pencil, which 
may be slightly moistened. In this way it is brought directly in 
contact with the diseased surface, and but {(t^^ applications are 
necessary. And it may be used with very young children after 
a little coaxing. 

When the tonsils are covered with a thick mucous coating, 
which may be diphtheritic, it is necessary to previously remove 
it, and the following liquid, to be also applied with a brush, acts 
extremely well : 

Pepsine, thirty grains ; dilute hydrochloric acid, one drachm ; 
water, five drachms ; glycerine, four drachms. 

The coating is quickly dissolved (digested) in this solution. 

Besides applying the acid locally, it is advisable to give it in- 
ternally .at the same time, thus : 

Salicylic acid, thirty grains ; mucilage of acacia, one ounce ; 
simple syrup, half an ounce ; water, four and one-half ounces. 
Mix. A tablespoonful every two hours. 

In the more chronic forms it is well to pencil the tonsils over 



BACTERICIDES. 



015 



with tannin, fifteen grains ; ozonized iodine, two drops ; glycer- 
ine, five drachms ; water, one pint ; or it may be used as a 
gargle still more diluted. 

For the prompt dispersal of threatened quinsy, apply with a 
brush three times a day, the following solution : 

Tannin, fifteen grains ; ozonized iodine, three drops ; carbolic 
acid, half a drachm , glycerine, five drachms ; water, two and 
one-half ounces. 



Invariably the result of disease germs, either 

Toothache, the microbe of dental caries, or the amylobacta 

of rheumatism, the former going for the body 

of the tooth, the latter for the fang. There are numerous 

others, one especially which forms lactic acid in a substratum 

containing sugar or starch. The salts of calcium in the sub- 



Do, 






^ 



Sn 



•.-• 



\l 




/? 







Bacterium of dental caries. Bacterium of dental caries as 

seen in the dentine of spon- 
taneous caries; as seen in 
tissue-starved teeth from 
precocious brain evolution. 

stance of the tooth are dissolved by the excreted acid, and the 
micrococcus is thus constrained to force its way into the tooth ; as 
more and more of the calcium is used up in the tubuli of the 
dentine of the tooth and ultimately spreads through and destroys 
the tooth. ] 

The microbe of dental caries is due to a degradation of the 
dentine, predisposed to by a want of phosphates, in the blood 
and brain of tissue-starved precocious children, imperfect nutri- 
tion; the presence of heat and cold, and of sweets, with the for- 
mation lactic acid in and around the tooth, add to the progress 
of microbe growth. 

The microbe of dental caries is a polymorphic micrococcus, 
the chains and filaments being but different phases of the same 



10 16 DISEASE GERMS. 

germ. Deposited in and around sound teeth, the germ will con- 
taminate the most healthy, and induces caries. 

The microbe bears culture well in beef tea and phosphates of 
lime, is pathogenic, for the injection of the germ into animals 
gives rise to caries of the teeth. 

The germ is sterilized by the microbe powder ; by soap tree 
bark and resorcin ; by peroxide of hydrogen. 



This term is used to designate a state of body 

Tubercular in which the tubercular bacilli is being con- 
Bacilli, stantly evolved in the blood. The disease germ 
tubercular bacilli is simply a change or an altera- 
tion, or degradation of the embryonic or primary elements of the 
blood. The precise method of degradation is unknown, but all 
states inimical to a high standard of vital force are productive 
of it. 

The primary cause is some inherent defect, or depreciation of 
the nerve centres, especially of that portion which presides over 
organic life and the elaboration of the blood, some adverse state 
either within the body or out of it, which causes the degradation 
of the primary molecule or cell into a disease germ, which when 
once formed is capable, either in the blood and tissues, or out of 
the body if in a nutrient menstruum, of a new and independent 
existence, with endless, nay prodigious power of reproduction to 
multiplication. 

The causes that bring about the defect of the nerve centres, 
this vital deterioration of the human race are very varied, races 
are distinct, therefore are incompatible, just like age and tempera- 
ment ; the use of alcohol and tobacco ; vaccination, isolation, 
monotony, or sameness; vice, immorality, debasing literature; 
deleterious trades, as factory labor; operatives in lead, phos- 
phorus, mercury ; masturbation ; drastic drugs ; meagre, un- 
wholesome and insufficient food ; insanitary surroundings ; ab- 
sence of sun light ; contaminated water, or water loaded with 
sewage ; drinking snow or ice water ; disease, or irritation in the 
body reflected to the nerve centres ; reflex emanation, or assimi- 
lation of morbid states; city life or overcrowding; immoral 
amusements. 

Observation and experience confirm the fact that the children, 
the product of two distinct, opposite antagonistic races are all 
tubercular ; individuals identical in temperament, the same in all 
physical and mental traits, are really consanguineous, and their 
union is equivalent to in-and-in breeding offspring highly tuber- 
cular. In a series of observations of the brains of drunkards. 



BACTERICIDES. 



IOI7 



decided effect in depreciating 



tobacco users, monotonous, or isolated persons, there was noted 
a general coalescence or obliteration of typical fissures of thought, 
a state present in hereditary insanity, epilepsy, idiocy, and other 
low types of the human brain, the offspring of all such are tuber- 
cular, and notably of a brain type. Vaccination directly from 
the heifer, or drinking the milk of cows may convey the tuber- 
cular bacilli direct, as two-thirds of all domestic animals are 
loaded with this disease germ. 

The vitalizing effects of virtue and morality, the depreciating 
effects of vice and immoral literature, produce their reward : in 
the former, health ; in the latter, tiiberculce. The absence of sun- 
light ; the isolation of the sexes, solitary confinement, drinking 
water laden with disease germs; insanitary states and other de- 
fects of modern civilization have a 
vital force and causing tuberculcE. 

The children, or progeny of all 
operatives in lead, mercury, phos- 
phorus, tobacco, cotton and 
woolen factories are tubercular. 
The loss of important secretions, 
as in masturbation, render all 
the outcomes tubercular ; re- 
flected irritation operates keenly 
in children, such as teething, 
worms, gastric catarrh, every- 
thing that has a lowering, or 
levelling, or pruning influence 
may be enumerated as a cause. 

The tubercular bacilli as seen 
in the blood and during cultivation, consists of rods, occasion- 
ally long, very thin, and rounded at the ends. They are both 
straight or curved, and frequently beaded ; occur singly, in pairs 
or in bundles. They are found in the cells of tubercles, espe- 
cially in the interior of giant cells. Propagate by spore for- 
mation. 

A tubercle bacillus consists for the most part, ot a very deli- 
cate sheath, with protoplasmic contents which have a great ten- 
dency to be broken up, or coagulated into little segments or 
roundish granules. 

The best medium for cultivation is solid blood serum of cow 
or sheep, with or without the addition of gelatine. The most 
favorable temperature for their development is 98° F. They grow 
slowly in cold latitudes. 

The bacilli are found in all tubercular deposits of man, ani- 
mals, and birds. The bacilli can be detected in the sputum and 
excretions. 




Bacillus tuberculosis in the blood. 



IOi8 DISEASE GERMS. 

Strictly contagious and infectious ; food, such as milk, flesh- 
eating, inhalation, close contact ; the bacilli or their spores are 
inhaled from the air, or taken in with food, find ingress by the 
pulmonary or intestinal mucous membrane. 

Morphologically identical bacilli are seen in lupus, tabes, etc. 

The tubercular bacilli is pathogenic of all forms of tubercular 
disease, its inoculation into animals reproduces the diseases, and 
vice versa into man. Ptomaines excreted give rise to fever, diar- 
rhea, and other symptoms. 

Individuals having these microbes of tuberculae in their blood 
and tissues, can communicate it to all with whom they come in 
contact, that is, it is contagious and infectious ; this fact is indis- 
putable. 

When once this constitutional deterioration has been acquired, 
the peculiar type of deterioration can be transmitted to the off- 
spring, and thus become hereditary, as well as acquired. 

There can be little doubt from the peculiar characteristics of 
the tubercle bacilli in those affected with it, that not only the 
blood but the breath is germ-laden, and it is this breath which is 
the principal means of spreading the disease. 

Nearly seventy-five per cent, of all cows and other domestic 
animals are also tubercular, man imparts his germs to them and 
they to him by their breath, exhalations, milk and flesh. 

A human being may live along to a good old age, his blood 
and tissues loaded with the tubercular bacilli, with a very feeble 
vital force, and unless there be some local weakness, some par- 
tial death, the germ growth may not be apparent, but let some 
organ or gland be damaged or weakened, the germ will, by ex- 
osmosis, pass through the walls of the vessels, deposit itself in 
the devitalized part and grow with the greatest activity. In this 
manner, the bacilli of tubercle find their way in or on the mem- 
branes of the brain in infants, who have received falls, blows, 
shocks, giving us tubercular meningitis ; lesions of joints ; ivhite 
swelling; coxalgia ; an inherent weakness of bones due to 
starchy food and absence of phosphates, rickets ; a feeble mesen- 
tery, due to diarrhea or cholera infantum, the bacilli tuberculae 
will localize in the mesentery, giving rise to tabes mesenterica ; if 
living structure is feeble or damaged, microbes will localize there, 
giving rise to pulmonary consumption. 

Although this diathesis is extremely common, seventy-five 
out of every hundred being affected, there is no immunity or 
protection against it except to maintain the highest standard of 
health possible. Although it is essentially a most contagious 
malady, transmitted from parent to child, from husband to wife, 
blended and interwoven through society at large, still it is in- 



BACTERICIDES 



IOI9 



capable of establishing a morbid race, which is an utter impossi- 
bility, the evil curing itself by non-procreation. 

When tubercle escapes from the blood through the walls of 
vessels that have lost their contractility, it appears under the 
microscope to consist of small round cells or cysts, imbedded in 
a cellulose membrane, and it can be seen growing like other 
germs by a proliferation from the walls of the nuclei. If the 
mother cell or cyst be squeezed lightly between two pieces of 
glass, so as to rupture it, in its contents can be detected millions 
of minute tubercles, their mode of life, progress, death, or de- 
generation depending upon their number, character of tissue, or 
structure in which they are effused, and the amount of partial 
death present in the part ; all influence or modify the progress 
and vitality of the germ. From the degraded cell or mother 
germ, the growth is by a budding or duplication, and when it 
dies, either from age, want of nutrition, or some adverse state, 
its albuminoid* contents become first milky, then cheesy, then 
calcareous, and in any of these three stages it may break down 
and be thrown off or absorbed. Its color may be influenced by 
particles of coloring matter in the air or food. Its ultimate de-. 
generation is phosphate of lime. 

Symptoms. — As these germs eat up the pabulum, the liquor 
sanguinis of the blood, there is always great debility, indigestion, 
torpid liver, defective pancreatic secretion, paleness and white- 
ness of the skin, general feebleness, with rapidity of pulse. The 
debility and loss of flesh are progressive, correspond with germ 
evolution, for as vital force grows more and more feeble, tuber- 
cle bacilli make a rapid growth, temperature rises. The devel- 
opment and growth of the microbe is favored by all and every 
condition which is inimical to a high standard of vitality. The 
part in which the bacilli are exosmosed from the blood, invari- 
ably suffers some depression. Generally there is a dryness of 
the hair, puffiness of the face ; swelling of the lips and nostrils ; 
purulent discharge from the ears ; vesicular eruptions about the 
head and orifices ; enlargement of tonsils, and glands of the neck, 
and throat; often fetid odors from the axillae, groin, feet ; en- 
gorgement of any gland with the bacilli will give rise to special 
symptoms of tubercular growth, fever, increased pulse, with some 
impediment of structure. If the blood is charged with those 
microbes, a migration into a weakened structure will take place 
at any period of life, although from three to fifteen, or from 
eighteen to thirty, are the critical periods, ages when the system 
can least resist depressing influences. 

The state of nervous bankruptcy, the blood germ-laden with 
the tubercular bacilli, does not seem to be antagonistic to high 



I020 DISEASE GERMS. 

intellectual culture, or gigantic mental attainments, but those 
possessing this diathesis are incapable of long, persevering 
efforts. 

To prevent the development and transmission of tuberculosis, 
no diseased person should be permitted to marry, and State en- 
actments should be made forbidding opposite races, or persons 
identical in temperament, from marrying. Great care taken of 
mothers, no drain or strain on their physical and intellectual 
resources, especially during pregnancy or lactation. Strictest 
attention paid to the infant's food, quality of milk, clothing, and 
air it breathes. Avoidance of all insanitary states, as bad venti- 
lation, ill-drained or damp houses. No tubercular mother should 
be permitted to nurse her child. An avoidance of all that tends 
to deteriorate, as sexual ex:cesses, bad food, or imperfect diges- 
tion. The diet should be of the best and blood-manufacturing ; 
dress, exercise, repose, and association, should be looked after; 
the function of skin and bowels to be aroused, the powers of di- 
gestion increased and everything done to increase brain vigor, 
correct faulty nutrition and promote the formation of healthy 
blood. 

As to the cure of tuberculosis, v/e would merely state, that 
all cases are curable before it has taken up a local habitation, 
except those cases due to a mixture of races ; for these there is 
no hope, as no sanitary arrangement, no amount of bathing, 
no kind or quality of food, no climate either on sea or land, 
and no known drug or method of trestment that can stamp it 
out — it is indelible. To cure it, we must resort to every means 
of restoring or building up vital force, and the germ must be 
annihilated in the blood, as no living disease-germ, can be 
eliminated. 

Digestion, assimilation and secretion merit our first attention. 
Daily bathing, using iodine freely in the water, temperature 
regulated by vital force of patient, followed by inunction of a few 
ouhces of olive oil into the body. Sleep should be prolonged 
to eight or nine hours, in harmony with the earth's magnetic 
law ; head of bed to north, foot to south, insulated by glass 
castors; clothing woolen, a good non-conductor and vitalizer. 
Diet varied, abundance of fresh, wholesome animal and vegetable 
food, embracing oatmeal, milk, cream, egg, boiled fish, beef, 
mutton, poultry, game, with abundance of bread and butter. 
As to location, one where there is an abundance of fresh air, 
pure water, and no insanitary surroundings ; free ventilation. 
Change is essential to a high grade of physical and mental vigor. 
The patient should be surrounded with a vitalizing, religious, 
and high moral atmosphere, and his reading, history or science. 



BACTERICIDES. J02i 

Medical agents to be used embrace two classes — one to 
strengthen, construct nerve power, restore lost vigor; the other 
to destroy a living disease-producing germ in the blood. The 
two classes of drugs should be administered alternately two or 
three hours apart, and changed weekly, as man becomes habitu- 
ated to any one drug long continued, it becomes in a great 
measure inoperative. 



Phthisis pulmonahs is due to 

Tubercular Bacilli in the tubercle bacilli depositing 

Lung Structure. itself either on the laryngeal 

(Pulmonary Consumption}) mucus, mucous membrane, or 

in the substance of the lung — 
the germ being a denizen in the blood prior to the lung damage 
which permitted its exudation. 

The tubercular diathesis must exist in the individual, either 
inherited or acquired. The typical form of depression of the 
nervous system v/hich gives rise to tuberculosis, to the degrada- 
tion of normal living matter or bioplasm into other living mat- 
ter, a disease germ is not yet fully elucidated ; suffice it to say 
that it is essentially a germ^ disease, and consequently is both 
contagious and infectious in the true sense of the term. 

Destructive changes in the lung may take place from other 
causes, other microbes, but their irritation there invariably modi- 
fies the nervous system reflexly, that the tubercular diathesis is 
created. 

In the glucose diathesis, and chronic alcohoHsm., states or 
conditions in which the blood and tissues are loaded with the 
sugar-fungus, the grape sugar so devitalizes or weakens the 
whole nervous system, besides irritating the large aerating sur- 
face of the lower lobe of the right lung, in the imperfect combus- 
tion of sugar, that an intense tubercular diathesis is created, and 
the bacilli of tubercle effused into the irritated lung, pulmonary 
tuberculosis is the result. Patient does not die from diabetes 
proper, but from the microbe-smitten lung. 

Again, in pneumonia, the pathogenitic micrococcus of that in- 
flammation, not being annihilated between the microbe in the 
blood, its irritating action in the crypts of the lung tissue, the 
imperfect aeration of blood due to the germ-smitten congested 
lung speedily creates a tubercular diathesis, and tubercle are 
thrown out alongside the pneumococcus, and a destructive mi- 
crobe eating process is set up. 

Perhaps from a lift or strain, or from the inhalation of irritating 
noxious gases, or other causes, a small blood vessel might rup- 



022 



DISEASE GERMS. 



ture in a healthy individual, the blood congealing in the air cells 
will irritate, depress, the nerve centres, normal living matter will 
be degraded into other living matter — tubercle ; this will become 
deposited around the clot, and a germ-eating process established, 
and so with foreign bodies, solid particles in various occupations 
of life, as miners, grinders, factory operatives. Besides, the dis- 
ease germs of cancer and syphilis often set up an irritation. 

These, of course, are accidental cases, to which we simply 
refer. 

I^^/One thing is necessary; there must be a typical state ot ner- 
vous depression, which gives rise, under adverse condi'tions to 
vitality, a degradation of normal bioplasm, into a disease germ, 
or that state must be inherited or acquired in some way. Once 
the bacilli tubercle are in the blood, then all that is necessary is 
some irritation either in the larynx, or bronchi, or in the substance 
of the lung; when this state of irritation or debility is produced, 




p*-> ; 


.pi 


y^j% 


?igS 




-•4# 




. -3f 




r^»?% 




)' '";6.V> 


q 


w% 


% 


■^M ^' 




y^-^° P 




1) '"o 0, • 




\yl .■ 






W%f * 




i& 


'■i\ 



Acute tuberculosis, as seen around an air-cell. 




Acute tuberculosis. A small 
portion of the most exter- 
nal part of a yellow tuber- 
cle from the lung. 



a process very similar to inflammation is set up — congestion, ef- 
fusion in the weakened part; in the effusion there is the blood 
serum, lymph, and the bacilli. 

For the sake of convenience, it is well to divide pulmonary tu- 
berculosis into acute and chronic — the former when the bacilli are 
effused on the larynx or bronchi ; the latter when they are ef- 
fused into the substance of the lung. 

Acute phthisis pulmonalis commences suddenly, with slight 
rigors, fever, rapid pulse, dififlculty of breathing, cough, bleeding 
from the lungs, hoarseness, loss of voice, profuse sweating, diar- 



BACTERICIDES. 



1023 



rhea, rapid emaciation, tubercle being only effused on the bron- 
chial mucous membrane, called mucous or laryngeal phthisis. 
There is another rare acute form — lungs pretty clear, but mottled 
all over with tubercle, like grains of barley, chiefly in middle and 
lower lobe ; patient dies early in both forms from apparent ex- 
haustion. 

Chronic pulmonary phthisis. — This is a common form generally 
met with in the germ tubercle finding its way into the weak 
structure of the apex of the upper lobe of the left lung, spreading 
downwards on the apices of both lungs, and growing and effusing 
from above downwards. There is first effusion of tubercle in 
weakened structure, then growth, prodigious multiplication of 
germs, which soon interfere with passage of air into air-cells. 
Then nature desires to protect herself from the presence of those 
bodies; she excites less or more inflammation around them • 




Several alveoli are seen filled with 
debris ; in the centre of this are 
numerous nuclei, and amongst 
them the tubercle-bacilli. 



Tubercle-bac'lli interspersed 
through the lung structure. 



lymph is effused around the germ tubercle, and encloses or en- 
cysts it; and between the disease-germ and inflammatory pro- 
ducts, the lung becomes solidified in its substance, and does not 
permit ingress of air. After an indefinite period the germ dies, 
yields to the influence of adverse conditions, and is expectorated 
or absorbed either in its albuminoid, milky, or cheesy state, leav- 
ing a cavity in the lung. In more rare cases there -may be de- 
posit of tubercle in the middle of a lobe ; it may grow by aggre- 
gating other germs, or of its own innate property, and form a mass 
albuminoid, milky, cheesy, and finally calcareous, and break down 
and be expectorated, leaving a vacuum, cavity or cavern in the 
lung ; the formation of such a cavity is called a vomica. The 
germs of tubercle may be deposited in the nerve centres, sub- 
mucous coat of stomach and bowels, in mesenteric glands, liver, 
and kidneys. 



1024 DISEASE GERMS. 

The predisposing cause of pulmonary consumption is tht 
presence of tubercle in the blood ; the exciting cause is some 
irritation, as cold, damp, dust, foreign bodies, mechanical strains, 
lifts — any thing we can imagine that would weaken the vital ca- 
pacity of the bronchial mucous membrane or lung substance. 

Symptoms. — Languor, lassitude, debility, with increased heat ; 
respirations and pulse ninety to one hundred ; emaciation, pro- 
tuberant eye balls, clubbed nails, loss of hair ; cough at first dry, 
subsequently expectoration, difficulty of breathing, haemoptysis 
or spitting of blood, night sweats, hectic flush on cheeks, burning 
sensation in hands and feet, indigestion, loss of appetite, loathing 
of fatty articles, weakness of voice, hoarseness or loss of voice; a 
festooned appearance at reflected edge of gums, often diarrhea ; 
often a dull, aching pain in shoulder blades. The increase of 
heat and wasting bear a direct ratio to the germ growth and de- 
posit. When tubercle is deposited in the sub-mucous tissue of 
the bronchi, or on its free surface, symptoms are greatly aggra- 
vated, and bleeding from the lungs more common ; often slight 
congestion of liver and kidneys, so that urine often contains 
sugar or albumen. In women, cessation of the uterine function 
is common. As the case progresses, the debility, wasting, sweats, 
and other symptoms become worse and daily more marked. Di- 
arrhea, at first due to altered or acid secretions, is now dependent 
on the germs in the coats of bowels, and to ulceration about 
ilium and colon ; aphthae about mouth and the fauces ; tender- 
ness and oedema of extremities ; mental faculties usually remain 
clear until death. 

Now all the above symptoms are easily explained by the pres- 
ence of a disease-germ in that fluid. This germ may have lain 
quiescent for many years in the blood, ready to spring into activ- 
ity the moment conditions favorable for its growth should take 
place, and the pabulum adapte'd for its nutrition should be at 
hand. It is also true that if a high standard of health could be 
maintained by the affected individual, the germs would undoubt- 
edly die out. The tubercular germ in a state of activity uses up 
in its own nutrition, growth, and development the vital elements 
of the blood and tissues. 

The microbe wedged into a nook or corner, as seen in this 
illustration, after a time dies or else goes through various forms 
of transition, caseous, calcareous and then expectorated, leaves a 
cavity or vomica, as seen in this diagram. 

In some cases, where the vital forces are greatly shattered 
and the bacillus is making extremely rapid growth, the work 
or energy of the germ is so efficient as to make nests for the 
spores. 



BACTERICIDES. 



02$ 



The occupation of a patient, especially if there be dust inhaled, 
gives a coloring to the lung, the microbe and sputum are colored. 
This illustration shows the coal dust of 
the miner. 

T/ze predisposing causes of pulmonary 
tuberculosis are the presence of the 
bacilli, and there must exist in all cases 
a local weakness, which forms a predis- 
position, or germ bed ; this predisposi- 
tion is an impairment of the vital force 
of the part ; a state which favors germ 
growth. The soil in which the germs 
are implanted exert some influence on 
their growth. In all cases of pulmonary phthisis the quantity of 
germs on which the disease starts with is never very large, the 
vital tonicity of lung retards their growth, whereas if the lungs 
are weak they grow prodigiously fast. Every human being must 
have either inhaled the microbe tubercle from his fellow-man or 
swallowed it in milk or other food, and the reason we are not 
all affected is simply the fact that our vital force is good, we 




Miners' phthisis, with melanotic 
matter interspersed through- 
out the lung. 





Cavitities, or vomica in the 
limg, made by the tuber- 
cular bacilli ; showing 
lung structure eaten out. 



Diagram of infarction 
of lung tis-ue with 
tubercular bacilli. 



Nests of tuberc'e bacilli in the lung; 
acute form of phthisis pulmonalis. 



have not a suitable patch of weakness for their settlement and 
growth ; a lack of resisting power, with a local weakness, enables 
the microbe to thrive. 

The exciting causes are irritation of all kinds, cold, wet, inhala- 
tion of noxious gases, dust, mechanical violence. 

The effects of the presence of this microbe in the blood and in the 
respiratory tract are to eat up for its own nutrition all the vital 
elements of being ; the germ is pathogenetic, its tendency is ta 
destructive metamorphosis in lung tissue, and like all other 
disease germs the bacillus itself secretes a special ferment, which 
by certain changes gives rise to morbid action ; a cadaveric alka- 
loid whose very presence gives rise to volcanic disturbance, fever, 
diarrhea, sweats, etc. 

It is this alkaloid which is excreted by the tubercular bacilli.^ 

65 



1026 



DISEASE GERMS. 



which gives rise to very many of the symptoms of fever, hectic, 
diarrhea, sweats. 

The ptomaine of the tubercular bacilli is peculiar in its toxical 
effects. 

Morbid Anatomy. — Human beings and domestic animals in a 
state of normal existence placed in or under states adverse to the 
maintenance of a high standard of health have the primary 
elements of th- ir blood altered, changed, degraded into the 
disease germ tubercle, which floats in the circulation and passes 
by exosmosis through the walls of the bipod vessels in weakened 
parts of the body. From this germ-laden blood it is thrown 
out or passes through in an albuminoid form, as seen in the 
annexed cut, aggregated together in round masses by the law of 
affinity, and goes through a process of 
fecundation, growth and death — being 
first albuminous, then cheesy, latterly 
calcareous. When those degraded ele- 
ments are in the blood they are capable 
of pas-ing out of the body by the breath, 
saliva, sweat, urine and alvine evacuations 
and propagate the disease tuberculosis, 
(fP li'^^^P^^^ ® & by contHgion and infection; besides 
**3 ©k;t3^i^^^iM^a ftA fatheis and mothers having this diathesis 
can transmit it to their offspring. 

Whether the evolution of this microbe 
in the human blood of 80 per cent, of our 
people in large cities be due to incompati- 
bility of temperament, or to meagre, 
adulterated or deleterious food, or insani- 
tary states or surroundings, to the abstnce 
of sunh'ght, or hygiene, to isolation, 
monotony, deleterious trades or deba>ing 
habits, use of alcohol, drugs, disease, poverty of nerve force, 
we are not going to discuss. Sufficient it is, an adverse state 
being brought about wears out the vital force and evolves the 
germs and soon becomes a pilpable reality in a depreciation of 
the human stock 

Fe^rble vital force, degraded elementary molecules into the 
bacilli of the tubercle, a disease germ floating in that life-giving 
fluid, sooner or later gives a manifestation of speciil disease in a 
loss of strength an el flesh, in a protuberant eyeball, clubbed nails, 
night sweats, which are exhausti ig ; as the exudation is the 
serum of the blood, rich in phosphates and chlorides, there is a 
■failure in the lymph canals and pink marrow to raise the 
standard of the blood, and the organism becomes still further 
impoverished. 




The bacill 



BACTERICIDES. 



1027 



Persons who lose flesh or lose tone should not procrastinate 
an hour, should not wait for ni<Tht sweats and cough to appear 
or until lun.cT consolidation takes place. Neither should those 
who suffer from inso nnia 
delay, for a sleepless brain 
demonstrates a want of 
nutrition and imperfect 
nourishment. 

The appearance of a sec- 
tion of the substance* of 
the lung in which the ba- 
cilli tubercle has been 
effused is one of slight 
congestion, or hepatiza- 
tion, with the g^vm inter- 
spersed in gravish spots. 
Tne external surface of 
the lung may appear nor- 
mal, or show dots of gray 
consolidation scattered 
throughout. In the incip- 
ient state it is albuminoid, 
later on, milky ; lat.^r >till, caseous. After the preliminary exos- 
mosis, the tubercle consolidates itself, and if the defective nutri- 
tion of the lung is not t 




Section of the lung sHmu,,,- the ravages of the germ, 
with the bacilli encysted. 



)0 great the baci 




^7 - -i 's^' 3 



xm 



li becomes encysted in 
a fibrillated net work 
and microscopically 
has the appearance as 
in the annexed dia- 









i 






These again, are the 
especial seat of the 
tubercle bacilli. May 
not the bacilli have 
something to do with 
the degeneration ? 

How do the bacilli 
act in producing a 
tubercle? It cannot 
be merely a mechan- 
ical action ; I con- 

, , 1 • , w ^'^^^ ^^ ""'O'^t proba- 

bly a chemical one. You see in the above diao-ram a dark 
central ma^s ; a mass of micrococci; a clear ring'' around and 
then, beyond, an inflammatory ring. The course of events is 



6i, -^-:^sr^^O 



Another pe. im-n of the micohf 
rein.*rkat)ie gr.wth of the gen 



;!•- ', -Ivnving the 
cakciicd liiigs. 



I028 DISEASE GERMS. 

clear; the micrococci, growing in mass, have produced a poison 
which has killed the tissue around, but further away has been 
more dilute, and has there set up inflammation. I need not enter 
into the details. Now, I conceive the state of matters in phthisis 
to be the following ; and, of course, the view as to caseation 
applies to tubercles anywhere. Bacilli are inhaled into the air- 
cells of a lung which is in a fit state, whether by predisposition 
or otherwise, for their growth. They at once attack the epithelial 
cells, and in the first instance, cause their hypertrophy and mul- 
tiplication. The bacilli growing in these cells produce poisonous 
chemical substances, and the cell, which, in the first instance, was 
stimulated to increased growth by a small quantity of the poison, 
soon succumbs to the increasing amount, and undergoes casea- 
tion. Some cells, or groups of cells, are, however, stronger than 
the others, and go on growing, so as to form giant- cells. These, 
generally, also ultimately succumb, though in some instances 
they may get the upper hand, and the bacilli may disappear. 
While this is going on, inflammation occurs around, and the pro- 
cess creeps from air-cell to air-cell. I believe, also, that this view 
of the production of a poisonous substance by the bacilli may 
explain the fever and wasting of phthisis. 

The pathology of piilmonayy tuberculosis. — The tubercle bacilli 
consists of several round cells or cysts, in a cellular membrane 
floating in the blood, ready the moment any weakness takes 
place in an organ or tissue of being effused, with other products. 
Once a local lesion is established, a state of vital depression pro- 
duced, the germ thrown out from the blood, countless millions of 
the microscopical progeny of the bacilli in the mother cyst or 
cell, penetrate its walls, hatch out, grow, multiply, and undergo 
a process of degeneration and death. Tubercle differs from all 
oth^r germinal matter in its process of death ; when effused by 
exosmosis through the walls of the blood vessels, it is an albu- 
minoid body, no effort at repair, they become milky, then cheesy, 
and latterly ?:n inorganic body, phosphate of lime. 

// is a well attested jact that the living germs of tubercle, though 
weighty, leave the body of the infected by the breath, sweat, 
u ine, stool, and are carried from individual to individual. This 
living contagion is to be more dreaded in our country than in 
any other, because we live among mixed races of men, distinct 
in certain great characteristics of being, and the passage of a dis- 
ease germ from race to race increases its virulence or activity. 

All domestic animals who are the victims of adverse states, 
inimical to their vitality, as overcrowding, insanitary conditions, 
meagre or poor food, exposure, have their normal bioplasm de- 
graded into the microbe " tubercle,'* which passes to the human 



BACTERICIDES. 



1029 



race by close contact, and gives rise to a virulent form of tuber- 
culosis. 

The bacillary origin of phthisis is now very generally acknowl- 
edged. A proof of such origin is furnished by inoculation, but 
it has been recently still further established, especially by the 
experiments of Cornet, that the disease — at all events in certain 
animals, as guinea-pigs — may be produced simply by the inhala- 
tion of the dried dust of the sputa. Now the fact that the dis- 
ease may be communicated in this manner is of immense prac- 
tical importance, for while, on the one hand, it proves the extreme 
danger of such a mode of introduction, on the other it indicates 
the measures and precautions which should be adopted to reduce 
that danger to a minimum. It is, of course, where the expecto- 
ration most abounds, and where it is most liable to become dried, 
that the danger is greatest — as in the rooms, hotels, and hospitals 
occupied by consumptives. Again, it has been experimentally 
shown that but little if any 
danger is to be apprehended 
from the inhalation of the 
breath of the phthisical, or 
of the air of streets, towns 
and promenades frequented 
by them. In the first place, 
the expired air has been 
found to be free from bacilli ; 
and, in the second, although 
the sputa may be expecto- 
rated on the ground, etc., 
the dried particles or dust 
of these quickly become 
dispersed and scattered 
through the air to such an 
extent as to be rendered practically harmless. Moist and freshly 
expectorated sputa consist in great part of water, and when dried 
become not only very light but very friable, so as to be easily 
broken up into dust and so scattered about by slight currents of 
air. The rate of drying depends not only on the temperature 
and state of humidity of the air, but also on the nature of the 
material on which the sputa fall. Thus, if they come into con- 
tact with any absorbent material, such as carpets and pocket- 
handkerchiefs, they quickly dry in consequence of the with- 
drawal of the water by capillary attraction. Hence, the great 
danger which arises from expectorating into handkerchiefs. 

Etiology. — When tuberculosis is either created or acquired, 
that is when some adverse condition exists; the peculiar de- 




Diagram of the dead germ undergoing calcareous 
degeneration ; the cheesy, cretaceous, chalky 
material into which the dead germs merge are 
very generally encapsulated. 



I030 



DISEASE GERMS. 



pression of vital force, under which the germ tubercle is evolved, 
and is freely elaborated in the body, or vital force being some- 
what feeble, the germs from another infected body find ingress 
into the body and blood, and there bre^J in the lymph spaces, 
every structure in the entire body becomes changed, weakened, 
deficient in viral force. 

The tubercular bacillus eats up for its own nutrition, the vital 
elements of being, the blood, brain, all the important accessories 
of life are poverty-struck. The hair is dry, like tow, the .>>kin 
thin, muscles soft arid flabby; bones deficient in phosphates; 
secretions sluggish, acidity and dyspepsia; general impairment 








^'if 



Y 



m'^A. 



2) 




Tii'ienle b u illi ftoin phthisicl spu- 
tum ; A, i.-ol.itcd Liicilli ; B. groups 
of ihe same ; ihc uii>t.nntu gi..iiiilar 
clei'ris '.f t..iiN coi puselc.> ami mucus 
are seen taiiiily at C, D. x 500. 



Thr microbe of syphilis a^ .seen in the inter-cnrpuscular 
spices, irom the blood of an affected individual, i^co 
diameters. 



of the nervous system. Even the marrow of the bones is eaten 
up by the microbe. 

T/ie diagnosis or recognition of tins micro-organism in the blood 
tissues^ and Inng : 

The recognition or diagnosis of tuberculosis is not altogether 
dependent on tlie symptoms we have enumerated; we have the 
remarkable appearance of the skin, loss of hair, hectic fever, 
cough, hemorrhage, consolidation of lung; or, if upon the bron- 
chi, loss of voice, general nervous bankruptcy, with ihe' presence 
of an excessive amount of phosphates and chlorides in the urine. 
The microscopical examination of the sputum and blood is never 
failin'^ in a diagnostic point. The faeces are valuable in the lat- 
ter stages, when the rectum becomes germ-eaten. 

Sputum. — Human tubercular sputum is infallible in diagnosis, 



BACTERICIDES. lOjI 

as the germ retains all its virulent characteristics, even when 
dried. The germs in the sputum will bear cultivation well, will 
even isolate and clear themselves of all extraneous matter. Pure 
bacilli, from their original breeding ground, introduced into 
some nutrient medium, will produce their characteii^tic offspring. 
Physical Signs. — If the tubercular bacilli be deposited or^ the 
larynx and bronchi, the lungs on percussion may be clear from 
apex to base, but shortness of breath, loss cf voice, and haemop- 
tysis, will be predominant. If the bacilli have been effused in 
the substance of the lung, probably the apex of the left, or both 
lefc and right, beginning at the top aid proceeding downwards; 
if consolidation is not perfect, feeble or harsh respiratory mur- 
murs may be detected, audible and prolonged ; perhaps a faint 
crepitus, or dry crackling ; if the germ deposit is heavy, flatten- 















The bacillus of tubercle in the spuium ot 
phihi.>ical patitnts. 



Tubercular bacilli as seen in the sputum, mag- 
nified 750 diameters. 



in£f of the ribs and lack of intercostal movement. The dulness 
on percussion is decided, and as germ deposit progresses, chest 
movement becomes more deficient. As tubercles die and are be- 
ing expectorated, large and small crepitation ; if tubercle has 
eaten away lung substance, there will be a sinking in, a retrac- 
tion of the intercostal spaces, and there will be an unusual clear- 
ness on percussion. The respiration will be cavernous, 'as com- 
ing from an empty cavity. 

It must always be born in mind that there exists in nearly all 
cases of hepatic disease, dulness of the apex of the right, passive 
congestion without tubercle. As a general rule, tubercle de- 
posits itself in the apex, and proceeds davvnwards ; whereas, 
nflammation begins at the base and proceeds up ; tuberc.e may 



I032 



DISEASE GERMS. 



be deposited at the base, in conjunction with the germs of pneu- 
monia, or the sugar fungus of chronic alcoholism or diabetes. 

Tubercle may be deposited in a weakened patch in the centre 
of a lobe ; germ growth may be active or slow, it spreads in 
every direction forming a round mass, breaks down, is expecto- 
rated, leaving a cavern or vomica in the lung, as seen in the 





Illustrating the advent of the The tubercle bacilli, having finished its career, has 

tubercular bacilli in the left a cavity or vomica in the substance of the 

apex of the lung in the fii st lung, 

stage of pulmonary tuber- 
culosis. 

annexed diagram which illustrates a cavity in the centre of the 
middle lobe of the right lung. Germ is effused from a weak 
point in its centre, they multiply rapidly and form a large patch ; 
often increase in size by peripheral disintegration, or there might 
be several small colonies in the lobe, they might coalesce and 
form one large, irregular mass, which proceeds through the 
usual metamorphosis, albuminoid, milky, caseous, and phosphate 
of lime ; this latter breaks down, is expectorated, forming an ex- 
cavation, a cavern or vomica. When a cavity forms, the tissues 
around become indurated, resisting, the cavity itself contains air, 
and a grumous purulent fluid of a yellow or greenish color. As 
a rule, cavities are quiescent, and frequently contract by an ap- 
proximation of their walls. 

Often before there is any appreciable lesion in the lungs, the 
following signs give a warning note and tell of the threatened 
mischief, and before there has been any deposit of tubercles that 
can be detected : stoop ; anemia ; arthritis ; micrococci ; hoarse- 
ness ; hectic flush; sore throat; bad breath; rapid pulse; 
haemoptysis ; amenorrhcea ; family history ; red line on gums ; 
rheumatoid pains; pityriasis versicolor; weak, tired feeling; 
shortness of breath ; acromial depression ; prolonged expiration ; 
hacking night-cough ; cog-wheeled breathing ; thin ear, nostril, 
and lip; harsh vesicular murmur; congestion of vocal chords ; 
brilliancy of eyes ; general feeling of apprehension ; curved nails ; 



BACTERICIDES. 



033 



■clubbed finger-ends ; emaciation, while appetite is good ; con- 
stant high evening temperature ; insufficient expansion of the 
side to be affected. 

It is customary to divide the presence of tubercle in the sub- 
stance of the lung, into stages: (i.) effusion of tubercle; (3.) 
perfect consolidation of lung substance from tubercular deposit or 
growth, or both; (3.) death, or breaking-down of the microbic 
mass. 

Often numerous complications exist, as asthma, bronchitis, 
pleurisy. 

It is impossible to speak correctly of its duration, the laryn- 
geal or bronchial form is rapidly fatal, unless extremely well 
managed ; when the microbe is in the substance of the lung, it is 
essentially chronic, admits of retardation, and very frequently a 
cure by germicidal remedies. 

Prophylactic measures. — In a state of perfect health, man is 
proof against all micro-organisms; he is proof against the degra- 
dation of his own living matter into microbes ; proof against 
their ingress in any form ; if it were not so we would rapidly 
fall victims to this bacilli, which we are inhaling at all hours 
with impunity. If we are susceptible to the ingress of a germ, 
we can also be rendered proof against it by maintaining the 
highest standard of health possible. 

To increase vital force, we must ward off all agents within and 
Avithout which lower it; change, avoidance of monotony or 
sameness, is essential to a high grade of vitality ; insanitary con- 
ditions avoided ; and all things which are calculated to weaken 
the human mind. 

Treatment. — This embraces three essential points; (i.) every 
possible means to maintain and restore vital force ; (2.) the use 
•of remedies to palliate the prominent symptoms, and (3.) the use 
of germicides to destroy the microbe, the factor of disease, (i.) 
Every possible means should be resorted to acquire increased 
vital force ; to improve the general well-being of the affected ; 
every comfort within reach should be supplied, his or her sur- 
roundings should be looked after, the body should be sponged 
off morning and night, well dried ; massage from a highly vital- 
ized nurse, the clothing should be flannel next the skin, other- 
wise woolen. A climate in which ozone abounds is the most 
beneficial, as the sea shore, high, dry altitudes in summer, while 
the city probably in the winter is the best ; gentle open-air ex- 
ercise, never to fatigue. The sleeping apartments well venti- 
lated. 

The diet should be very varied, nutritious, and consist as 
much as possible of articles rich in blood elements ; the most 



1034 



DISEASE GERMS. 



nutritious, animal and vegetable, with abundance of ripe fruits ; 
if stomach fails to digest, follow with ptpsine; warm milk from 
the cow drank before the vital elements escape, cream, raw eggs. 

Tonics aie indiccted, as phosphated tincture of oats, quinine 
wine, comp. matiicaiia, to build up and promote an appetite. 

Remedies to palliate prominent symptoms. 

If wasting be a prev^ailing and persistent symptom, germs 
active, metamorphosis great, try inunction of warm olive oil 
into the body at bedtime ; extract of malt, brandy and cream to 
arrest excessive waste by sterilizing germs ; sterilized malted 
milk. 

If there be fever, increased heat, respirations, pulse, try either 
antipyrine, or tincture of aconite, strophanthus; comp. syrup of 
tolu and resorcin. 

If there be great acidity, indigestion, try comp. tincture cin- 
chona and mineral acids; aromatic sulphuric acid, and quinine; 
American columbo ; comp. tine, matricaria, papoid, triturated 
with bicarbonate of soda. 

Jf there be diarrhea, and this most exhausting, it must be 
arrested at once by administering a piil of equal parts of tannin 
and pulverized opium, one grain of each after every motion of the 
bowels, when they exceed one per day. 

As this diarrhea usually depends upon a migration of the 
microbes to the mucous coat of the bowels, and as the rectum is 
literally miciobe-eaten, completely riddled, it will be essential to 
place the patient upon the great intestinal vitalizer, the Virginia 
stone-crop, and alternate that with fifteen-grain doses of resorcin. 
In nearly every case this will kill the tubercular bacilli in the 
bowels and the stone-crop restores and heals the ulcers, naphtha- 
line, creolin, salol, should have a trial. 

If there be Jicsmoptysis, or bleeding from the lungs, try first 
either strophanthus or digitalis, erigeron, gallic acid; spirits of 
turpentine, sulphuric acid and alcohol. 

The patient is usually seen after the first burst of hemorrhage ; 
and if the bleeding continue after quiet is secured, astringents 
may be found useful. Gallic acid is believed to be one of the best 
of them, but it must be given in large doses of twenty grains. 
The most effective remedy, however, we believe, is the hypo- 
dermic injection of ergotin. This will often arrest the bleeding 
at once, when other means fail. Inhalation by the atomizer of a 
solution of sub-sulphate of iron will often act almost magically. 
Unless, however, active bleeding is going on, we may be content 
to give nitro-muriatic acid and ipecacuanha, the acid serving, 
we fancy, to give tone to the relaxed vessels which have yielded 
the blood. 



BACTERICIDES. 



1035 



The subsequent treatment of these cases requires the greatest 
care, and may be rewarded with briih'ant results ; for they are 
cases in which the disease is often in the smallest sense constitu- 
tional, and therefore in which recovery is always to be hoped for, 
while in no kind of condition is neglect attended with more un- 
fortunate results than in haemoptysis. 

If there be night siveats, try either aromatic sulphuric acid and 
quinine, or atropia, agaric. 

To relieve coiigJi, renelcr expectoration easy, try first ozonized tar 
syrup; if that fa-Is then use either pfunia, or mixtures of syrup 
of senega, squills, ipecac, tolu, lobelia, marshmallow, slippery 
elm, flaxseed tea and lemon juice, raw eggs and salt, syrup of 
poppies, with chloride of ammonia. 

A mixture of aconite, belladonna and camomile; compound 
oxygen. 

If expectoration be excessive, inhalations of either carbolic acid 
or turpentine, or terebene ; or beech creosote combined with com- 
pound syrup of tolu, which is so very effectual in destroying 
laryngeal and lung microbes. 

To rid the system of dead germs, compound saxifraga; small 
doses of iodol. 

To relieve Jiectic^ phosphated tincture of oats, glycerite of 
kephaline, aromatic sulphuric acid, chlorine water, salol, 
naphtha'ine. 

As the hectic is due to ptomaine poisoning the remedy to get 
rid of hectic must be a powerful bactericide. 

To procure long-cojitinued refreshing sleep, try first sulphonal ; 
that falling, then either of the following remedies; cnloralamid 
in thirty to forty-grain doses. 

3. 77?^ most important class of remedies in the treatment of pul- 
monary tuberculosis are germicides, locally over the germ- 
smitten lung; by inhalation; bv the stomach and rectum. 

(a) Local germicidal applications to the chest are of great effi- 
cacy, the remedy acting as a local vitalizer ; by endosmosis ; as a 
stimulant. They should be applied over the germ-laden or eaten 
part. The common tar plaster, made of lobelia, bloodroot, capsi- 
cum, Indian turnip, mandrake, stimulates, raises the standard ot 
vitality, promotes absorption, sterilizes germs. Ozone ointment, 
iodol, resorcin, added, make a splendid germicidal application;- 
chloroform, in which benzoic acid, thymol, and other antiseptics 
are incorporated, is of great efficacy in 'the annihilation of mi- 
crobes. Painting over the seat of consolidation nightly with con. 
ozone, and when the skin assumes an erythematous blush, 
sprinkle over it iodol, and keep re-applying. 

(b) Tuberculosis being infectious and contagious, many 



1036 



DISEASE GERMS. 



germs emanate from the body by the breath, and the propriety 
of disinfecting the bronchial tract and killing those microbes can- 
not be doubted. The fever of pulmonary tuberculosis is due to 
the germ, to its protoplasmic changes, and the respiring volatile 
antiseptics, as the nascent chloride of ammonia, is attended with 
most salutary results ; or such formulas as iodol, resorcin, naph- 
thaline, distillation of the pine, comp. oxygen, ozonized iodine. 

The inhalation of these agents either sterilizes or destroys the 
germ, and an appreciable improvement is at once visible. An 
ordinary steam atomizer is the most available mode of using any 
of the above remedies. 

(c) Germicides introduced into the stomach pass into the circu- 
lation, and coming in contact with the bacilli in the blood, de- 
stroy it. We will enurherate a few of the most efficient. When 
used, one might be administered one week, then another, and 
two or three selected from which the best results are obtained. 

Glycerite of ozone, in doses of from twenty to thirty drops, 
added to a little water, three times daily, is one of the best, most 
active, of all germicides — it is the best because it has a chemical 
affinity to the bacilli tubercle ; it seeks it out and kills it. While 
doing this it imparts oxygen to the blood and tissues. Besides, 
it is nature's great scavenger to diseased blood, destructive to all 
micro-organisms, while at the same time it is highly vitalizing to 
the blood. 

It is a good plan while administering this remedy for the anni- 
hilation of the microbe, to administer very small doses of the 
ozonized tar syrup, to cause the dead germs to be freely expecto- 
rated. 

Comp. oxygen is another remedy which might be tried with 
advantage, especially in cases of laryngeal or bronchial cases ; 
can be given internally, used as a mouth and throat gargle, and 
in the inhaler. 

Chloride of lime, in doses of three or four grains, triturated in 
sugar of milk, and added to a teaspoonful of glycerine, taken 
after meals, has great efficacy in destroying the germs, arresting 
the night sweats, healing pulmonary lesions. 

Hypophosphite of potassa, in five grain doses, thrice daily, ad- 
ministered in meat juice, often operates well in killing the 
germs. 

Carbolic acid, in this form, is of utility ; say, carbolic acid, 
tincture of iodine, muriatic acid, of each, two drachms, rubbed 
up in sugar of milk; then add to one ounce of alcohol. Mix 
well, and add to fifteen ounces of water. Dose, one teaspoonful 
every two hours. 

Creosote is, in some cases, invaluable. 



BACTERICIDES. 



losr 



A few years back creosote was a widely advertised remedy in 
consumption, used by inhalation. After a season the use of it 
fell into the shade. Perhaps too much was expected of it, as is 
so often the case when new or novel remedial agents are first 
brought into notice. Of the value of creosote in the treatment 
of consumption by inhalation I have some experience, though 
limited, yet it is of fairly decisive kind. Two cases of confirmed 
phthisis, I am pretty sure, have been cured by using the steam 
atomizer with creosote. For one sitting of half hour, twenty 
drops of creosote, dissolved in a tablespoonful of alcohol, this was 
added to two fluid ounces of water and atomized. The patient 
breathed a dense fog of atomized creosote water during the time. 
A small apartment six and one-half feet square and seven feet 
high was extemporized by placing four screens in form of a 
square, and covered over at top by another ; the screens were 
made of slats, like a sash frame, and thick cloth of cotton was 
tacked over each ; the outside of this cloth was given several 
coatings of boiled starch, in which a little glue was dissolved. 
This served to make it somewhat light. In this little apartment 
was placed a small table and a chair. Air entered, of course, 
throughout all the cracks and crevices. The treatment was re- 
peated twice, sometimes thrice a day. The time extended over 
six months. 

The effect of the treatment was first a speedy betterment of 
the bronchitis and purulency of the expectorations. After two 
weeks the fever was much milder, and in a month the night 
sweats, hectic, and cough were both under certain and positive 
control, so much so that they hardly troubled the patient. After 
six weeks they were gone. The appetite soon became better, 
digestion gradually improved. 

Among the troublesome symptoms that worried the patient 
grievously before commencing treatment, were fermentation of 
the food in the stomach, caused, no doubt, by gastric catarrh, a 
trouble I find quite constant among consumptives in this climate. 
Another symptom was dumb chills that seemed to come on every 
day or two, accompanied by lowness of spirits ; these chills were 
followed by a slow fever that lasted the entire day, and termi- 
nated at night in an exhaustive sweat. All these symptoms dis- 
appear under creosote inhalations. The internal use of creosote 
is efficacious, best given thus : creosote, one drachm ; tinctures of 
elecampane and spikenard, of each, four ounces ; tincture of cap- 
sicum, one ounce. Mix. One teaspoonful every three hours, 
and increase it to one every two hours. It makes an excellent 
change for a week at a time, from the glycerite of ozone. 

We enumerate a few bactericides used by some physicians. 



1038 



DISEASE GERMSJ 



The only successful remedies are of the germicide class, as 
glycerite of ozone, creosote, guaicol, and oil of black mustard. 

The bacteriologists have made numerous celebrated experi- 
ments with this agent, and found it to rank next to dioxide of 
hydrogen. The oil of black mustard prevents the development 
of bacteria, and destroys them. The initial dose must be small, 
as It is somewhat irritating. Its administration destroys the ba- 
cilli of tubercle, lowers temperature,- slows the pulse, and retards 
perspiration. 

It must be highly diluted, and administered at regular intervals, 
keeping up a feeling of warmth over chest and abdomen. If 
properly given, there is an improvement all the time, without an 
exception; reduces cough and expectoration; arrests night 
sweats; and exhibits a marked diminution of the bacilli in the 
sputum. 

Ozonized iodine, in very small doses, added to a little water, 
has been most successfully used in both lung and laryngeal 
tuberculosis, with most beneficial results. Same remedy by 
inhalation. Its use causes the tubercular bacilli to disappear 
from the sputum. 

lodol alone is an excellent local remedy. 

Ulcerations in the inter-arytenoid re^^ion have cleansed and 
healed up completely, and the characteristic arytenoid oedema 
diminished under its influence. Tuberculous ulcerations of the 
epiglottis and pharynx have benefited by it and been arrested, 
and the distressing pains on deglutition, which accompany this 
condi ion, are much relieved by iodol. In some patients, in whom 
solid food was entirely interdicted by reason of the pain on swal- 
lowing, deglutition has become comparatively easy, under daily 
laryngeal insufflations of iodol. If the iodol is carefully and accu- 
rately applied over the ulcerations it will completely heal them. 
I hive cases now under treatment in which there was oiiginally 
extensive laryngeal ulceration, but in which now all active mis- 
chief is arrested. Iodol remarkably diminishes the cough of this 
conlition. It is not to be supposed, of course, that insufflations 
of iodol, or of any other substance, will cure extensive phthisical 
disease of the larynx, but they will certainly arrest ulceration, 
relieve pain and cough, and allow the patient comparative com- 
fort. The iodol remains for a long time in contact with an ulcer- 
ated surface. 

Sprays of glucozone are most effectual and salutary combined 
wiHi any form of iodine treatment. 

Terebene.five to ten drops on sugar every two or three hours ; 
or terpin hydrate in two-grain doses, often works marvellous re- 
sults in pulmonary tuberculosis. 

Sulphurous acid, fumes or in water, is an excellent bactericide 



BACTERICIDES. IO3Q 

The bacillus tubercule locab'zing^ 

Tubercular Bacilli itself in the nasal fossa, which may 

in the Nasal Fossa, breed and run through its different 

stages of growth and death. 

Etiology. — This affection is extremely rare, and is correlated 
with the presence of tubercles in the lungs or other organs. The 
symptoms diVQ chiefly those of coryz i ; but recognition o\ the affec- 
tion depends on rhino^copic examination. Tubercles varying in 
size from a grain of millet to one of wheat, and yellow in color, 
may be seen as isolated masses, chiefly on the septum, and tur- 
binated bones. As elsewhere, the tubercles may soften and leave 
an ob-tinate form of ulcer. The surrounding mucous mem- 
brane will be more or less tumefied, and covered with purulent 
secretion. 

The prognosis is necessarily bad, and similar to that of tuber- 
cles elsewhere. 

The diagnosis is founded on the appearance of the ulcers and 
the presence of other phthisical symptoms, the history and 
progress of the case being tiki^n into account. The microscope 
will also give valuable aid. not only by showing the formation of 
the growth, but also by demonsrating the existence or otherwise 
of the special bacillus of tubercl*". 

The treatment must necessarily be palliative, and will consist 
of detergent irrigations, ozone et chlorine, chloride of gold and 
Hydrastis canadensis, followed, if necessary, by excision, scraping, 
or burning of the nodes with the galvanic cautery, the use of nitrate 
of silver and insufflations of iodoform with or without morphia. 
All operative interference will be aided by a preliminary applica- 
tion of cocaine. 

General treatment for tuberculosis pushed with energy. 



Weakened throat and larynx, affords 
Tubercular Bacilli a suitable nidus for the deposit, growth 

on the Larynx. and settlement for the bacillu--. 

{Laryngeal P/u/usis) The bacilli may be deoosited at a 
portion of the lung ; e. g., the apex ; ill 
supplied with blood and air. or in altered pulmonary tissue, the 
result of acute inflammation, a^ at the base. 

Larynx. — Bacilli ma\' be carried into the general circulation by 
the lymphatic system, or. in the case of cavities, may be con- 
veyed to the larynx by means of the sputa. The former, since it, 
does not involve a previous breach of surface, is the most proba- 
ble route in the commoner f )rms of laryngeal tuberculosis. 

The tuberculous process is manifested in the larynx, as in the 



[040 



DISEASE GERMS. 



lungs, in two ways : first, as the result of anaemia, in which case 
the marginal and apical regions are primarily attacked ; secondly,, 
as the result of an inflammation frequently induced by functional 
abuse, in which case the vocal chords and ventricular bands are 
situations in which the disease is not infrequently first manifested. 

Erosions, non-tuberculous in character, may appear in the 
larynx of a tuberculous patient ; doubtless some of those that 
heal are of this nature. 

Clinical evidence has long warranted the supposition that a 
laryngeal may precede a pulmonary tuberculosis. Recent facts 
have proved the truth of this hypothesis. 

Fauces and Pharynx. — A nidus may be formed in this region 
by absorption of the contaminated fluids of pulmonary, laryngeal, 
and oral secretion, and the bacilli be conveyed through the 
general system. 

In the case of a primary faucial tuberculosis there is probably 
a previous breach of continuity. 

Clinical evidence would show that there is a possibility of a 
primary faucial tuberculosis, but the fact has not yet been verified 
by post-mortem evidence. 

To7isils. — While faucial and pharyngeal tuberculosis are acutely 
painful, the tonsils may be attacked without symptoms, provided 
the other portions are free from ulceration. 

Treatment. — Considerations under this heading are limited to 
cases in which the disease, though well established, is not 
advanced. 

1. The first indication is, by climate^ hygiene and general 
measures, to place the patient in the most favorable position for 
resisting the baneful influence of the bacilli and rendering their 
life impossible ; preference is given in early cases to sea voyages 
and mountain air over hot or moist climates. 

2. Inhalations containing oxygenating elements, peroxide of 
hydrogen and administered by oro-nasal inhalers are preferable 
to those of steam. 

3. Medicines include, fir.^t, atropine as a probable alkaloidal 
antidote to symptoms of the septicaemic process indicating a 
ptomaine toxaemia ; secondly, kephaline, of which that of calcium 
is preferred as most favorable to rapid (calcareous) degenera- 
tion of the tubercle ; thirdly, glycerite of ozone, which it is sug- 
gested may act as a specific in the tuberculous disease, though 
not to the same extent as other drugs. 

4. Germicides are of two classes : (a) those which may power- 
fully affect the general system ; (U) those of a more purely local 
character. Of the first maybe mentioned peroxide of hydrogen. 
The use of sulphuretted hydrogen and carbonic-acid gas per 



BACTERICIDES. ,04r 

rectum is a method of treatment which is still on its trial, and so 
far as can be judged, it is more favorable in cases of chronic 
bronchitis than in tuberculosis. The microbicidal effect of the 
gas is very feeble. 

Conclusion. — That, while throat symptoms may be greatly 
relieved even in cases of advanced pulmonary disease, there is 
seldom any true cure, but that each year there is a greater hope of 
such a happy result. 

There can be no doubt that ulcers in the regions under con- 
sideration can be healed, and success in this direction is in pro- 
portion to the accessibility of their site. 

Treatment. — In its early stages the treatment of phthisis 
laryngea ought not to be of an active and meddlesome charac- 
ter ; and general advice as to avoiding changes of temperature, 
damp and cold atmosphere, hot and irritating food and drink, 
and tobacco smoking, combined with tonics and drugs by inhala- 
tion, etc., to relieve the cough, is of more importance than any 
local throat treatment. When, however, ulceration of tubercular 
deposits has taken place, and there is much pain on taking food, 
along with hoarseness and irritating cough, then we must adopt 
systematic local treatment in the shape of spraying or brushing 
the affected parts with solutions of cocaine in glycerine in borax. 
5 to TO per cent; cocaine pastiles ; insufflations of iodoform or 
iodol ; lactic acid carefully applied with the brush, and varying 
in strength from 20 to 60 or even 80 per cent; gradually increas- 
ing the concentration as the parts become tolerant of it. Solutions 
of menthol in olive oil to allay pain, and insufflations of morphia 
and bismuth for the same purpose, are good. All these measures 
must be combined with the usual cough mixtures, tonics, tar 
syrup, glycerite of ozone, which are used in cases of pulmonary 
phthisis. 

The question of climate is most important if the patient can 
afford it. Mountainous locations in Pennsylvania are excellent. 



When the system is heavil}r 

The Tubercular Bacillus loaded with the microbe tuber- 

in the culae, if some irritation exists in 

Stomach and Bowels. the stomach, it will infiltrate its 

walls, and in some cases, if not 
arrested by building up the constitutional powers and killing the 
germ with bactericides, the germ-tubercular colony often as- 
sumes an immense size. At first an active germ mass, by-and- 
by caseous, and latterly calcareous. There may be simply one 
nodule, or several. 



1 042 



DISEASE GERMS. 



In any stage, it may either slowly or suddenly break down 
and pass bythebowels, leaving an ulcer behind, or it may cause 
perforation of the stomach and death. 

In the walls of the intestines the same course is pursued, aa 
irritation, an exudation of plasma from the germ-laden blood, in 
which the microbe is present, its deposit in or on the walls of 
the bowel, either in one or several colonies. 

The very same degenerative changes are liable to occur in the 
bowels, as in the stomach, congestion, caseous consolidation, 
calcareous degeneration, either ulceration or perforation of the 
bowels. 

Throughout the ileum, but especially, as in typhoid fever, in 
the solitary and Peyer's glands and those structures at the lower 
part of the small intestine and in the caecum, there are large 
patches of ulceration at variable intervals, commencing as small, 
round, discrete ulcers at the upper part of the canal, and becom- 
ing confluent below into irregular patches, which extend through- 
out the entire circumference of the canal. 

Each ulcer is of an irregularly circular form, and bounded by 
a thick, raised, round, and inflammatory bo'rder. Internally, the 
margin is irregular and continuous, with coarse granulations, 
between which are scattered little yellow masses of tuberculous 
matter, firmly adherent to the base of the ulcer. Some of the 
ulcers may extend to the peritoneal coat, and their existence 
may be known, before the intestines are opened, by an irregular 
thickening and a corresponding irregularity of the peritonaeum. 

The points of difference between the tubercular ulcer and the 
typhoid ulcer are the following : The ulceration in the tubercu- 
lar ulcer extends transversely round the whole surface of the 
intestine ; the edges and base of the ulcer are thickened and in- 
durated. This form of ulcer very rarely heals, and perforation is 
also very rare. Some contraction and narrowing of the gut fre- 
quently occur. 

The presence of the tubercular microbe in either the stomach 
or bowels, is usually recognized by the gastritis or enteritis 
present, diarrhea, or constipation ; the presence of the tubercular 
bacilli in stools, some, but very little pain ; in the later stages, 
the caseous and calcareous masses can be readily felt through 
the abdominal walls, the emaciation is usually immense. 

The same constitutional, hygienic, and medicinal treatment as 
for tuberculosis, build up the vital force by every possible means ; 
destroy the bacillus with the most powerful bactericides. 

Special treatment for the germ in stomach, administer dioxide 
of hydrogen ; fl. ext stone crop ; kephaline and quinine ; Hy- 
drastis and avena sativa. 



BACTERICIDES. 



1043 



Diarrhea occurring during the progress of the tubercular 
bacilla in any part of the body, would be strongly presumptive 
that the bacillus would emerge on or in the coats of the bowel, 
and if the microbe could be detected in the stools, the diagnosis 
would be perfect. 

In this event, bactericides must at once be applied to the en- 
tire abdomen, as concentrated ozone, with chloroform ; ozonized 
iodine with chloroform ; or aromatic pinol, 
over and above all, a flannel roller. Kli^^^'l'%P^' 

Internally, glycerite of ozone, alternated ^^^S^^W 
with ozonized stone crop. ^^R^^^ftSf 

But if there are any evidence of ulceration ^^S^P^Mf 
by the presence of the streptococcus pyo- fi^^^^j^!|p 
genes in the stools, then in addition to those I^K^^Sffil 
remedies, intestinal disinfectants, as naph- iifpf-^^f^^B 
thaline, salol, salicylate soda, creolin. f^iP?^ >^!i I- " " 

With rep-ard to intestinal disinfectants, we Tubercular ukers of the 

<^ ileum 

must carefully consider the effects those will 
produce on the organism. 

When the contents of the stomach and bowels are undergoing 
decomposition, either from yeast, sarcinae, bacteria, or tubercle, 
we may get good results by the use of creosote, or salol, or 
naphthaline, because these substances come directly into contact 
with the microbes in the stomach, and a quantity of them which 
is too small to be injurious to the patient, will be suf^cient to 
act as a disinfectant. If the intestine is to be disinfected, these 
drugs will not produce this effect so readily, because they will 
be partly absorbed in the stomach, and one has to look either 
for some remedy, which, on account of its sparing solubility, 
will pass through the stomach into the intestine without being 
absorbed, or else one which will not have much poisonous 
action. 

Such we have in the stone crop ; an invaluable drug in all 
states of ulceration, it tends to promote a renewal of life in that 
structure. 

Of all parts of the intestinal tract, the microbe seems to have a 
special affinity to the posterior part of the rectum ; here the 
tubercular bacilli deposits itself in nodules upon the surface of 
the bowel, hard to the feel, smooth and round. If the germ is 
permitted to establish itself, and undergo caseous, calcareous de- 
generation, it gives rise to ulceration, and a germ-eaten rectum ; 
often with fistulous openings, or crescentic thickening. 

If such a state of things exist, germicide treatment must be 
pushed, and locally to the rectum, microbicides, as rectal bougies 
of either resorcin, or thallin, or papoid, or creolin, or naphthal- 
line, or iodol. 



I044 



DISEASE GERMS. 



Encmata of boroglyceride, ozonized pine tree, witch hazel, 



etc., will do much to effect a cure. 







Tubercle bacilli in liver. 



The tubercular bacillus sometimes migrates into the liver, 
creates considerable irritation, and often jaundice. 

In such cases, small doses of the peroxide of hydrogen, alter- 
nated with the phosphate of soda, speedily remove the symp- 
toms. 



The Tubercular Bacilli 
in the Peritoneal Membrane. 

( Tubercular Peritonitis). 



Depression of the perito- 
neal membrane offers a favor- 
able location for the localiz- 
ing of the bacilli ; it may ex- 
ist alone, or be complicated 
with the microbe in the lung. 
Tubercular deposit on the peritonaeum is accompanied with 
some fever, acute pain in the abdomen, increased by pressure, 
loss of flesh and strength, thirst, loss of appetite, and continuous 
diarrhea, or diarrhea alternating with constipation. 

The diseases with which we are most apt to confound acute 
tubercular peritonitis are typhoid fever and acute non-tubercu- 
lar peritonitis, and in some instances the resemblance is so close 
that it is only by great care and watchfulness that we can avoid 
falling into error. As a general rule tubercular peritonitis of 
this kind begins suddenly, whilst typhoid is usually preceded by 
a period in which the patient has been weak, feeble, and feverish, 
In the former, pain in the abdomen is more marked, and there is 



BACTERICIDES. 



1045 



tenderness over different parts ; whilst pain in the latter is rarely- 
severe, and any tenderness that may be present is confined to the 
iliac region. In tubercular peritonitis the temperature rises at 
once, and not regularly, as in enteric fever, and the pulse is usu- 
ally more rapid. As the case proceeds the temperature varies 
more in peritonitis, spots are rarely observed, and the stools have 
not generally the typical appearance of those passed in typhoid ; 
whilst at a later period the persistence or frequent returns of ab- 
dotninal pain and tenderness, and of vomiting, the variations of 
the tem.perature, the alterations of constipation with diarrhea, and 
the increasing prostration, will in most instances, enable you to 
distinguish between these diseases. In addition to these differ- 
ences, you will in many cases be able to render your diagnosis 
more certain by the discovery of fluid in the peritonaeum, or by 
the detection of a tumor in the abdomen; or you may find the 
signs of effusion in the pleura, or of a consolidation in the apex 
of one or both lungs. Still more difficult is it to distinguish be- 
tween acute tubercular peritonitis and ordinary peritonitis when 
the former does not assume from the first the typhoid form. In 
many cases I believe it is impossible to arrive at a certain con- 
clusion in the early stage, for both may attack persons previously 
healthy, both may be ushered in by similar abdominal symptoms, 
and it is only by watching the progress of the disease that you 
can form an accurate opinion. As a general rule the pain, ten- 
derness, and vomiting are less distressing in the tubercular form, 
the temperature is lower, and there is more usually diarrhea than 
constipation. As the disease progresses the abdominal symp- 
toms recur from time to time, instead of slowly subsiding the 
temperature remains high, emaciation becomes more marked, the 
effusion into the peritonaeum is very slowly absorbed, and you 
may discover signs indicating effusion into the pleurae or pulmo- 
nary consolidation. 



A child under two years of 
Tubercular Bacilli in age with either an hereditary or 
Mesentery. acquired tubercular constitution, 

(Tabes Mesenterica, or may be subjected to some irrita- 
Marasmus) tion of the bowels, either from 

worms, diarrhea, cholera infan- 
tum, which necessarily weakens the mesentery, into which the 
bacillus of tubercle enters, and lodges in its meshes or net-work, 
breeds, grows with great rapidity, destroys its proper function as 
a blood-raising gland ; obstructs the passage of chyle through 
the convoluted lacteals, which traverse the mesentery in all direc- 



1046 



DISEASE GERMS. 



tions, and give rise to anaemia and leucocythemia, and as a result 
all the tissues of the body starve and waste away. „^_I^ 

The spongy net-work of the mesentery becomes enormously 
engorged with the bacilli. 

Prior to, or more generally associated with it, there is either 
diarrhea or cholera infantum. About the earliest premonitory 
is, the abdomen becomes hot and tender, bloats, more or less con- 
stant pain in the bowels, sometimes so severe as to cause the lit- 
tle sufferer to instinctively draw up its knees towards the ab- 
domen ; deep red color of lips ; angles of mouth covered with 
small ulcers, or lips fissured ; passages from the bowels resemble 
chopped spinach, and very acid. 

Later on, they are very fetid, more frequent, and distressing ; 
abdomen rapidly grows large, child more pale and anaemic, the 
emaciation greater, until he gets down to skin and bone; even 
the marrow in bones wastes; skin white and wrinkled; intense 
debihty, with rapid, increasing weakness. The abdomen, al- 
though intensely swollen, soon be- 
comes irregular to the feel, lumpy in 
masses like large eggs at first ; when 
tubercle is active and growing, soft ; 
then a cheesy feel, and latterly, cal- 
careous ; there may be a tubercular 
condition of lungs, bronchi, or mem- 
branes of brain. Its duration is un- 
certain, depending on the condition of 
The tubercle bacilli in the omentum vital forcc and season of the year. 

in tabes mesenterica. jf -^ ^pp^^^ ^^^j^ -^ Juue, thc little 

sufferer, unless taken to the seashore or country, stands a poor 
chance of recovery before September ; whereas, if it appears in 
August, there is usually little difficulty in tiding the patient into 
the cool weather. It may occur at any season, but much more 
common when the vital forces of the child are depressed by 
solar heat and city life — a season when cholera infantum is 
prevalent. 

In the treatment of these cases, the first thing to do is to disin- 
fect the intestinal tract and kill the microbes of cholera infantum, 
and those of the green diarrhea ; this can be effected either by 
the administration of naphthaline, or resorcin, or calomel. 

The diet should either consist of mother's milk, or sterilized 
malted milk, or beef juice ; the entire body should be bathed 
morning and night with castile soap and cold water, followed 
by a salt water bath ; kept in a quiet, cool place, with abun- 
dance of fresh air. 

To the entire abdomen, some bactericide, such as con.'^ozone 




BACTERICIDES. IO47 

to erythema, followed with ozone ointment ; or if con. ozone is 
not procurable, apply spices ; say a mixture of pulverized cloves, 
allspice, cinnamon, and cinchona, equal parts of each, saturated 
with vinegar or acetic acid ; spread between folds of book muslin, 
and apply all over, then above a roller ; when it cakes it can be 
crumbled up, moistened, and re-applied ; or, the peroxide itself 
could be applied. The germicide principle of either penetrates 
by endosmosis to the tubercular bacilli in the mesentery, either 
kills or sterilizes them ; it also decapitates the comma-bacillus 
in the bowels. At all events, the nausea, the vomiting, diarrhea, 
cease; microbes disappear from the stools. 

Whatever germicide remedy is used, it must be powerful 
enough to kill, or at least sterilize the various microbes present ; 
general principles must guide. 

But in all cases the general treatment for the destruction of the 
tubercular bacilli must be enforced. 



Individuals with a strong tuber- 

The Tubercular Bacilli cular cachexia, are liable, if any 

on the part of the body be weakened, to 

"Walls of the Bladder, have the bacillus deposited on the 

{Tubercular Cystitis.) devitalized part. 

When the bladder becomes af- 
fected, deposits of tubercle occur in its mucous lining, especially 
about the trigone ; these, after a rime, softening and breaking 
down, are succeeded by distinct ulcerations with punched-out 
edges, which, when they remain separate from one another, are 
usually of small size and often very numerous ; in other cases 
they run together, and, becoming confluent, form ulcers of con- 
siderable dimensions, e.g.^ as large as the palm of the hand. 
The muscular coat subsequently becomes thickened from inflam- 
mation, and at the same time contracts, so that the capacity of 
the bladder is often considerably diminished ; occasionally per- 
foration of its walls ensues, and under these circumstances, sec- 
ondary abscesses may form in its vicinity. 

Tubercular cystitis may manifest itself in three different ways. 
In the most common form, the testicle is the part primarily at- 
tacked by tubercle ; this is frequently followed by suppuration, 
and after a while the prostate and vesiculae seminales become 
similarly affected ; eventually the disease spreads further onward, 
involving next the bladder, and then the kidneys. Under these 
circumstances, the affection is very slow in its course, often con- 
tinuing for as long as ten or fifteen years. In the second form, 
the bladder is first involved ; the prostate and kidneys may after- 



1048 DISEASE GERMS. 

ward become affected, but the testicles usually escape. In the 
third form, the implication of the genito-urinary organs is sec- 
ondary to the development of tubercle in the lungs. 

One of the earliest evidences of tubercular cystitis is slight 
haimaturia, the blood coming from the mucous lining of the 
bladder, and in many cases this continues for a considerable pe- 
riod, sometimes for several years, before the more severe symp- 
toms manifest themselves. Sooner or later, severe pain is usu- 
ally felt, but it differs from that met with in cases of cystitis due 
to calculus, inasmuch as it is almost constantly present, not being 
relieved by rest or sleep. 

Micturition is increased in frequency, and accompanied by 
tenesmus and a burning sensation, owing to the fact that the 
trigone is the part of the bladder which is usually the chief seat 
of ulceration ; the urine contains pus, and the deposit is more floc- 
culent and less of a gelatinous character than is usually met with 
in cases of chronic cystitis due to other causes. 

The position of the patient is often characteristic. He fre- 
quently lies crouched up in bed, so as to relax the abdominal 
muscles, for in this way, by taking all pressure off the bladder, 
slight relief is often obtained. 

The prognosis is always very unfavorable, most cases eventu- 
ally terminating fatally, either from the local affection, or occa- 
sionally, if the kidneys become affected, from the supervention of 
uraemia. Unfortunately, very little cfan be done in the way of 
treatment. Washing out the bladder with some germicide ano- 
dyne solution, suppositories, fomentations, etc., sometimes afford 
slight relief; but in most instances the severe pain, which is 
doubtless due to the constant irritation of the urine as it flows 
over the ulcerated surfaces, continues unabated, and it is the very 
intractable nature of this symptom which in many cases of pain- 
ful cystitis is of assistance in helping us to recognize the tubercu- 
lar origin of the affection. 

General treatment for tuberculosis, including glycerite ot 
ozone, ozonized stone crop, uric acid solvent, often retards the 
disease and prolongs life. 

Tlie tubercular bacilli in the kidneys. In all diseases due to the 
presence of a microbe in the blood, we almost invariably find the 
germs blocking up and breeding in the organs of excretion. This 
is specially so in the rectum and kidneys of young persons, who 
are the host of the germ. Males are more prone to this affection 
than females. The right kidney more seriously implicated than 
the left. 

When the germ is thus deposited, they are usually most 
abundant in the cortex, in the arterioles, and other parts. The 



BACTERICIDES. 



049 



tubercle undergoes its various stages of growth and degenera- 
tion. 

The symptoms are those of tuberculosis, pulmonary or intesti- 
nal hectic, night sweats, etc., pain in the loins, irritable bladder, 
scalding urine, with casts of the bacilli ; invariably tubercle in 
lungs, prostate, lymphatics. 

General treatment for the diathesis. 



The Tubercular Bacilli 
in the Rectum, ly^ 

( Tubercular Ulceration}^ 







We have seen that simple in- 
flammation and ulceration of the 
rectal mucous membrane and 
deeper tissues are more fre- 
quently present than what is 
generally supposed, and is often treated for disease of th"e liver 
and dyspepsia. 

Tubercular ulceration is generally in the posterior portion of 
the bowel, a weakened patch in which the tubercular bacilli have 
localized and where they are 
in an active state of growth, 
the walls of the rectum pre- 
senting a worm-eaten appear- 
ance. 

The annexed cut is a form 
of rectal ulcer, almost inva- 
riably present in the last 
stages of pulmonary tuber- 
culosis ; the posterior portion 
of the rectum is germ eaten ; 



in that riddled structure the 
tubercular bacilli are seen in 
their albuminoid, cheesy and \ 

calcareous stages. 

This ulcer, with its per- 
forating fistula is always amenable to a cure by the local appli- 
cation of resorcin or naphthaline ; with glycerite of ozone in- 
ternally. 

The symptoms are nearly identical with the simple form : diar- 
rhea, followed by constipation ; severe pain in the coccyx, radiat- 
ing through the hip and down the thighs, passing of mucous and 
bloody matter during stool ; burning, itching, great uneasiness in 
the bowel from the presence of the microbes ; inclination to strain 
at stool, and after movement a burning sensation after stool, but 
usually pain is slight, neither is there much local disturbance, but 
the reflex symptoms are vertigo or giddiness ; loss of memory, 




Rectal ulcer. 



1050 DISEASE GERMS. 

pain in the back of the head, indigestion, bloating of the abdomen, 
with order of the bladder and kidneys. 

The great prevalence of tubercular ulceration of the rectum 
may be gathered from the fact that 90 per cent, of all cases of 
pulmonary tuberculosis have a worm-eaten rectum. 

A species of ulceration of the rectum, very nearly analogous 
to the above, is met with among the insane. 

In our large, over-crowded cities, among prostitutes, with 
broken-down constitutions, aggravated by poor or insufficient 
food, alcoholic drinks, insanitary surroundings, we meet with 
gangrenous, or phagedenic ulceration of the rectum ; skin adjacent 
to the sphincter, often extending to the nates, the germ present 
being the oidium albicans, the evidence of squalor and rot. For 
the destruction of this we require oup most powerful antiseptics 
and germicides, with the best of internal nourishment and tonics, 
to reconstruct the shattered vital force. 

Gonorrhea of the rectum, venereal warts, condylomata or 
mucous patches near the verge of the anus must be treated on 
general principles. 



This frequently follows gonorrhoea. 
Tubercular Bacilli in In the early stages the symptoms, be- 
the Prostate. ing those of catarrh, escape notice, 

and the tubercle in the prostate can- 
not be detected by the finger until it has become considerably de- 
veloped. The catarrhal condition of the prostate, with slight ir- 
ritation of the bladder, lasts an indefinite time ; eventually atten- 
tion is directed to the prostate by the occurrence of other symp- 
toms, such as frequent seminal emissions, or by weight in the 
perineum and pain in the sacrum. In other cases the patient 
notices increased frequency of call to micturate, but a slov/ness 
in starting the stream of urine ; then he feels a burning or cutting 
pain during the flow. As soon as the shape and consistence of 
the prostate are altered, the finger in the rectum finds the pros- 
tate irregular, perhaps larger than natural, tender, particularly at 
the posterior part near the trigone. The disposition of these 
irregular thickenings is variable. When cystitis is developed, 
copious viscid pus, mixed with shreds and blood-clot, form the 
urinary sediment, and the urine contains albumen in considerable 
quantity. The further progress of the case is accompanied by 
gradual participation of the ureters and kidneys in the septic in- 
flammation, and the patient is gradually exhausted. Acute gen- 
eral tuberculosis may terminate his sufferings. The ages of the 
patients usually range between nineteen and forty years. Numerous 



BACTERICIDES. ^ IO51 

and highly instructive cases of advanced disease have been de- 
tected by the cystoscope, in which the surface was irregular, with 
pits at the uvula vesicae or neighboring part of the floor of the blad- 
der, partly filled with shreds of tissue, muco-pus, and blood-clot, 
though in those cases cystitis, ulceration, burrowing abscess in the 
floor and walls of the bladder are usually superadded before death. 

The differential diagnosis of tubercle in the prostate. In early 
cases the presence of tubercle elsewhere may be wanting, as the 
prostate is often affected before other organs. The disease most 
commonly suspected when tubercle is irritating the prostate is 
stone in the bladder. The urine is at first only moderately tur- 
bid in both. In prostatic tubercle there is often a gleet or history 
of such having continued since an attack of gonorrhea; a little 
shreddy mucus may be washed out with the first portion of urine 
voided, the remainder being only slightly turbid. In stone, on 
the other hand, a drop of blood often comes at the end of the 
stream, instead of pus at the beginning. When blood comes 
from the prostate, it is usually washed out first as coagula mixed 
with curdy pus. If the patient be sounded, and stone be there, 
it can be generally detected. Sounding does not always discover 
any alteration in the shape of the prostate or trigone, unless the 
tuberculous disease be far advanced. The distinction of vesicle 
tumor from prostatic tubercle is so great that confusion is not 
likely to occur. Tuberculous pyelo-nephritis creates symptoms 
which often suggest disease of the neck of the bladder. In these 
cases the absence of change in the condition of the prostate and 
the presence of tenderness in the renal regions indicate the real 
seat of the disease. 

The treatment of tuberculous prostatitis. — In the early stages the 
catarrh must be cured, and the general treatment for tubercle ap- 
plied. In the later stages, the ragged cavities must be carefully 
washed out. A good antiseptic solution is two grains to the 
ounce of sulphate of quinine, two ounces being injected and left 
in the bladder after the pus and urine are well cleared out by re- 
peated small injections of boric-acid solution. Still more anti- 
septic is an emulsion of iodoform. In cases of chronic cystitis, if 
the bladder is well washed out, and a couple of drachms of this 
emulsion injected, the most fetid ammoniacal urine is replaced 
by acid urine ; fetor disappears, and the pus rapidly diminishes. 
Again, in cases of cystitis caused by neglect of prostatic reten- 
tion, the urine in ten days becomes quite free from deposit, and 
even when calculus, or tumor, or malignant ulceration coexists, 
the improvement is enormous. 

Tubercular deposits, nodules, ulcers, on the floor of the bladder 
are readily made out by the use of the cystoscope. 



I052 



DISEASE GERMS. 



Cases might be cited, in which the various coats were literally- 
eaten with the bacilli. These were cured by washing out the blad- 
der, and then injecting iodoform emulsion, so that in a fortnight 
the patient — a man with advancing pulmonary tubercle- — was 
cured of his bladder trouble. When the pain of washing the 
bladder is severe, cocaine previously injected often renders the 
operation bearable. When things are too far gone for this, ether 
should be given. while the bladder is thoroughly washed with a 
large silver catheter, and Clover's extracting bottle, then a drachm 
of iodoform emulsion is injected and left in. The subsequent 
washings may then be carried out with very little suffering. The 
formula for the emulsion is— iodoform, two parts ; mucilage, four 
parts ; glycerine, two parts ; water, twenty parts. 



The microbe of tubercle when 

The Bacillus Tubercle in the blood has a great affinity to 

in the Testes. deposit itself in weakened parts and 

there breed, but of all structures in 

the body the parotid gland and testes are decidedly favorable 

loeations. 

Masturbation, sexual excesses, gonorrhea, stricture, sexual in- 
compatibility, are common causes, which damage the testes, and 
afford a location for the germ to run in ; once there, the tendency 
is to cause a general infection before suppuration takes place. 

A resection of the tubercular deposit in the epididymitis at the 
earliest possible moment is advised, but this is really unnecessary 
in the face of such valuable remedies as we now possess for the 
destruction of tubercle. 



The tubercular microbe, when 

The Tubercular Bacillus the blood is over-crowded with 
in the Eye and Ear. the germ, often appears in the 

eye, in and upon the conjunctiva 
and cornea. (See Tubercular Ophthalmia}) 

The microbe can be isolated from the serous discharge from 
the eye. 

The ear is still more obnoxious to inflammation of a tuber- 
cular kind than the eye. It is very doubtful if we can isolate any- 
one case of otitis media or otorrhea without the germ of pus and 
tubercle. In otitis, from the micrococci of scarlatina, running up 
the eustachian tube to the inner ear, this germ is present ; in per- 
foration of the membrana tympani, and in all forms of dis- 
charges from the outer ear, this microbe is present. 

Such cases even existing for years, should be placed upon the 
usual bactericide treatment of tuberculosis. 



BACTERICIDES. 



1055 



The Tubercular Bacilli 

in the Skin and 

Mucous Membrane. 



The microbe of tubercle in ter- 
ribly broken-down cases, often 
appears upon the skin as well as 
the mucous membrane of the 
mouth. 

Almost every variety of cutaneous disease appears with the 
germ, but the pathogenic bacillus in some mysterious manner 
has the ascendancy and runs them into round or crescentic 
forms, even erythemia, roseola, lichen, lepra ; psoriasis all appear 
in circles, and may be called any name corresponding to the 
nomenclature of skin disease. 

The bacilli can be isolated by scraping off the surface of the 
ulcer. The bacilli are short, straight, or curved rods, with 
irregular, undulating and slightly notched contours, of a deep 
blue color, and contain from two to four spores. They are never 
free, but are invariably included in wandering cells, in groups of 
from two to nine. The cells themselves are rarely found at the 
centre of the infiltration, but exist in pretty large numbers at its 
edges, and in the adjacent apparently healthy tissues. Lustgarten 
has also demonstrated the presence of these bacilli in the spinous 
cells of the rete Maipighi in papular eruptions, through which he 
explains the clinical fact that moist papules become contagious 
when they are deprived of their epithelial investment. 

The Bacilli of Tubercle in the 
Skin. — Individuals possessing * 
the tubercular diathesis are lia- 
ble at all times, if any weakness 
be induced (either by a mechan- 
ical or chemical irritant) in any 
part of the skin, to have the 
bacilli effused from the blood in 
the devitalized part. A dam- 
aged part is a vulnerable one for 
germ deposit, spore breeding. 

The annexed diagram is a 
photograph of a tubercular infil- 
tration following a burn on the 
elbow, which h^ealed kindly un- 
der ordinary remedies, but a 
few months later became a tu- 
bercular colony of great growth. 
The germs are seen in indolent, 
circular or oval superficial patches, having caused some loss of 
substance, which is covered by crusts of tubercle. 

Here and there throughout its centre could be seen dissemin- 
ated miliary nodules, transparent or of a light yellow color. 







'"^m^ 



f^¥'fi 



The tubercular bacilli acti 
the cutaneous surface ; 
the elbow. 



vely breeding on 
bove and below 



054 



DISEASE GERMS. 



Such an incrustation is not common, but when met with can 
only be cured by the destruction of the bacilH of tubercle. So 
far the glycerite of ozone is the only remedy that will kill the 
germ and prevent its reproduction by a fresh degradation of 
living matter. It is our best germicide 
in tuberculosis, and superior to all known 
remedies, except the glycerite of kepha- 
line or tincture of oats in constructing a 
dilapidated brain. The very fact that it 
contains a very large percentage of com- 
pound hypophosphite of lime, soda, iron 
in a fine state of subdivision, ready for 
assimilation, renders it* invaluable as a 
constructor of shattered nerve force. 

Ozone tablets might also be adminis- 
tered so as to cause the dead germs to 




The bacillus of tubercle mag- 
nified 950 diameters, from 
the above arm. 



exfoliate rapidly. 

Locally to the germ colony on the arm, a lotion of the per- 
oxide of hydrogen should be applied over night, and the oil of 
boroglyceride during the day. 

Other remedies, as thymol, ichthyol, ozone ointment, ozonized 
sulphur water are of utility. The general management of a case 
of tuberculosis should be enforced. 

The nails also may suffer onychia maligna^ the matrix of a 
single nail may be infiltrated by the bacillus, or several, or all, 
and the severity of the case will depend upon the amount 
of germs present; in every case there is. inflammation, which 
begins under the free edge of the nail ; the pain increases 
so that sleep is disturbed ; the part is red and the nail-bed 
swollen ; an ulcer develops that creeps along the side of the 
nail till it reaches the lunula or root, and at last the nail 
falls off. The ulcer is usually covered with bloody pus, and 
resembles a diphtheritic ulcer without its phagedenic character. 
The ulcer remains stationary for an indefinite time in spite of in- 
ternal and external treatment ; it may be for three or more years ; 
without attacking the periosteum and bone, or spreading beyond 
the ungual phalanx. 

The treatment should be active, glycerite of jozone and saxi- 
fraga ; locally bactericides, solutions of boroglyceride, creolin, 
sozoidol ; build up the constitution of the patient by every possi- 
ble means. 

In the mouth, the bacillus tubercular appears in round, 
scooped out ulcers {tubercular aphthcc), in deep ragged, eating 
ulcers (tubercular stomatitis). 

Such cases are pre-eminently contagious and infectious, each 



BACTERICIDES. 



1055 



ulcer, however small, contains millions of cocci, oidium albicans 
and the bacillus tubercular. These are readily seen by micro- 
scopes of low power, indeed the bacillus can be seen in the 
centre, in the form of cheesy flakes. 

In the treatment of such cases every possible means must be 
taken to improve the general health of the patient, the most 
liberal diet, fresh air of the country, salt-water bathing and 
mouth bactericides. The gums, cheek, tongue, throat must be 
washed out or gargled with lotions of boroglyceride three times 
a day, and also before eating, and then pickled down in either 
resorcin or thymol, or naphthaline, or creolin jelly. 



The microbe of tuberculosis lodges 
Tubercular Bacilli frequently in the bones and produces 
in the Bone. great havoc, ulceration (necrosis or 

caries). In these circumstances, the 
medulla contained in the cancellous tissue of the bone undergoes 
fatty degeneration, and, as in other parts of the body, this de- 
generated tissue disintegrates, and so cavities are formed in the 
head of the femur, containing a quantity of oily matter and 
bone-earth. It is this bone-earth or grit that sets up, not only a 
rarefying ostitis, but also the formation of the florid granulations 
characteristic of caries. The same changes occur as a conse- 
quence of tuberculosis of the medulla. 

On making a microscopic examination of a bone affected with 
tuberculosis in its early stages, we find nodules composed of an 
aggregation of round cells (among which are usually one or more 
giant-cells), which compress and so occlude the vessels in the 
affected area ; but the blood-channels surrounding the nodule 
and the spaces through which the round cells escape are choked 
with corpuscles. With the exception of increased cell-growth 
from the brood-cells, the surrounding tissues appear healthy. I 
have already referred to the changes which occur in the tubercles, 
the caseous degeneration of which, in the greater number of 
cases, ends in destruction, not only of the osseous tissue, but also 
of the joints, and the soft parts in their proximit}^ 

Symptoms. — There can be no question as. to the fact that tuber- 
culosis of bone is in its early stages easy of cure, but most diffi- 
cult to recognize; in the course of time, however, there is no 
difficulty as to our diagnosis ; but the cure of the disease is 
almost impossible without extensive damage to the affected tissues. 
It requires no stretch of imagination to understand that the pro- 
duction of cell growth in a structure like the medulla, only 
sparingly supplied with nerves, may progress to a considerable 



1056 



DISEASE GERMS. 



extent without causing pain. There is one symptom, however, 
referable to nerve-irritation, almost always present in cases of 
this kind ; and that is a certain amount of stiffness in the mus- 
cles surrounding the diseased bone. This is especially the case 
in tuberculosis of the bodies of the vertebrae and of the hip-joint. 
The stiff back or neck, and the occasional days of stumbling in 
the early stages of morbus coxarius are well known, but too 
often disregarded symptoms of diseased bone. From the com- 
mencement of tubercular disease of the medulla, however, imme- 
diate and forcible pressure on the bone generally causes marked 
pain; otherwise, the pain is often felt at the distribution of one of 
the nerves connected with the diseased bone or joint. Subse- 
quently, the pain becomes more marked, and is greatly increased 
if the diseased part be moved or jarred ; suppuration occurs, 
and sinuses form leading to dead bone, with all the long-continued 
and well-known consequences. 

Treatment. — We must bear in mind the fact that, supposing the 
exciting cause of tubercle be a bacillus, it is certain that an 
hereditary predisposition, and other recognized circumstances, 
prepare the soil in which any such influence can take root and 
grow. Pure air, sunlight, and plenty of wholesome food, are 
essential to the building up, or fortifying tissues against the action 
of any causes which provoke the growth of tubercles. If tuber- 
cles have formed in the bone, means tending to invigorate the 
patient's health must be enforced, and at the same time the dis- 
eased tissue should be protected from concussion or injury. 
Rest to the diseased bone is useful, and it should be employed 
so as to relieve pain caused by the pressure of the extremities of 
tender parts against one another. But, in my opinion, it is a mis- 
take to suppose that rest or confinement to a couch or bed for 
weeks and months, particularly in young children, is a judicious 
method of treating cases of this kind, especially in the early' 
stages of the disease. I am convinced that the actual cautery, 
applied judiciously, near the seat of the disease, and repeated if 
necessary, is of great service in many of these cases. In more 
advanced instances, good hygienic conditions, great patience on 
the part of the patient, his friends, and the medical attendant,* 
and the removal of diseased bone, together with free drainage, 
will bring about results more favorable than could otherwise be 
attained. Superiosteal excision of the diseased extremities of the 
bones is sometimes attended with most favorable results. 

Internally, comp. saxifraga and phytolacca should be adminis- 
tered alternately; the small but active quantity of iodide of pot- 
ass, which they contain, rouses up the vital energies which throw 
off the microbe, while at the same time, kephaline, avena sativa, 
aid in the reconstruction of osseous tissue. 



BACTERICIDES. 1057^ 

Tubercular bacilli in the various 

Tubercular Bacilli in bones of the body, or, as it is termed, 
Bone. rickets, is one of the most common 

(Rickets) diseases of children, and it is an affec- 

tion, with regard to its etiology, na- 
ture, and treatment, of which we know too little. The manifes- 
tations which attract attention are the intense tubercular habit, 
the malformation of bones, due to the bacillus eating up their os- 
teogenetic tissue, and deposition of lime salts — the presence of 
the bacillus in the blood being the cause of the osseous lesion. 

Rickets may be defined as a chronic tubercular disease in chil- 
dren, which deprives growing bones of their nutrition, accompa- 
nied by functional disturbances of various organs, more especially 
the nervous, respiratory, and digestive organs. 

The age at which rickets commences during the first three 
years of life varies considerably, but almost all statistics place the 
age whei the greatest number of cases come under notice as 
from twelve to eighteen months, and the next most frequent 'as 
from six to twelve months ; or taken in years about forty-seven per 
cent. coTie under observation during the first year of life, 
and forty-two per cent, during the second year, after which the 
numbers rapidly decrease. There seems also good reason to 
believe that rickets may run its course during foetal life, the dis- 
ease having ceased when the children are born (foetal rickets), 
while the existence of congenital rickets, i. e., of children born 
suffering from the disease, is generally admitted. 

In all large cities, with adulterated food and insanitary condi- 
tions, it is generally admitted that about ten per cent, of all the 
children are affected. 

The bacillus of tubercle strikes at the nutrition of bone ; it 
may affect different organs, although not always to the same ex- 
tent. There is invariably an increase in the number of the white 
corpuscles of the blood. 

Excessive sweating of the head is a typical symptom of tuber- 
culosis, due to an irritation of the nerves by the ptomaines of the 
bacillus ; the febrile exacerbations, the general irritability, the 
restlessness at night, together with the skin eruptions, all indi- 
cate an irritation of the central nervous system by either the 
microbe or its ptomaine. It is this same irritation which gives 
rise to the occurrence of laryngismus stridulus, which is gener- 
ally associated with rickets, and more especially with cranio- 
tabes. Other causes will produce this laryngeal spasm, (i) Pres- 
sure on the brain through the soft cranial bones ; (2) reflex from 
the digestive tract ; (3) anaemia of the brain in rickety children ;. 

67 



058 



DISEASE GERMS. 



(4) the presence of noxious substances in the circulating blood, ir- 
ritating the vagus centre. 

All tubercular children suffer from disturbances of the digestive 
apparatus. These vary in severity from slight dyspepsia to severe 
gastro-intestinal catarrh, anomalies of dentition. 

The frequency with which the various parts of the skeleton are 
affected varies with the age of the patient, in children below six 
months the bones of the skull being most frequently attacked, 
while in the following six months the thorax is the chief seat of 
the disease, the rule apparently being that the bones in which 
growth is most rapid (these varying with the age of the patient) 
are most readily and markedly affected. As regards the anoma- 
lies in dentition, dentition is delayed, the teeth erupt irregularly, 
and not in groups, as is normally the case, and they are not so 
good as in healthy children. 

The presence of the tubercular bacilli in the blood is the pri- 
mary cause of rickets, derangements of the digestive organs ; 
erroneous feeding, excess of farinaceous food, and other lowering 
conditions tend to increase it. No doubt, imperfect aeration of 
the blood, due to living in badly ventilated apartments, has much 
to do with it. 

In support of this view we would remark that this disease is 
extremely rare in warm climates, and chiefly occurs where, 
owing to the cold climate, there is much in-door life, or in 
crowded cities where the general hygienic conditions are bad. 
That it is not merely a question of bad feeding or poverty is also 
shown by the fact that it is very rare in gypsy children. Further, 
the number of cases of rickets is much greater in spring, after a 
winter spent in-doors, than in autumn, after a summer spent out 
of doors. Result of imperfect aeration of the blood — carbonic 
acid and water accumulate in it and in the juices of the body gen- 
erally. Further, as the result of the imperfect oxidation, numer- 
ous by-products accumulate in the blood, and it is these pro- 
ducts and the excess of carbonic acid that lead to the irritation of 
the central nervous system, with the consequent symptoms. A 
similar irritation is also exerted on the ossifying bone, leading to 
increase in the amount of new material, while by these products 
the alkalinity of the blood is diminished, and thus the lime in it 
enters into combination, and its deposit in the bone is prevented. 
Rickets is a bone disease, dependent upon the presence of the 
tubercular bacillus in the blood. Either the microbe or its pto- 
maine, or some unknown irritant acting on the bone, leads to in- 
complete deposit of lime salts in place of true ossification ; to the 
formation of an incomplete form of bone, devoid of lime, and to 
increased absorption of already existing bone. 



BACTERICIDES. IO59 

The real essence of rickets consists in a tubercular diathesis, 
the germ giving rise to inflammatory hyperaemia, and increased 
new formation of vessels in the osteogenitic tissue, the ptomaine 
of the germ, a chemical irritant ending in the softening. 

Rickets, then, is a name applied to the presence of the tubercle 
bacilli in bone. 

The disease may appear at birth ; most generally the impair- 
ment begins between the fourth and twelfth month. 

Most commonly the rickety condition is not noticed until the 
child begins to walk, or is affected by his first teething. 

Of 343 collected cases 98 appeared in the first year. 
«< " 176 " second year. 

" ** 35 *' third year. 

« "19 " fourth year, 

" «' 10 *' fifth year. 

«< ** 5 " sixth year. 

Of these 147 were males and 196 were females. At first the 
most ordinary symptoms are those which indicate irritation of 
the intestinal canal ; there may be diarrhea alternately with con- 
stipation, enlargement of the abdomen and more or less emacia- 
tion. The child is dull and languid, peevish and fretful ; the 
appetite is bad, and the sleep disturbed at night. If it tries to 
walk it is *' taken off its legs ; '^ it is thirsty and will drink plenty 
of water ; it has pain in the bones ; a pale face and flabby skin ; 
the hair on the head is thin, and blue veins marble the surface 
by their prominence; the fontanelle remains open. In the next 
stage there are three symptoms to be chiefly noticed, (i) A 
profuse perspiration of the head, neck, and upper part of chest. 
This sweating is worse at night, beads of sweat may be noticed 
on the head, while the lower part of the body is dry and hot. 
(2) There is a desire to kick the clothes off on the part of the 
child, as if with a wish to be cool ; so that the little patient lies 
with its naked legs on the counterpane. (3) There is general 
tenderness, so that the child cries when it is moved about. The 
urine is thick, and deposits a pale sediment of phosphates on 
cooling. The next set of phenomena are those connected with 
the deformity of the skeleton. With the increasing paleness 
and flabbiness of the skin, the wrists and ankles enlarge, and the 
ends of the ribs are knuckled. The long bones of the extremi- 
ties, and chiefly those of the legs, begin to yield, not being 
strong enough to bear the weight of the child. The deformity 
is very great in some cases, and such children are called knock- 
kneed or bow-legged. The spine is curved forwards ; the head 
falls backwards, and the face looks upwards ; lateral curvature of 
the spine is not so common, and with this curvature there is 
generally the deformity known as pigeon-breast. 



Io5o DISEASE GERMS. 

The back is flattened, there is a hollow under the arm-pit, the 
ribs are pressed in and the breast-bone or sternum is more 
prominent than usual. At each inspiration the softened ribs are 
sucked in, and the space for the lungs and heart is much en- 
croached upon. In this way also the bones of the arms become 
distorted, and the more so if the child tries to support itself by 
its arms and hands. The forehead is square and projecting. 
The head is generally unusually large and the top flattened. 
The process of teething is generally delayed, and those that are 
through, decay and soon fall out. The bones forming the pel- 
vis are sometimes distorted, and add to the general mischief. 
Such children are generally of an inferior intellect, although 
sometimes thou^^ht by their mothers to be very precocious ; this 
seems due to the fact that such patients are more in the society 
of their elders, and have an old-fashioned way about them, be- 
cause they cannot play with other children. After this the child 
may gradually get worse ; the emaciation goes on, the abdomen 
is more tumid, the softening of the bones, and the deformity in- 
creases, and generally disease of the liver, kidneys, or spleen 
comes on. Death may occur from bronchitis or congestion of 
the lungs, or from diarrhea, or from waxy degeneration of differ- 
ent internal organs, or from general dropsy. Children affected 
with rickets are liable to attacks of spasmodic croup, convulsions, 
and chronic hydrocephalus. So death may end a life, which to 
the unfortunate child has been one of unabated misery. Yet 
many cases do recover and grow up to adult life, but the de- 
formity remains, and they are never so healthy as other people. 
The favorable symptoms will be, an increase in weight, an ani- 
mated expression, and less pain in the limb; the pulse is less 
frequent, and the stools not so pale ; the urine will return to its 
natural color, and the appetite is more natural. The growth of 
the limbs then goes on with great rapidity, and the muscles ac- 
quire a powerful development. Many of the dwarfs are examples 
of recovery from rickets ; they may possess plenty of strength in 
spite of their deformity ; they are generally irritable and sulky, 
keeping aloof from their fellow- creatures, in consequence of their 
misfortune, being the subject of derision and mockery by their 
more fortunate brethren. The sooner the disease comes on after 
birth, the more likely is it to be fatal ; as a rule, if the disease be 
not far advanced, and if the deformity have not much affected 
the spine and chest, a favorable result may be looked for. 

Treatment. — Improvement of the general health is the first 
thing to be sought after. The child should be placed in a warm 
and dry atmosphere, with due ventilation and pure air. The 
greatest possible attention paid to bathing. These twice a day 



BACTERICIDES. IO61 

baths should consist of bactericides ; iodine, glucozone, p'ne, 
etc. ; clothing- flannel. The very best of diet, including malted 
milk sterilized. 

General treatment for the annihilation,, and preventing the 
evolution of the bacillus. 

The conclusions arrived at by the most profound bacteriolo- 
gists in the United States, are that in the glycerite of kephaline 
and ozone ; in the tincture of oats, and glucozone, in the treat- 
ment of rachitis, we find remedies giving the most brilliant re- 
sults. Not only afford amelioration, but are curative and pre- 
ventive. 



Whenever the tubercular bacilli 

Tubercle Bacilli exists in the blood of children, all 

in the the tissues, glands, bones of the body 

Vertebral Column, are weak, deficient in their natural ele- 
ments. This is especially true of the 
vertebrae which possess this inherent weakness in a high degree, 
rendering it soft and flexible. 

A child possessing this tubercular organization, placed 
in some avocation which causes the muscles on one side 
to become unduly developed and powerful, such as the 
habitual use of the right arm in a dressmaker or black- 
smith; constant assumption of an unnatural attitude, or in 
hitching one shoulder in wearing a low-necked dress; nurses or 
mothers carrying childi^n always on one arm^ ; repeated standing 
on right leg, left knee bent ; a tubercular diathesis, in which the 
the muscles are weak, relaxed, flabby, or where there is a predis- 
position to rickets, or a deficiency of earthy salts in the bones, so 
that there results a loss of equilibrium between the resistance of 
spinal column and weight of upper part of the body where the 
vertebrae are soft, spongy; rickety diathesis strong, even amount- 
ing to inflammation, ulceration, or caries of the vertebrae or their 
inter-vertebral spaces. 

There are three varieties : 

Lateral curvature, the convexity being to one side, usually the 
right. 

Posterior curvature, or excurvation. 

Anterior curvature, or incurvation. 

I. Lateral Curvature. — This is the most common form. Ap- 
pears chiefly in young girls from four to eighteen years of age, 
of a weak, tubercular habit, whose bones and muscles are defi- 
cient in vital elements ; who have been nursed and pampered, not 
supplied with the proper kind of food, nor had abundance of 



1062 DISEASE GERMS. 

sunlight, or sufficient amount of exercise in open air; and where 
there has been an inattention to a natural position in standing or 
walking, or in wearing low-necked dresses, or high-heeled gaiters, 
corsets and tight-lacing. Its recurrence is much favored by 
myopia, which is so prolific in our large school-houses from 
over-crowding and forced strains of the eyes, which leads to a 
constrained position in writing, walking or in ordinary duties. 

Symptoms. — One shoulder is observed to be higher than the 
other, with a growing-out of the scapula. While one shoulder 
is high, the other is unduly depressed. So one hip projects, 
while the opposite curves inwards. On an examination, the ver- 
tebral column is found to be curved ; in double lateral curvature 
it is twisted like the letter S. As the thoracic and abdominal 
cavities are more or less depressed, the movement of the lungs 
and heart are interfered with, and the play or peristaltic action of 
bowels, liver, uterus are impeded. The general health suffers 
greatly ; difficulty of breathing, dyspeptic and other indications of 
derangement ; pain in side from pressure exerted on the nerves. 
If it is dependent directly on a rickety diathesis, there are the 
usual cachexia and distortion of the limbs. 

In the treatment we must bear in mind that the bones 
which form it are made almost entirely of the spongy or 
cancellous tissue, and for that reason are specially liable to 
disease, which sometimes burrows a good distance into the 
bone before any one, not even the owner of the spine, guesses 
what is going on. Another trouble to which the spine is 
liable is curvature, which usually appears first between the 
ages of twelve and eighteen, just when delicate girls are grow- 
ing very fast, and probably out-growing their strength. It is very 
unfortunate that in these cases the spine does not keep pace with 
the other parts of the body; the head and chest grow, the 
shoulders broaden, but the strength of the spine does not 
increase fast enough to bear this extra weight, and so it 
bends. It is as if you were to try and balance a heavy stone 
on the end of a thin stick ; the stick would bend, and the spine 
does just the same and for the same reason. There is no real 
disease, simply the bacillus, which gives rise to weakness, and 
this trouble is usually laid upon girls ; about nine cases of it in 
girls to one in boys. And another thing is, it is usually due to 
the occupations followed by girls, as distinct from that followed 
by boys, and besides, a boy will go and join some healthy game 
after his work is over. 

That there need be little, if any, difference between most men 
and women, in the matter of muscular strength, is proved by 
what goes on amongst some barbarous tribes, where the men 



BACTERICIDES. 



1063 



lead idle lives, and the women do all the work and carry the 
heavy weights, and their muscles grow very strong ; and 
you certainly will not find spinal curvature amongst them ; 
that is a trouble of civilized life. You must clearly understand 
that curvature of the spine is due to tubercle, and is entirely the 
fault of a child's up-bringing, and her friends do her a grievous 
harm if they do not take measures in time to correct it, for in 
time it crushes the other organs in the body, and may shorten 
life. What ought to be attempted is: (i) to feed the child 
better ; (2) to give her as much fresh air as you can possibly get 
for her ; (3) not to let her sit up at a table or any work for many 
hours together without support to her back, but place her in a 
chair with a back, and prop her up well with pillows, so that 
the poor weak back does not get over-tired and yield; (4) if you 
can possibly avoid it, do not choose for a delicate over-grown 
girl work at which she must sit bolt upright, or in a stooping 
position ; (5) whenever she can do so let her lie on a couch ; 
(6) if she is short-sighted take her to the eye department and 
get her spectacles. A child with spinal mischief will have a sharp 
pain in the back if it jumps off ever so little a height, and if this 
happens once he will not be in a hurry to do it again but you 
will notice that he moves about carefully, and will not hurry 
himself, and have the sprightliness of a healthy child. The 
position which a child will choose as the most comfortable in 
spinal disease should also warn an experienced eye: he will lean 
forward, and often grasp the thighs very firmly — a position very 
much like that which boys assume when playing leap-frog. 
Gf course the child finds this position the least painful because, 
to some extent, it takes the weight of the body off the diseased 
spinal bones and throws it on the upper part of the legs. 
Another point to remember is that a child will often, when the 
disease has attacked the upper part of the spinal bones, complain 
of pain at the back of the head. Of course this may be merely 
a headache, but if it is repeated often this warning must not be 
overlooked. Again, if the disease is in the upper part of the 
spine, the child's neck may be stiff, so that when he wants to 
turn his head he will turn all his body round, and to look up- 
wards he will bend the lower part of his back, and also a child 
will often make a habit of resting his chin on the top of the 
breast-bone, or of supporting it on the hand. Children with dis- 
ease of the spine will lose flesh. 

The diet therefore should be generous, consisting of animal 
food, milk, eggs, boiled white-fish, oatmeal, corn cake. 

The remedies used internally should consist of glycerite of 
ozone to annihilate the tubercular germ ; glycerite of kephaline 



1064 • DISEASE GERMS. 

and tincture of oats ; comp. tincture matricaria to stimulate an 
appetite. 

When not exercising for the benefit of her health, the recum- 
bent posture, with head low. Once, twice, or even thrice daily, 
-Strengthen the muscles of the back with vitalized massage ; follow 
with either a stimulating liniment or faradization. 

Clothing should be light but warm, so that there be as little 
weight on vertebrae as possible. 

Unless the case is bad, can be better treated more successfully 
without than with an apparatus. 

Posterior curvature prevails among the same class of children, 
and chiefly affects the cervical and dorsal regions. It is caused 
in infancy by the frequent practice of mothers and nurses, in 
raising the child, by placing their hands under the arm pits, and 
so compressing the ribs, and forcing back the sternum and spine. 
Under this common custom, the muscles and ligaments, which 
keep the vertebrae erect, become weakened and relaxed. In 
other cases it may depend on rickets. 

Anterior curvature, the tubercular bacilli are literally swarming 
in the blood, the nervous system is bankrupt, and the bacilli are 
being evolved in myriads ; all the bones of the body are soft, 
spongy, devoid of vital stamina, tubercular deposit, evolution of 
spores, germs, inflammation, destructive ulceration, caries of the 
bodies of the vertebrae ; the intervertrebral spaces tumble in, 
owing to interstitial softening, and absorption of calcareous ele- 
ment of bony tissue. As the bodies are destroyed or absorbed, 
the spine projects backward, forming an angle. In bad cases, 
where the tuberculosis is very aggravated, as many as five or six 
vertebrae may be implicated, with their intervertebral spaces. It 
is most frequently met with at the middle of the dorsal vertebrae. 

Symptoms. — Intense tubercular diathesis ; weakness ; coldness ; 
numbness of legs, with twitching and spasm. Subsequently, 
paraplegia, with paralysis of bladder and rectum ; tenderness, or 
dull, aching pain in back ; tightness of chest, with more or less 
•difficulty of breathing ; rigors ; formation of abscess in back, the 
pus of which finds its way along the course of the psoas muscle 
in the groin ; exhaustion, sweats, hectic. Under favorable treat- 
ment, the disease gets arrested ; bones collapse ; anchylosis 
occurs ; patient recovering with incurable deformity. Sometimes 
sudden death, owing to diseased bodies of the vertebrae giving 
way and crushing the spinal cord, or from discoloration, with 
ulceration and destruction of its ligaments. 

In the treatment push the bactericide treatment of tuberculosis 
as far as practical. Perfect rest in the recumbent position is in- 
dispensably requisite ; the use of a reclining couch, so shaped as 



BACTERICIDES. 1065 

;to keep the trunk perfectly quiet ; a stiff bandage of paraftine, 
.extending from the occiput to hips, to insure rest ; no attempt to 
be made to rectify the deformity ; pain to be reheved. 

As soon as the streptococcus pyogenes appears, the abscess 
should be aspirated and a few drops of peroxide of hydrogen in- 
jected. 

For mechanical support, the best application in all cases is a 
parafifine jacket, made after the manner of the plaster of Paris 
bandage. To make this jacket, take a large sheet of cotton- 
wool, long enough to reach from the nape of neck to beyond 
;the buttocks. The thickness of the sheet is sufficient, but if the 
.physician desires to have it thicker, he can double it or use two. 
It is then to be submerged in the liquid paraffine for five 
minutes. Have the patient in a nude condition, in the precise 
position in which it is desired to be retained ; then turn out the 
.cotton, saturated with the parafifine, on a piece of oil-cloth, or 
any smooth body, oiled to prevent it adhering ; spread it out 
to its original size ; and after it has cooled sufficient so that you 
can place the back of the hand on it without inconvenience, it 
is ready for applying to the back. This cooling process will 
occupy three or four minutes. The sheet of cotton, so saturated, 
is applied to the back, from neck to hips, and well round the 
body. Its adaptability is perfect, filling every curve or crease. 
Then apply a bandage over all, pressing the cotton firmly. This 
pressure causes a cohesion of the cotton and paraffine. Then 
have a piece of ice handy, which will cause the paraffine to be- 
■come as hard as a block of marble. If it is desirable to prevent 
the hardening, refrain from applying the ice ; the paraffine in that 
case will take at least twenty minutes to cool. 

Spina bifida, or cleft spine, is also due to the presence of the 
tubercular bacilli in the vertebrae during foetal life, which gives 
rise to an arrest of development or growth of the posterior 
arches of one or more vertebral bones : the membranes which 
loosely envelop the spinal cord become distended with fluid, and 
are bulged out through the tissues in the walls of the canal, and 
form under the skin a soft and rounded tumor. When the mal- 
formation affects several of the vertebral bones the base of this 
tumor is broad, but when only one or two of the arches are defi- 
cient, or merely fissured, there is more or less of a pedicle or 
stalk. The size, conformation, and appearance of the tumor, 
and the symptoms caused by the malformation, differ very much 
in different cases. The state of things is usually as follows : in 
the lumbar region, just above the sacrum, and in the middle Hne 
of the back, is a large fluctuating and rounded tumor, evidently 
containing fluid, and the surface of which is covered by thin and 



I066 DISEASE GERMS. 

distended skin. At the base of this tumor a fissure, or large 
hole, can generally be felt in the posterior part of the spinal col- 
umn. When the child is placed upon its belly the tumor shrinks 
to a slight extent, and the skin becomes flaccid ; in the erect 
position of the child the tumor swells and the skin becomes 
stretched and smooth. As the child grows, serious nervous 
symptoms, such as convulsions and palsy of the lower extremi- 
ties, make their appearance. In most cases. spina bifida termi- 
nates fatally, and the patient dies in convulsions, which in some 
instances are immediately preceded by giving way of the walls 
of the tumor. The affection, however, does not always cause 
death ; several cases have been recorded in which the patient at- 
tained an advanced age without suffering any ill effects from the 
tumor, which continued to grow, though not out of proportion 
to the rest of the body. A more favorable and occasional termi- 
nation of cases of this kind is a closure, through adhesive inflam- 
mation, of the walls of the orifice between the spinal canal and 
the tumor. A closed and comparatively harmless cyst is thus 
formed, which is called a false spina bifida. The walls of the 
tumor formed in cases of spina bifida are composed of the skin 
and extended membranes of the cord, and sometimes a portion 
of the cord itself spreads out into a thin membrane. The con- 
tents of the tumor are a thin clear fluid, a portion of the cord 
and some of the spinal nerves. 

In consequence of the close connection between the tumor in 
spina bifida and the contents of the spinal canal, all surgical at- 
tempts at a radical cure of this affection are extremely hazardous. 
The too frequent result of such interference is acute inflamma- 
tion of the cord and its membranes, causing convulsions, palsy, 
and finally death. 

Symptoms. — A tumor, varying in size from a walnut to a 
child's head. There is fluctuation, swelling, most tense whert 
the child is in erect posture. The tumor may be transparent, 
or the skin may be unaffected, or it may be congested, purple, 
or blue. If only one or more lumbar vertebrae are affected, 
spinal cord does not deviate from its course, and only the pos- 
terior spinal nerves have any connection with the sac. If the 
tumor occupy part of the lumbar and part of the sacral region, 
the cord itself, and all its nerves will almost always be found in 
close contact with the sac. Not necessarily fatal, but likely to 
be if there is hydrocephalus, or paralysis of the bladder or rec- 
turn and lower extremities, or if the tumor bursts. 

The general treatment for tuberculosis should be pushed with 
care and energy. The glycerite of kephaline, tincture of oats, 
salt water and iodine baths; most nutritious diet, avoiding 



EACTERICIDES IO67 

Starch. Every means which the nature of the case will admit of 
for to overcome the tubercular condition. 

To prevent further protrusion, a compress of some kind might 
be applied with great care. 

The collection of cerebro-spinal fluid is first due to the want 
of the normal support of the vertebrae ; its increase due to the 
irritation and unravelling of the serous fibres, causing exudation. 
The collection is termed hydrorachitis. 



Irritation, shocks to the cartilagi- 

Tubercular Bacilli nous extremities of the ends of bones, 
in the from falls, jumping, or other mechani- 

Hip-Joint. cal irritation, depreciate the nerve 

i^Coxalgia.) centres, liable, if the tubercular condi- 

tion does not exist, to create it. 
The knee, hip, and wrist, are most obnoxious to the ingress of 
that bacillus. The greater tendency for the germ to appear in 
those three joints, is accounted for by the presence of pink mar- 
row in the concellous structure, which dischrages the function of 
ordinary lymphatic gland, namely the elevation of the blood 
discs ; so that when weakened in any way, they become invaded 
with myriads of the bacilli. 

Most common among children between the ages of seven and 
fourteen ; met with up to thirty years age ; boys, from their stir- 
ring habits, are its victims. 

The first symptom which is observed in the child, is the 
dragging of the affected limb after the sound one, a flattening of 
the nates ; pain at first confined to the knee, and in standing, the 
patient advances the foot a little, slightly everting the toes, and 
does not rest his weight upon it. After a while pain comes on 
in the hip-joint itself, and generally conntinues chronic for sev- 
eral months. At length the symptoms may disappear, and be- 
come far more serious ; thus the affected limb becomes shorter 
than the sound one, the motion in the joint being impaired or 
destroyed, and permanent dislocation taking place. 

To assist in making an early diagnosis, a careful study should 
be made in a difficult and doubtful case of those limitations in 
th^ motions of the joint which become apparent only when the 
extremes of normal motion are approached. This may be done 
in various ways. I have found two methods easy in practice and 
certain in revelations. The first method applies to rotation, 
which is a direction in which limitation of motion first takes 
place. Let the patient lie supine with the feet slightly apart. 
With the hand placed lightly on the knee of the unsuspected 



1068 DISEASE GERMS. 

limb, a rocking or oscillating motion is given to the whole limb, 
outward and inward rotation following each other, while the toe 
sweeps through an arc of nearly i8o°, the inner border of the 
foot striking the table, and the outer border nearly reaching that 
level. This occurs in the sound limb. A similar manipulation 
of the suspected limb may reveal a slight limitation of rotation, 
the result of hip disease. The other simple procedure relates to 
flexion. Let the patient, still on the table, sit up and kiss the 
knee. By flexing the neck and back, and drawing the limb up 
with the hands, this can be easily done with the unaffected limb, 
while an attempt to do it with the suspected limb may reveal a 
slight limitation of flexion indicative of incipient hip disease. 
Another diagnostic sign, too little thought of, perhaps, but of 
importance in the very early stage, a brawny thickening about 
the joint in front of the capsule or behind the trochanter. There 
will in some cases be found a condensation of the soft tissues, 
due apparently to the vicinity of osteitis, not visible perhaps, but 
recognizable by palpation or pinching with the thumb and 
finger, and then often not detected except by comparing the two 
sides. It will be found that a smaller pinch of the skin and un- 
derlying tissues can be made on the sound than on the affected 
side. These tests are to be used, of course, in connection with 
other diagnostic helps, and with due regard to other conditions 
which have the power to produce similar phenomena. Properly 
used they may betray the presence of hip disease in a patient 
entirely free from pain and lameness at the time of the examina- 
tion. 

Later on, the bacillus destroys the cartilage lining, the ace- 
tabulum, and covering the head of the femur ; the microbe of pus 
puts in appearance, and forms large masses in the cavity of the 
joint, ptomaines are excreted by both germs, hectic appears, and 
if nature or art does not effect an opening into the joint, the pa- 
tient may die or recover with anchylosed joint and a wasted use- 
less limb. 

The treatment in the earliest stage consists in maintaining the 
limb at perfect rest (the patient in the recumbent posture), in a 
straight position, which is best effected by putting on the limb a 
counter extension apparatus, and placing two sand bags, one on 
each side of the limb, the external one reaching as high as the 
arm-pit. Local stimulation over the germ-infiltrated tissues, 
with powerful bactericides, the irritating plaster ; if sinuses form, 
run them in one, and use injections of peroxide of hydrogen, 
somewhat diluted, into and around the joint cavity ; otherwise 
general treatment for tuberculosis. Aspiration of the joint, and 
injecting eight vol. peroxide has been tried with success. 



BACTERICIDES. 



1069 



Tubercular Bacilli in 
the Knee-joint. 

( White Sivelling.) 



great 



number 



of strong 



The knee-joint is the largest in the 
body, and is composed of three 
bones ; the thigh-bone (femur) ; shin- 
bone (tibia), and knee-cap (patella). 
These bones are held together by a 
igaments, and the movements of the 
joint are controlled by numerous muscles. Like all movable 
joints, the articular surfaces are covered over with cartilage, and 
a large and complex synovial membrane is insinuated between 
the structures forming the joint. A remarkable feature about 
the articulation, it has in common with one or two more in the 
body, viz., the inter-articular fibro-cartilages, or as they are here 
called semilunar ; their office is to defend the joint from severe 
and sudden concussions, and their mechanism is so adjusted, 
they are always between the ends of the bones when, and at the 
point at which the greatest pressure is experienced. From the 
complex nature of this joint, their size, and exposed situation, it 
is obvious that it must come in for a large share of injury, and it 
is peculiarly subject to disease. The natural movements of which 
this joint is capable are flexion, extension, and partial rotation 
outwards and inwards. 

The tubercular diathesis is intense, the joint and all its struc- 
tures badly damaged, before the bacillus can enter. 

More common among children than adults. 

It commences with slight lameness, sweUing of the joint, and 
from the pain or stiffness of the articulation, the muscles are not 
brought into play, and so waste and atrophy. 

The gtneral train of symptoms is as follows: Tubercular 
habit, some exciting irritation ; occasional pains in the joint, be- 
comin^j^ g^radually worse ; swelling 
so slight at first that it is scarcely 
recognizable, gradually becomes 
a globular enlargement, owing to 
infiltration of the synovia with the 
bacilli, and latterly in and around 
the joint If the disease proceeds 
unchecked the bacillus dies, and 
undergoes cheesy and calcareous 
degeneration, anchylosis, disor- 
ganization of the joint ensues. 

The same rule holds good with 

reference to the knee, as the hip ; 

the same pathology and germicide 

treatment. This illustration is a microscopical appearance from a 

lymphatic in the groin of a patient, aged seventeen years, who 



0/ ©0 







The bacilli of tu'^ercle infiltrating one of tke 
lymphatics of the groin. 



IQjO DISEASE GERMS. 

had suffered for eight months with tubercular synovitis of the 
knee joint. The patient was much emaciated, terribly anaemic 
and broken up in all the essentials of Hfe. He was placed upon 
the glycerite of ozone in alternation with the concentrated tinc- 
ture of kurchicine in half teaspoonful doses, thrice daily. 

Improvement was perceptible the second day of treatment, 
which continued on for three months, when he was perfectly cured. 

The tubercular effusion in and around the joint was somewhat 
troublesome ; ozonized clay effected most excellent results, but 
after using it about ten days lost its effect altogether; liquid 
ozone operated well; this was followed by iodol, which also did 
good work ; hot fomentation of wormwood, one ounce resorcin 
to the pint were efficient, iodized oil was most effective. 

The effusion of tubercle into the synovial fluid of the knee 
joint must not be confounded with enlargement of the bursa 
mucosa, situated in front of the patella, and of the tendon imme- 
diately below it. It is frequently noticed in those who have 
much kneeling, as household servants, carpenters, plumbers, 
carpet-layers, etc. Enlarged bursse of the patella are frequently 
attacked by inflammation and suppuration, and usually there is 
extensive inflammation of the surrounding cellular tissue. Some- 
times troublesome burrowing ulcers remain after these abscesses, 
which are singularly obstinate, attended with fungus growths, the 
surrounding skin being dark and unhealthy, with deep burrow- 
ings under the integuments of the knee, and a foul offensive dis- 
charge. In severe instances the bone (patella) may become ne- 
crosed. The treatment consists in the first place of complete 
rest, and a well-fitting splint must be applied, and all motion of 
the joint prevented. If a recent enlargement, a stimulating lotion 
of acetic acid and hydrochlorate of ammonia, or a small blister, 
will often cause it to subside. If there is considerable thicken- 
ing, as there always is if the tumor has been of long duration, 
evacuation of the sac and subsequent counter-irritants will often 
effect a cure. Some surgeons use a seton, which is composed 
of a ^Qvj threads of silk passed through the cyst, and by setting 
up suppuration and the consequent contraction and granulation 
the cavity becomes obliterated. When the tumor has become a 
solid, gristly mass there is no other treatment than dissecting it 
completely out. ' the cases most commonly brought under 
observation, rest, ^v,. :hing, hot fomentations, and purgatives, and 
failins: these a free incision, usually effect a cure. 

Efforts have been made, by various remedies, to cause a disin- 
tegration of the calcareous mass in and around the joint, either 
by the ozonized clay or dioxide of hydrogen, with electricity, 
but with no satisfactory results. 



BACTERICIDES. JO/I 

Next in order to the knee and hip- 
Tubercular Bacilli in joint comes the wrist, here the same 
the Wrist-Joint. microbes often lurk, and here the 
amount of lymph glands are numer- 
ous, pink marrow abundant, consequently the anaemia is great. 

Treatment same as in the other joints ; locally, try the ozonized 
clay, if suppuration has not taken place ; or better still the gal- 
vanic cautery, followed with concentrated ozone ; if suppuration 
has taken place remove matter by aspiration, and inject eight- 
vol. solution of peroxide to destroy the microbe. 



Curative treatment has chiefly been attempted by stomach 
medication, and by the local application of bactericides. 

Local destruction of the bacillus tubercle by inspiring bacteri- 
cides, has been effectual and is worthy of a trial, breathing the 
germicide it often strikes the germ. 

There are various forms in which remedies employed for inha- 
lation can be administered, and several methods by which their 
direct application can be accomplished. All inhalations may be 
divided into two principal groups — the moist and the dry. 

In the first group, or moist inhalations, we have — 

1. Warm vapors arising from water heated to various degrees 
of temperature, and charged with medicinal substances properly 
prepa'*ed for vaporization. 

2. Medicated spray, produced by mechanical force. In the 
second group, or dry inhalations, we have — 

(^.) Gases or vapors produced by heat or chemical action, and 
mingled with the air. 

(/;.) Minutely divided solid substances, or impalpable powders. 

Each of these forms requires special apparatus for their pro- 
duction and administration, such as the inhaler, the atomizer, the 
evaporating dish, properly contrived syringes. For inhalation, 
important gases, as oxygen, chlorine, and nitrous oxide are oif 
great utility. 

The use of oxygen is of utility — a valuable remedy, in those 
cases of lung diseases which arise from imperfect decarboniza- 
tion of the blood. In some forms of asthma it is also exceed- 
ingly beneficial, relieving the difficulty of breathing and restoring 
the patient to a healthy condition. It must, of course, be used 
with caution and only under proper professional advice. 

Chlorine also has been highly spoken of by many writers on con- 
sumption, and has been even supposed by some to cure every 
stage of this affection. Numerous physicians have mentioned 
several severe cases of consumption that were perfectly cured by 



I072 DISEASE GERMS. 

this gas, and I am fully convinced that there are certain advanced 
stages of this disease in^which its inhalation is extremely benefi- 
cial. In chronic catarrh, and those affections of the lungs and 
air-passages in which direct stimulation of the mucous membrane 
is advisable, this gas, properly diluted with atmospheric air, may 
be applied with the greatest advantage. Like all other forms of 
remedial agents it must be used with caution and judgment, and 
when it is so administered it is perfectly free from danger, un- 
pleasant sensation or inconvenience. 

This gas may be easily obtained by placing a teaspoonful of 
peroxide of manganese in an earthenware saucer, floating in a 
basin of boiling water, and pouring upon it about fifty drops of 
hydrochloric acid. This will disengage a sufficient quantity of 
the gas to medicate a room of moderate size. The fumes which 
arise will rapidly diffuse themselves through the atmosphere, and 
be inhaled in the natural act of respiration. It will be necessary 
to keep the doors and windows of the apartment closed during 
its use, and indeed, if possible, it is better to appropriate a small 
room for the purpose, into which the patient may go for a few 
minutes several times a day, otherwise it will be necessary to pre- 
pare the vapor freshly as required. 

Nitrous gas has also been found very effective in many forms 
of lung disease, its action upon the system doubtless depending 
in a great measure upon the amount of oxygen which it contains. 

This gas may be obtained by pouring about half an ounce of 
sulphuric acid into a saucer, and adding to it, at short intervals, 
small quantities of pure nitrate of potash. By this means the air 
of an apartment will be quickly charged with the gas. 

When judiciously applied it speedily relieves violent parox- 
ysms of coughing, soothes the irritation of the mucous mem- 
brane, and promotes expectoration. In ashma and chronic 
bronchitis also it is very efficacious in overcoming the sense of 
oppression ot the chest and difficulty of breathing which always 
accompany these distressing complaints. 

The vapor of creosote may be obtained by mixing ten drops 
of this substance with half an ounce of water, and allowing it to 
evaporate in the fumigator and slowly diffuse itself through the 
atmosphere of the apartment. This quantity will be sufficient to 
medicate the air of an ordinary-sized room. 

This vapor has been found very useful in the advanced or 
ulcerative stages of consumptive disease. It should not be admin- 
istered whilst any inflammatory action is present, but when used 
with due caution it is attended with the best results. 

In the early stage of tuberculosis, before the bacillus has made 
much of an inroad, the microbe can often be sterilized, and a 
complete restoration of general health effected by inhalations. 



BACTERICIDES. 



10/3 



When the g-erm has effcicted an entrance and become localized 
in the lun;^, sofcening of the tubercle and its expulsion by expec- 
toration is much aided by inhaled vapors. 

When the greater portion of the lung is microbe-eaten, an 
ulcerous cavity formed, the possibility of a cure depends a great 
deal on the energy of the treatment. 

If the microbe, on the contrary, involves the whole of one lung, 
the prospects of recovery are greatl}^ diminished ; but still cure 
is possible so long as the other lung retains its integrity and is 
unobstructed in its functions. Life may be preserved even after 
the destruction of one lung. A person in this condition cannot 
have the same power of endurance in pursuit of his ordinary 
occupations, but he may still live and enjoy comparative freedom 
from suffering for many years. In such cases, which have hitherto 
been considered hopeless, a properly conducted course of inhala- 
tion has produced the following marked effects : the cough and 
expectoration have been controlled, and the constitutional dis- 
turbances greatly modified. In this condition the patient may 
remain stationary as regards flesh, although this will be, of course,, 
below the former standard. 

When both lungs are involved in extensive disease, cure is im- 
possible, and it is folly ever to hope for so great an improvement 
in the healing art as to embrace these cases among the list of 
curable. The most that can be accomplished is to afford relief 
by cleansing the lungs from mucus and pus which obstruct the 
bronchial tubes ; to soothe the cough and allay the irritation of 
the lung, so as to promote sleep, and make the patient com- 
paratively comfortable. But, in defiance of any skill within the 
power of man, the duration of life is a question of weeks or 
months. This, however, is no reason why some well-directed 
effort should not be made to procure the greatest amount of relief 
possible, and this can be more confidently looked for from the aid 
of inhalation than, from any other mode of treatment 

From the above remarks it will be seen how necessary it is for 
those who are predisposed to pulmonary disease to keep a close 
watch over the earliest perceptible signs of its approach. All 
authorities agree that in its first stage consumption is as amena- 
ble to treatment and as curable as any other form of disease. It 
cannot be known too soon who are the subjects of it, and it is 
impossible to ascertain this but by a most thorough, careful and 
frequent examination into the constitutional and local symptoms 
of the disease. Every one ought to be examined regularly at 
stated periods during the year, and there are no seasons better 
suited for this than the autumn and spring. If the lungs are 
hea'thy, an examination cannot produce the complaint, and if 
68 



I074 



DISEASE GERMS. 



any evidence of the malady be detected, the sooner the patient 
comes under treatment the better chance there will be of his 
deriving benefit, and the greater probability of an ultimate cure 
being effected. The treatment should in any case be persevered 
in so long as the least vestige of the disease remains. 

To kill bacteria is one thing, to kill germs is quite another. It 
has been proved that they can stand a short boiling, that they 
can be floated in air-bubbles through strong vitriol, that they can 
be washed with a carbolic solution of any strength short of five- 
per-cent. without being killed, or losing their power of self-multi- 
plication. Is it likely, then, that) any vapor which could possi- 
bly be inhaled would be capable of destroying organisms which 
are so retentive of their vitality ? I think it is quite obvious that 
all evidence shows that it is impossible, either to keep germs out 
of the body, or by antiseptics to kill them. What else, then, can 
inhalations do ? vSimply ameliorate. 

While Prof McFall was performing experiments on the living 
matter in the atmosphere, it became necessary very frequently to 
prepare sterile solutions, and he was much troubled by the pro- 
longed boiling which was necessary to destroy with any certainty 
their contained vitality. But he found that if, instead of giving 
his solutions one long boil, he heated them several times for quite 
a short period, leaving them at the ordinary temperature in the 
intervals, he could quite readily devitalize them. This method 
he described as sterilization by discontinuous heating. He dis- 
covered, in fact, that however hard and resisting the germ may 
be, there is, in the life-history of every bacterium, a period when 
it is very soft, tender and easily destroyed ; and that, although he 
could not touch the germs themselves, he could let them hatch, 
and, by repeated slight heatings, kill their offspring as they came 
out, while they were too young to produce a fresh generation ; 
and thus he was able, without ever reaching the point of ebulli- 
tion, completely to devitalize the fluids which he had found most 
resisting, even to very prolonged boiling. The recognition of 
this difference between germs and bacteria, as regards the action 
of destructive agents, explains many things otherwise difficult of 
comprehension, and enables one to understand how organic sub- 
stances can often be protected from decomposition by the addi- 
tion of very minute quantities of antiseptics, in proportions quite 
too small to be in any way considered germicidal. 

The modus operandi is probably in all cases the same : the 
germ is allowed to hatch, the young is killed by an antiseptic far 
too weak to touch its parent, and thus the race dies out. Now, 
it seems to me that this is the explanation of antiseptic inhala- 
tions. The materials which have been found most useful are not 



BACTERICIDES. 10/5 

mere gases which intermingle with the inspired air and then pass 
out again with it, but are vapors, gaseous forms of soluble bodies 
which are deposited wherever their penetrating vapor comes in 
contact with water. On every moist bronchial tube, on the walls 
of every cavity, and even in every congested spot in the lung, the 
inhaled carbolic vapor condenses and carbolizes the tissues ; and 
we are, I think, forced to believe that the benefits derived from 
the use of antiseptic inhalations are due to this infiltration of the 
lungs with this antiseptic material rather than to any action upon 
the floating germs. It must, however, be granted at once that 
this impregnation of the tissues never goes to any great extent, 
and the question arises whether so mild a dose can have any 
effect in preventing bacterial growth. There is plenty of evidence 
to show that antiseptic inhalations diminish the irritating qualities 
of the expectoration, and lessen the number of bacteria in it; but 
there is no proof at all that it can be rendered entirely free from 
bacteria by any amount of antiseptic vapor ; in fact, all evidence 
goes the other way. 

Now, it has often been assumed that, if we cannot stop the 
growth of micro-organism in fluids lying in the tubes and cavities, 
we certainly must not expect to check the development when 
embedded in the substance of the lung. But the cases are dif- 
ferent ; the one is a question of dead matter, the other of living 
tissue. Decomposition of expectoration obeys the same laws as 
experiments in test tubes ; but the growth of bacilli in the living 
substance of the lung is resisted by the vitality of the tissues 
themselves. Life is the great antiseptic. There are few points 
in which the difference between things living and things dead is 
more markedly shown than in the power live bodies possess of 
resisting, by virtue of their own vitality, the growth within them- 
selves of those lower organic forms which, in dead tissue, readily 
take root and grow, and by their development, rapidly reduce the 
lifeless elements to their lowest chemical affinities. For scores of 
years man's body resists decay, and then, when life departs, he 
rapidly swarms with myriads of bacteria ; not that there is any 
chemical change making his body more suitable food for them, 
but because they are able at last to take possession, now that the 
resisting power of vitality has departed. 

As it is with the germs of decomposition, so it is with those of 
tuberculosis. When they attack the lung, they do not usually at 
first affect those parts which are most actively performing their 
functions ; the very parts into which they are most freely carried 
by the air are least susceptible to their attacks ; their active vitality 
is their protection; but, in the apices and parts injured by pre- 
vious inflammations, they settle and breed disease. And, even 



1076 



DISEASE GERMS. 



when phthisis is well established, and when the air in the chest 
mu>t be crowded with its germs, large portions of the lung 
remain for long untouched ; showing on the one hand, how great 
is the resistance to the disease inherent in the tissues themselves, 
and, on the other, giving a rough measure of the amount of help 
required from treatment. For, if the difference between a soil fit 
and one unfit for bacterial growth is to be measured, for example, 
by the difference between the functional activity and resulting 
vital resistance of an» upper and lower lobe of the lung, surely it 
is not unreasonable to hope that, by impregnating the pulmonary 
tissues with antiseptic material, which, we know, renders them 
less fitted for the cultivation of bacilli, we maybe able to make up 
the lacking resistance, and so prevent the access of disease. 

The inhalation of bactericides certainly has a tendency to steri- 
lize the bacillus, and thus aid in at least arresting the disease. 

First, the material used ought to be capable of absorption by 
moist surfaces ; it should be a vapor, not a gas ; and a dry vapor, 
not an atomized solution. Second, as no attempt to filter or steri- 
lize the air is required, all complex forms of respirator may be 
discarded. The freest possible access of air should be allowed, 
the vapor being breathed with* it as constantly as possible ; so 
that the simplest and most open respirator is always the best, 
the mere diffusion of the vapor in the room sometimes being suf- 
ficient. Thirdly, we must combine with the treatment by inhala- 
tion, all medicinal, dietetic, and hygienic measures which tend to 
improve the general condition of the patient, and thus increase 
his vital resistance. 

It is worth bearing in mind that the view of the matter, which 
I have so imperfectly brought before your notice, shows the har- 
mony and unity of purpose which exist among the various 
means which we make use of in the treatment of consumption. 
If we accept the germ-theory of the origin of tuberculosis, all 
treatment, both local and general alike, must aim at preventing 
the growth of certain bacteria in the body ; the struggle is be- 
tween one great life and- myriads of small ones; and while all 
general treatment tries, by providing healthy work, good food, 
and pure air, and by ai-tention to all the details of a bactericide 
treatment, the treatment by inhalants should consist in a selection 
of a few of our best germicides, as eucalyptus, menthol, creosote, 
iodine, ozonized sulphur water, comp. oxygen. 

There is really no cessation of attempts to attack the microbe 
by inhaling or through the stomach. 

The baneful parasite brood of bacilli are hard to kill, and it 
requires tact, and good remedies to drench the germs, and cause 
their departure from the pulmonary cells. 



BACTERICIDES. 



1077 



Ozonized sulphur water or ozonized iodine, are most obnoxious 
to the tubercular bacilli ; their anti- parasite and disinfectant 
properties are great, and their use is of real benefit in pulmonary- 
phthisis, in thoroughly rooting out the germ. More recently, 
inhalation of hydrofluoric has met with success. 

Where a special inhaling chamber can be contrived, the vapor 
may be driven into it by means of atmospheric air forced through 
a mixture of the acid and water in various degrees of dilution. 
Simpler portable contrivances have been employed, consisting of 
a bottle containing the mixture of acid and water, through which 
the air may be drawn by means of an india-rubber tube, and in- 
haled direct ; or of a bag containing a definite quantity of air, 
which is connected by tubing with the acid bottle, two wash-bot- 
tles being interposed between the acid bottle and the inhaler. 
A definite volume of air is thus drawn through the whole appa- 
ratus until the air-bag is exhausted. The strength of the acid 
solution varies from fifteen to twenty or thirty per cent. An 
eminent physician contributes a note on the action of hydro- 
fluoric acid in the treatment of phthisis, in which after a full 
recognition of preceding work, he advocates the careful trial of 
the remedy as one which is, at any rate, simple and innocuous, 
and may greatly contribute to the recovery of early cases. He 
points out, that in this, as in every other form of inhalant, the 
strength must be so graduated, that long-continued inhalations 
can be practiced without discomfort. Inhalations that are pain- 
ful, or in any way distressing to the patient, are of very little 
value in practice, as they can never be long continued. Hence 
no positive standard can be laid down for the strength of the 
acid to be used in each case. The first sensations on inhaling 
the vapor are always somewhat irritating to the nose and fauces, 
but toleration is quickly established, and patients are soon able 
to inhale the vapor continuously. The remedy has been most 
successful in the early cases, and the first notable improvement 
is always in the appetite. He also notes that night-sweating is 
diminished, but that the fever is not always reduced in propor- 
tion to the improvement in other directions, nor do the number 
of bacilli diminish to any material extent. The same may be 
said of the local physical signs. Cough is not very much af- 
fected, but the sputa, as a rule, becomes less profuse. Diarrhea 
and laryngitis are not much affected, being generally met with in 
the case of advanced disease. The inhalation, after the first few 
moments, is attended with pleasant sensations, and patients al- 
ways express themselves as being better for it at the time. 

The hygienic management of all cases of tuberculosis is im- 
portant, it includes proper directions as to ventilation, diet, cloth- 
ing, exercise, bathing, etc. 



1078 



DISEASE GERMS. 



Ventilation is most important, as a very large proportion of 
microbial diseases are due to germ-laden atmospheric areas; 
thus it is bad in quality, often charged with noxious vapors, or 
irritating impurities, variable in temperature, liable to transitions 
in electrical conditions ; all these sources affect health. In some 
the effect is a direct, and in others an indirect, cause of disease. 
The changes in the temperature of the air are less serious than 
those in its purity. The former produces active inflammation ; 
the latter is the parent of low fevers and consumption. The 
former is the most speedy in its influence on the health, the lat- 
ter the most fatal in its effects. 

The influence of pure air is seen in those who live active lives 
in the open air; riding, walking, or working. The effects of im- 
pure air, on the contrary, are seen in the pallid visage of the in- 
door mechanic, in the fragile form and hectic-tinted cheek of the 
seamstress, everywhere, in fact, when great numbers of human 
beings are crowded together without the means of sufficient 
ventilation. 

Germ-laden air is most depressing to the one affected. Air 
must be considered in the light of food, the amount of supply, 
the mode or manner in which it is introduced, as well as the 
equality of its distribution, are essential considerations in every 
well ventilated-apartment. 

With respect to the purity of the air as a preventive or curative 
agent, there are some curious facts which appeal to our judg- 
ments in rather a circuitous, but yet cogent way, and which 
would seem to militate against many of our proconceived notions, 
and make us reverse much of what we have hitherto enforced in 
practice. Some physicians have held the view that an excess of 
fibrine (hyperinosis) in the system predisposed to, if not favored, 
the development of tubercle. In pregnant women, the disease, 
if already present, is held in abeyance during the period of gesta- 
tion, owing to the fact that the arterial blood assumes, in a large 
measure, the venous character, from the excess of carbonic acid 
in the system in general, but in the circulating fluid in particu- 
lar ; and as venous blood contains a less proportion of fibrin 
(hypinosis) than does the arterial, the arrest, or prevention, of the 
development of phthisis in the gravid state is thus rationally and 
physiologically explained. The bright carnation or vermilion 
hue of the skin of consumptive patients furnishes additional 
proof of the excess of oxygen over carbonic acid in such cases, 
and would seem to indicate the most rational remedy for the 
prophylaxis or cure of the disease, which, under the circum- 
stances, would necessarily be the very opposite of that recom- 
mended by so many writes and authorities on consumption. 



BACTERICIDES. IO79 

The solvent action of venous blood on fibrin prevents materially 
the deposition and development of tubercle, and goes far to 
strengthen the significance of the foregoing views, so that we are; 
forced to infer that air contaminated to a certain extent by car- 
bonic acid is not after all, so deleterious to phthisical patients as 
we have been led to suppose. The well-known anesthetic action 
of carbonic acid upon the terminal branches of the sensory 
nerves in general may not only allay " formative irritability," 
which, according to Virchow, plays such an important part in 
the genesis of tubercle and other morbid growths of tubercle, but 
also effectually calm the incessant, hacking cough which accom- 
panies phthisis in all its stages, and thus become a potent pre- 
ventive, as well as a curative agent, in the disease. 

The effect of climate upon the tubercular bacilli is remarkable, 
some climates rich in ozone will often completely sterilize the 
germ, whereas others bring it into amazing activity. 

It is difficult to suggest a climate adapted to all constitutions, 
and in recommending special localities a fearful risk is incurred, 
as the whole matter is involved in uncertainty. 

To parties who have ample means there are to be found locali- 
ties suitable everywhere for their special case. Within the limits 
of our native land there are differences of climate which can be 
made available according to season. In winter there are shel- 
tered nooks on our southern and Pacific coasts; in the heat of 
summer there are the cool and bracing places of the north. 
Even in our homes it is practicable to secure a temperate yet in- 
vigorating air, with all the personal comforts to which we have 
been habituated, in which we can enjoy the charms of a con- 
genial and social intercourse with friends, and in which the 
domestic ties are preserved intact to the latest moment of exist- 
ence. 

The diet of those suffering from the tubercular bacilli in their 
bodies should be of the best, and liberal to the utmost degree, 
as the condition of the patient will permit. 

Clothing, summer and winter, should be woolen, light as con- 
sistent with sufficient warmth. 

Exercise, moderate, is invaluable. In our day too little atten- 
tion is given to this subject, and the most erroneous notions pre- 
vail among the people; some of the evil results are forcibly illus- 
trated in the case of the invalid. Do we not daily see those who 
are able to walk without any considerable fatigue shut up in close 
over-heated rooms, lest a breath of pure air should reach them ; 
whilst others, reduced to the last extremity of emaciation by dis- 
organization of the lungs, are made to undergo long and tedious 
journeys on their way to a warm climate? 



Io8o DISEASE GERMS. 

Proper exercise is that physical exertion which calls into use 
the greatest number of muscles, and should be carried to that 
amount which the patient can bear without fatigue. A walk of 
a quarter of a m.ile in disease may be equal to thirty miles in 
health. Every invalid should take regular exercise daily, which 
must be apportioned in quantity and in kind to the nature of the 
disease and the strength of the patient, and should always be 
determined by the physician, in accordance with the condition of 
the invalid. This particularly applies to cases of consumption, 
and also to other diseases afl'ecting the breath, as asthma and 
those of the heart. 

In addition to these outdoor exercises there are many kinds of 
passive exercise, such as swinging, rocking, inflating the chest, 
and the use ot dumb-bells, which may be resorted to indoors 
when the state of the weather prevents the patient from going 
out. 

Much misapprehension exists in regard to the influence of the 
weather, and, as a consequence, few invalids take half the exer- 
tion they should and can take with perfect safety in the open air. 
Rain is an insuperable objection ; and a raw, damp, windy day 
should never be braved under any circumstances. Snow, on the 
contrary, when unaccompanied by wind or sleet, offers no obsta- 
cle to exercise in a covered carriage. The influence of a dull, 
cloudy day is felt almost as much in the house as in the open 
air, and the necessity for exercise is quite as imperative as on a 
fine clear day. With a clear sky overhead — though there may 
have been recent rain — the invalid may drive out with entire 
safety. During the autumn and winter, dry cold days are the 
best for outdoor exercise, and with the protection of a respirator, 
invalids may go out in the coldest weather, not only with safety, 
but with comfort to their feelings and benefit to their health. 

Bathing is an essential element in the treatment of all suffer- 
ing from the presence of the microbe in any part ; its tempera- 
ture, period of use become a matter of regulation by the attend- 
ing physician. 

There are, however, certain general maxims which ought to be 
clearly understood : 

I. The use of cold water should be particularly avoided by 
those suffering from the bacillus tuberculosis. The quantity of 
blood circulating in the superficial blood-vessels at the surface of 
the body is very considerable, and the action of cold water ap- 
plied to the skin is certain to disturb the equilibrium of the 
circulation, and to drive back a large proportion of the blood on 
the internal organs, especially when these are already the seat of 
disease, thus producing a liability to congestion. 



BACTERrCIDES. . IO81 

2. The use of hot water should be avoided, as being very de- 
pressing in its effects upon the system, and, from the increased 
circulation which it causes on the surface of the body, rendering 
the patient more susceptible to change of temperature and conse- 
quent risk of "taking cold." 

3. Plunge-baths and shower-baths are also to be avoided by 
consumptives, as necessarily exposing the whole surface at once 
to the action of the atmosphere, and the sudden shock to the 
nervous system is equally prejudicial, being a frequent cause of 
disturbance to the proper action of the heart. 

In all cases where the bacillus of tubercle is present I recom- 
mend, as most beneficial, the use of water as nearly as possible 
the temperature of the blood (98° Fahr.). I also give the prefer- 
ence to sponging over every other form of bathing, recommending 
as a precautionary measure to uncover only a portion of the body 
at a time, and to regulate the temperature of the room by pre- 
venting draughts of air, and by having it sufficiently heated. As 
the perspiration is apt to be acid, and charged with oily secretion, 
the use of a small quantity of an alkaline substance in the water, 
such as carbonate of soda, will assist the cleansing of the skin 
more thoroughly and removal of dead microbes. In the more 
acute forms of disease gentle frictions of the skin after the bath 
will be beneficial, but in chronic complaints this will not be so essen- 
tial. Great care should be taken not to expose the person to the 
open air immediately after bathing, but to allow the equilibrium 
of the circulation to be fully re-established before venturing forth, 
for it will be found that with every precaution an amount of con- 
stitutional excitement will always be produced. 

It will readily be seen that I attach great importance to the act 
of bathing; not that I regard it as a specific or directly curative 
agency, but simply as forming a portion of the general hygienic 
management which cannot be too rigidly enforced by the physi- 
cian, or too faithfully put in practice by all who seek relief from 
pulmonary tuberculosis. 

As our readers would naturally like to hear what the most illus- 
trious, leading and learned members of the medical profession in 
the United States think and say regarding the " tubercular ba- 
cilli^' we hereby append extracts from their published essays on 
the subject. A very prominent, highly scientific, and most suc- 
cessful practitioner, H. S. Lane, M. D., Philadelphia, Jefferson Co., 
New York, says: 

** Tubercle, the degraded bioplasm or living matter of our 
own bodies, caused by conditions adverse to vitality, and when 
once present the bacilli being always abundant, whether there 
be formations or not, renders this diathesis pre-eminently conta- 



I082 • DISEASE GERMS. 

gious and infectious. If vital force be low, germs very active in 
the deposits in the periphery of the nodules, isolated or grouped, 
and the bacilli or young swarms are found in the sputum, sweaty 
saliva, stool. Spores producing bacilli are found in every tissue, 
but breeding is carried on actively in parts that are weak and 
feeble. Indeed their mode of evolution is the same as other 
germs — a weakened part, a station suited to the growth of germs ; 
incubation follows, the seed undergoes changes, same as a grain 
of oats in the soil. That particular germ may die, but in dying 
multiplies itself indefinitely ; new germs are let loose into the cir- 
culation and another colony is formed in another part or soil,, 
during the incubation of which there is a pause, a febrile excite- 
ment, a growth. 

The disease germ in the blood may multiply, but the chances 
are that if the individual has high vital force and normal physi- 
ological activity that growth will be retarded until there is a 
weak, vulnerable point, a locality, a zone where germs can 
grow. 

The transmissibility of the micrococci of tubercle may take 
place from man to man in apparent health ; from husband to 
wife, or vice versa ; or from tubercular disease or from domestic 
animals, especially from the milk of tubercular cows, but there is,, 
properly speaking, no fructification unless vital force is shat- 
tered. 

The diversity of disease-germs, aside from tuberculse, is easily 
explained, and harmonizes with physiological laws ; the germ is 
originally an elementary element of nutrition of some special 
tissue, and in that condition it is degraded by mechanical violence,, 
ill health, depressing causes, as poor food, insanitary states, 
which accounts for their difference when the condition of de- 
pressed vital force exists ; still there must be a receptivity of soil 
as an essential requisite to reproduction — a vulnerable point for 
their deposit or reception and fructification. These facts teach 
us that consumptives should in all cases be placed in an invigor- 
ating residence, with ozone-generating atmosphere, where no dis- 
ease-germ can live, for where ozone is, tuberculae cannot exist ; 
a diet rich in blood elements, surroundings free from all insani- 
tary states, body properly protected with flannel, and daily in- 
vigorated with bathing and massage. 

It must be born in mind that the lung at some point has suf- 
fered a partial death ; it is devitalized, passive, there is a stagna- 
tion, a lowness, a want of contractile power ; the nerve power, 
the tone of the blood vessels is lowered, circulalion is feeble, all 
is delicate, and the working capacity of the lymphatics and pink 
marrow is greatly impaired.'^ 



BACTERICIDES. 



1083 



E. S. Pixley, M, D., Pittsfield, Massachusetts, a most experi- 
enced and highly scientific practitioner, who has added much to 
the dissemination of the germ theory of disease, in a recent 
printed essay on chronic disease, says : 

" Tuberculosis originates in one or other of two ways, the 
microbe is either the changed, altered, degraded bioplasm of our 
own bodies, by living under conditions inimical to vitality ; or it 
is the product of others. Whether it is acquired, or the product 
of an invasion, the recovery or destruction of the patient depends 
upon the relative vital power of the microbe and the integrity or 
strength of his own vital force. In the struggle it is the object 
of remedies to weaken the one and strengthen the other. This 
can only be effected by selecting and administering such germi- 
cides as are innocuous to the human body, whilst they are as 
inimical as possible to the microbe. If the microbe is not anni- 
hilated in the blood and tissues it will excrete ptomaines, a chemi- 
cal substance disastrous to living matter. 

Numerous attempts have been made to destroy the bacillus 
in the lung, blood and other tissues by means of germicides, 
either inhaled through the bronchial mucous membrane ; or by 
the stomach, or by endosmosis through the skin or rectum; to 
destroy the bacillus without interfering with the delicate structure 
of an organ. The principle is a good one ; the glycerite of ozone 
is the remedy, which, when taken into the stomach eliminates 
ozone ; this, the great scavenger of nature, enters the blood, in 
which it either sterilizes or annihilates all microbial life. By the 
persistent administration of half a teaspoonful thrice daily, well 
diluted in water, the tubercular bacilli is constantly exposed to its 
action. The remedy is volatile ; permeates all the areas of living 
matter, circulates in the blood ; vitalizes that fluid ; has a specific 
power to destroy tubercle without injuring any tissue, even deli- 
cate lung structure. From its first dose, the microbes are para- 
lyzed, they fail to excrete ptomaines; hence hectic, diarrhea, 
fever, states in which ptomaines play an important part, are wiped 
out orally or otherwise. 

Over the germ colony, or desposit or infiltration, an active 
bactericide should be applied either constantly or at suitable in- 
tervals. Such a germicide as ozonized turpentine, if the tubercle 
is localized on the peritoneal coat ; if in the lung, the concentrated 
ozone with chloroform ; if in the knee-joint, glucozone ; such 
local applications are found to destroy tubercle when kept in 
close contact. Indeed the tubercle bacillus speedily disappears." 

The observations of Prof. W. V. Rutledge, M. D., of St. Louis, 
Mo., who is one of the foremost workers in the field of bacteri- 
ology, has developed the significant fact that the bacillus of tuber- 



1084 DISEASE GERMS. 

cle may co-exist with numerous other microbes, as those of 
lepra, syphilis, rheumatism ; that the evolution of the microbe can 
be prevented by a high standard of health. 

" The tubercular germ is undoubtedly the most common, one to 
which the human race owes more mortality during the working 
period of life, between fifteen and fifty-five, than any other, and it 
is the duty of the individual, as well as the government, that a 
systematic attempt should be made to diminish, and when possi- 
ble, remove the preventable cause of this scourge. 

The evolution of the microbe can be prevented by a rigid ob- 
servance of sanitary science, by abundance of the best of food, 
good clothing, a high moral atmosphere, and everything which 
tends to ennoble man. 

The reception of the germ from other bodies is more difficult 
to control. 

Amongst the various modes by which the infecting bacillus has 
been shown to enter the body, there are two which are of special 
importance in connection with the subject of this paper. Com- 
munication by means of the mucous membrane of the alimentary 
canal is of interest because of the prevalence of tuberculosis in 
cattle, and from the experimental proof of the infectiveness of the 
milk of tuberculous cows. As animals which are crowded together 
in sheds with deficient ventilation, etc., are most liable to tubercu- 
losis, an efficient inspection of cattle kept for dairy purposes is 
necessary. Although the injurious properties of the milk of 
diseased animals may be destroyed by boiling, precautions are 
required as to the selling of milk for food; and even though the 
bacilli are rarely found in the muscles, it has been suggested that 
tuberculosis should be included amongst the contagious and 
infectious diseases of animals. Infection through the respiratory 
system is, however, the most frequent starting point of phthisis ; 
and as the risk is intensified by close contact and by the crowd- 
ing together of sick and healthy, the necessity for ventilation and 
the prevention of overcrowding is apparent, and becomes more 
marked when the predisposing causes are considered. 

Wherever tuberculous persons or animals are congregated, the 
air must contain larg;e numbers of the tubercle bacilli, which 
must be taken in with the inspired air by many individuals, of 
whom only a proportion become phthisical. It is probable that 
even if the bacilli escape expulsion by the expiratory effort, the 
healthy tissues do not afford them a suitable habitat ; but a 
lowered vitality of the tissues, whether local or general, places 
them in a more favorable condition for the development of the 
micro-organism, and thus constitutes in the individual a predis- 
position to tubercular disease. Speaking generally, a suscepti- 



BACTERICIDES. 



1085 



bility to tubercle ma5^ be produced by diseases of the respiratory- 
system, or by constitutional enfeeblement. 

Amongst the predisposing causes, some of the most important 
result from the aggregation of persons in a crowded population, 
or from the industries which mark an advancing civilization. 

Indoor and sedentary occupations, as well as those in which 
dust is inhaled, influence largely the prevalence of phthisis; and 
much of this disease amongst those who follow these occupations 
is preventable. Here, again, the basis of all preventive measures 
is to be found in efficient ventilation of mines and work-places. 
Printers, tailors, and dressmakers afford sufficient example of the 
effect of employment in crowded and ill-ventilated rooms, and 
the prevalence of phthisis amongst these classes is shown to be 
very considerable. The home-workers are more difficult to deal 
with than those who are working in large establishments, but 
the provision of public work-rooms, in which conveniences for 
various occupations could be found, might lessen the evils of the 
present state of things. 

With regard to climate, its influence in the causation of 
phthisis is probably infinitesimal as compared with the effects of 
density of population. The dampness of the soil has been shown 
to have some influence on the prevalence of the disease, and this 
can be remedied by drainage. Damp in houses may be pre- 
vented by concrete foundations and the insertion of a damp- 
proof course in the brickwork above the level of the ground. 

Overcrowding is of two kinds — the aggregation of buildings 
on a confined area, with insufficient open space around and be- 
tween houses ; and the crowding together of the inmates within 
the house. Both arc unfortunately too common, and are potent 
factors in the development and spread of tubercular disease. 
By-laws should be enforced regulating the width of streets, the 
amount of open space around house*^, the minimum height of 
rooms and size of windows ; and efficient inspection of new 
houses should be carried out before they are allowed to be occu- 
pied. Tenement houses should be licensed to hold a certain 
number of inmates, and be liable to inspection. In considering 
the number of inmates to be allowed to a house, attention should 
be paid to the means of veitilation as well as to the num- 
ber and size of the rooms. As many diseases which produce a 
general debility thereby predispose to tuberculosis, sanitary and 
hygienic measures, framed for the control of these, tend to di- 
minish the amount of phthisis in a community: and seeing that 
insufficiency of food, of fresh air, and of exercise, continued anx- 
iety and mental depression, and dissipation must be reckoned 
amongst the predisposing causes, the philanthropist may assist 



I086 DISEASE GERMS. 

the sanitarian in the fight against this widespread disease. How 
many cases of consumption will result from the present epi- 
demic of measles in this city, which might have been checked 
by the timely closing of schools ! 

The fundamental principles which must form the basis of any 
successful attempt to diminish the prevalence of phthisis are : (i) 
to provide a sufficiency of fresh air in and around dwellings, and 
work-places and (2) to endeavor to improve the resisting power 
of the individual by all possible means, as physical training dur- 
ing the period of growth and development, by exercise and 
recreation, and good food. 

As the effects of the tubercular microbe in the individual are 
not confined to his generation, but handed down from parent to 
child, any causes that tend to increase tubercular disease among 
a people must be regarded as tending to produce progressive 
vital deterioration of race. We owe it, therefore, to humanity, 
to succeeding generations, to allow no time to be lost in com- 
mencing a systematic attack upon everything productive of this 
germ." 

Tuberculosis is a most contagious and infectious disease. We 
copy the following which is part of a report made to the Health 
Board by the eminent R. H. Randolph, M. D., Portland, on the 
prophylaxis of tuberculosis: 

" That the terrible mortality due to tuberculosis must not be 
reckoned only from the cases of phthisis, but that a large num- 
ber of examples of bronchitis, pleurisy, meningitis, peritonitis, 
enteritis, diseases of bones and their articulations, indolent 
abscess and others, are due to the same fatal and protean source. 

Tuberculosis is an infectious, parasitic malady, caused by a 
microbe, but can only be conveyed to healthy individuals under 
special circumstances. Besides its transmission by descent, the 
microbes can gain entrance aerially by the organs of respiration, 
by the stomach mixed with food, by the mucous membranes, 
and by the skin through wounds, scratches, or punctures. 

The most common and active source of contagion is to be 
found in the sputum of consumptives. In its liquid state, this 
has little activity, and can only very rarely do mischief; it is 
when dried and reduced to powder by attrition that it is most 
dangerous. When expectorated on the ground, the floor, or the 
surface of walls, on one's clothes, carpets, bed coverings and cur- 
tains, even in handkerchiefs or napkins, it may readily be re- 
duced to this pulverulent form, and then be distributed by the air, 
to be absorbed by the lungs, settle on one's skin, on mucous 
surfaces, or become mixed with food. In the faeces, also, of the 
phthisical, the microbe exists, and may be disseminated by simi- 



BACTERICIDES. 



1087 



lar means. Therefore the utmost care should be taken in the 
reception and disposal of the sputa ; the spittoon should always 
contain water or some antiseptic liquid ; never sand, sawdust, or 
ashes. The contents [should be thrown daily into the fire, and 
the vessel well washed with boiling water. It should never be 
emptied into drains, on dunghills, or on the soil of gardens. 

Handkerchiefs should never be allowed to become dry before 
washing, but be put into water as soon as possible after use. 
But the best plan is to use some cheap material and burn it. 

A healthy person should not sleep in the same bed as a con- 
sumptive, nor, if it can be avoided, in the same room. 

In hotels and establishments devoted to the use of consump- 
tives, the furniture should be of the simplest kind, and readily 
washed ; and all textile fabrics should be disinfected* before a 
change of occupancy by heating in steam under pressure. 

Besides the chances of human contamination, there is the 
ever-present danger of infection by tuberculous animals. The 
fatal microbe may be found in the milk, the flesh, and the blood 
of those used for the food of man ; in beef, in cows^, goats', and 
asses' milk, the flesh of rabbits and fowls. 

Cows' milk is most frequently infected, that ot the goat and 
ass much more rarely. But it is safer to boil them all before 
used as infants' food. The carcasses of all animals slaughtered 
for food should be jealously examined before the meat is per- 
mitted to be sold. There is a horrible practice, common in 
France, of people frequenting the abattoirs for the sake of drink- 
ing the warm blood ; one is glad to hear that it is exceedingly 
dangerous ; and meat should not be cooked in large joints, since 
the bacillus can stand a high temperature with impunity. The 
children of tubercular parents are most inimical to the disease, 
and this is obviously true, apart from the possibility of congeni- 
tal infection." 



The presence of the tubercular bacilli in 
Tubercle Bacilli the sputa, or in any other discharge of a 
in Sputum. patient is a sure proof of the tubercular in- 
fection of the individual. 
It might thus appear very easy to discover the tubercular taint 
in a person. Such really is the case, but the naked truth remains 
that it is occasionally exceedingly difficult to prove the presence 
of tubercle bacilli, especially because of their close resemblance 
to the bacilli of lupus and lepra. 

Prof, McFall, M. D., oi Dallas, Texas, however, seems to have 
discovered a procedure which promises the long-desired aid. This 
procedure is as follows : 



I088 DISEASE GERMS. 

" After the sputum or the pus has been treated in the usual man- 
ner on the watch-glass, it is allowed to dry thoroughly in the at- 
mosphere, and the glass then drawn in the well-known way 
through an alcohol flame. The glass is then taken hold of by 
brass pincers, or, still better, glass pincers, and dipped quite 
slozvly into the strongest undiluted nitric acid, i. c, the acidum 
nitricum fumens of 145 to 150 specific gravity; it is then taken 
out just as slowly, and at once dipped into a vessel containing 
pure water, and there rinsed. The thus prepared material is then 
dried and afterward placed into the coloring fluids according 
to the usual method, and in this the floating glass is permitted to 
remain for twenty-four hours, when the color is removed with 
diluted nitric acid. For the first coloring process fuchsin, for the 
second a solution of malachit, is employed by him. The fuming 
nitric acid used must each time be a fresh preparation, as it at 
once attracts the water from the atmosphere, and by giving off 
nitrous vapor changes to common nitric acid, which no longer 
retains the property of the fuming acid. 

Tubercle bacilli thus treated perfectly retain their form, shape 
and color ; only their contents have undergone an alteration ; 
their interior appears as little nodules attached to each other like 
a chain of pearls. The bacilli, therefore, seem to consist of a 
hyaline wall and coagulable contents. 

Neither the bacilli of lupus nor those of lepra show the same 
changes. This " chain-of-pearls " appearance, being characteristic 
of tubercle bacilli alone, may well serve, therefore, for the differ- 
ential diagnosis of the three kinds of micro-organisms mentioned, 
while the method will permit us, henceforth, at once to establish 
the presence of tubercle bacilli without having to await the results 
of inoculation or of pure culture. 

The present methods of detection often fail, he says, on ac- 
count of the frequent scarcity of the bacillus in any given speci- 
men, and the tenacious character of the latter renders it difficult 
to get the film on the cover-glass sufficiently thin and uniform. 
We advise that the whole sputa for the twenty-four hours should 
be placed in a conical vessel, very like a urine deposit glass, and 
that it should be subjected for another twenty-four hours to a 
uniform heat of 36-39° 0.(95-103° Fahr.). This temperature he 
considers to fairly represent the temperature existing in the lung — 
the habitat, for the time being, of the parasite. 

At the end of the above time the thicker portions of the sputa 
will have settled to the bottom of the glass, and will have lost 
much of their tenacity. The supernatant fluid can be easily 
decanted, or a drop of the thickened portion can be spread upon 
the cover-glass with uniformity, and, of course, is much more 



BACTERICIDES. 



1089 



liable to show bacilli, if present, than a drop of sputum before 
concentration. They are often five times as abundant. 

C. L. Sender, M. D., Burrows, Indiana, has made a specialty of 
the treatment and cure of tuberculosis. His high scientific at- 
tainments, together with his profound erudition, have made him 
a standard authority on the subject. 

In a recent essay on the subject we read : 

" The bacilli of tubercle, a degradation of the living matter of 
the patient's own body, which ^akes place under unfavorable 
condition to existence, or is received by weakened bodies in the 
form of contagion or infection — whichever, it colonizes in devi- 
talized parts, on or in the bronchial or pulmonary tissue, and is 
usually accompanied with great emaciation and debility, because 
the pink marrow and other lymph canals are germ-laden, blocked 
up ; difficulty of breathing after exercise, and a cough, which is 
always troublesome, and annoying expectoration, hectic fever, 
diarrhea. 

Under states or conditions prejudicial to a high state of life, the 
bacilli of tubercle may appear at any age, but poverty, hardships, 
colds, catarrh, pneumonia, and many other states of vital deteriora- 
tion bring it on', as certain deleterious trades, confinement, mo- 
notony, insanitary states, alcohol, excesses. 

Of all diseases, probably the presence of the malarial germ in 
our bodies has much to do with the greater prevalence of the 
disease in our country, but a very large per cent, of all cases are 
due to the sudden changes in our climate, to insanitary states in- 
cidental to modern sewage, and heating of dwelling ; to deleteri- 
ous food and perverted habits. Like all germ diseases, it is essen- 
tially contagious and infectious — a damaged part is its seat of 
deposit. It is there it breeds ; if lung substance is weak from 
any cause, it imbeds itself there ; if the lining membrane of the 
bronchi is impaired, there. It is always dangerous from the 
growth and development of tubercles. A vital organ smitten — 
a deposit on the bronchi is much more dangerous than when in 
the substance of the lung — the danger is in proportion to the 
amount of germs present, and their activity, which depends 
wholly on the amount of vital depression. 

The only cure for tuberculosis is the destruction of the bacilli 
tuberculas in the blood, and in the part where they have colo- 
nized, and the maintaining and building up of vital force. 

If there is cough, emaciation, haemoptysis, hectic fever, night 
sweats, etc., administer the glycerite of ozone, the only remedy 
so far discovered that will positively destroy the germ, the factor 
of disease. Under its persistent use, there will be strength, 
greatly diminished cough ; he will gain flesh,; every dose will 

69 



iogo 



DISEASE GERMS, 



reduce 'pulse, respirations, and abolish hectic, it will arrest night 
sweats and bleeding from the lungs. 

If there are great prostration, great and grave lesions in lung 
structure, or on bronchia ; if the patient, and even physician, is 
hopeless of a cure, we say giveil ; administer it persistently when 
the bacilli are active in an albuminoid state, for it will annihilate 
the germs : give it when the germ is merging from a caseous to 
a calcareous mass ; an inorganic body ; give, for it will then 
cause a chemical dissolution." 

/. F. Bcckner, M. D., Kentland, Ind., may also be regarded as 
standard authority on the tubercle bacillus. In his recent scien- 
tific and brilliant essay on the subject, he says : 

" The discovery of the tubercle-bacillus is a scientific fact ; all, 
with the same facilities, may see what others have seen. It is 
the one thing tangible, describable, known by its peculiarities 
among entities as readily as one individual is known from 
another. To doubt its existence in tuberculosis is to doubt the 
utility of scientific medical research, and to abandon further 
progress to the unstable dreams of theorists. The sputa of the 
phthisical contain these germs ; the air they exhale is loaded with 
them or their spores, and their introduction into the system of 
animals will always produce tuberculosis, while notliing else zvilL 
These are not speculations, but demonstrable facts ! Further- 
more, clinical observations go to prove conclusively that healthy 
individuals, living in an atmosphere contaminated by the phthisi- 
cal, will contract this disease, and not any other which might be 
due to a lowered vitality, from being in close quarters and breath- 
ing a vitiated air. 

On the general question, as to how far it is possible to con- 
tract tubercular disease by contagion, we certainly have at the 
present time no sufficient evidence to warrant us m arriving at 
any satisfactory conclusion. All that is certain, or even probable, 
is that when a large number of human beings are herded together 
in a small space one of the diseases which make themselves most 
commonly felt is tuberculosis, whilst in the presence of abun- 
dance of fresh air it can almost with certainty be banished. It is 
equally certain that under such favorable conditions that poison 
may be communicated from one individual to another, a fact 
which is abundantly demonstrated, both by general clinical evi- 
dence and likewise by experimentation of animals allied to man. 
We have before drawn attention to the disadvantages that arise 
from the intimate association of healthy and tubercular individu- 
als, but it by no means follows from these facts that any real 
danger exists of contagion from one person to another, provided 
that the most ordinary precautions are taken. We have yet to 



BACTERICIDES. IqqI 

appreciate and to understand what it is that makes an individual 
more prone at one period of his existence than at another to be- 
come infected with the poison of disease, and until it can be 
shown that infection from one individual to another takes place 
on a far larger scale than anything that has hitherto been demon- 
strated, it is certainly premature to conjure up dangers in the 
mind of the public which are purely hypothetical. With a rea- 
sonable supply of fresh air, and with our meat and milk thor- 
oughly cooked, there is but slight fear, if any at all, of tuber- 
cular infection, and certainly to attempt to lead people to believe 
that it is dangerous to inhabit any room which has been occu- 
pied by a consumptive person, unless it is furnished and uphol- 
stered in such a manner that disinfection can be easily and com- 
pletely carried out after the departure of each patient, by means 
of washing and sulphuring the rooms, is to frighten people un- 
necessarily, and to conjure up ideas in their minds which have 
no real basis for their existence." 

Oscar N. Snow, M. D., St. Albans, South Carolina, another 
eminent specialist on pulmonary phthisis, and who has achieved 
brilliant results with bactericides, in its treatment 'and cure. He 
says : 

" The gaseous treatment of pulmonary tuberculosis is a total, 
nay, a glaring failure. Eminent savans are now pushing forward 
an old but valuable remedy, lime water and phosphate of lime, 
not with the view of killing the microbe, but in the hope, in the 
far future, of creating calcification and fibroid changes in the neo- 
plasm — thus retrogressing or sterilizing the bacilli. 

The action of the phosphate of lime and lime water, or infu- 
sion of burned oyster-shells, is too well-known to need recapitu- 
lation at this late day, of their value in dentition, in small-pox, and 
even carcinoma no one can doubt, but in tuberculosis their use 
is powerless to arrest germ evolution. 

The glycerite of ozone is prepared chiefly from the hypophos- 
phite of lime and soda added to C. P. glycerine, ozone being 
added until it is thoroughly charged. 

This very fine chemical preparation of lime is easily and 
quickly assimilated, and has a much more rapid action in build- 
iug up vital force — in aiding a renewal of life, than the crude 
phosphate. 

The only chance of ever checking, or arresting, or curing, 
pulmonary tuberculosis, is by germicides, by building up vital 
force, by the administration of a microbe destroyer, like the gly- 
cerite ol ozone, a remedy that enters the blood — coming in con- 
tact with the germ annihilates it. The microbicidal effect of the 
glycerite of ozone is thoroughly established, as is illustrated by 



IQg2 DISEASE GERMS. 

over six thousand physicians, who- prescribe it daily and in their 
remarkable success in the management of the most hopeless 
cases of the malady." 

The leading scientific savan, and undoubtedly the most distin- 
guished and successful physician in Tennessee, her only bacteri- 
ologist, Pr^. W. J. Heacker, M. D., Beon's Station, Tennessee, 
says : 

'' PLilmoiiayy tubsrcitlosh miy b^ defined t:) be the deposit or 
presence of the tubercular bacilli, either in the substance of the 
lung or the mucous membrane of the bronchi ; the localization 
of the germ, its growth, its multiplication, its tendency to degen- 
eration, excavation of the parts in which it is situated, with wasting 
of the body, and other evidences of germ evolution. The bacilli 
must exist in the blood. The lung must be smitten, or damaged, 
or weakened, and the contractility of its blood vessels impaired 
so as to permit of the exosmosis of the bacilli from the germ- 
laden blood. 

The onward progress of the microbe depends altogether on 
the state of vital force, and how great the state of partial death 
in a portion of-the lung. Degeneration and destruction mark 
the different stages of growth. The progress of all cases varies 
according to the state of vital force and the nature of the lung 
lesion. 

The more of neurasthenia, the greater the amount of germs in 
the blood ; lung congestion ; capillary infiltration ; the progress 
of the germ is irresistibly rapid ; uninterrupted, harassing cough ; 
opaque, cheesy, clotty expectoration ; increasing shortness of 
breath, profuse sweats, frequent chills, rapid loss of flesh and 
strength ; gei-m-eaten rectum, aphthous alimentary canal. 

If vital force is not so depressed the degradation is less 
marked and the germs in the lung less abundant ; slower in its 
metamorphosis ; fewer tubercles, little cough, less fever and 
wasting. 

The bacilli of tubercle may deposit themselves either on the 
mucous membrane of the larynx and bronchi, or in the substance 
of the lung, the selection invariably being a weakened part or tis- 
sue for growth and reproduction. The localization of tubercle 
in the apex of the left lung is the most common ; here it may re- 
main latent for many years ; the lower lobe of the right lun^:^, if 
congested or damaged by repeated attacks of cold, offers 
another favorable location for the lodgment of these micro- 



To effect a renewal of life in the germ-smitten lung and 
destroy the germ in the affected part, and in the blood, is the 
most efficacious method of treatment. The administration of 



BACTERICIDES. 



1093 



that positive therapeutic, glycerite of ozone, annihilates the 
germs, checks the tissue waste, while it increases the quality and 
number of the red corpuscles of the blood. It thus lowers tem- 
perature, decreases the heart's action, alleviates cough, checks 
night sweats, and aids in the maintenance of the appetite better 
than all the bitter tonics, and is a more effective arrester of meta- 
morphosis than brandy. 



Tumors, or new growths, are divided by patholo- 
Tumors. gists into two main groups ; one of innocent or 
benign growths, the other of malignant growths. 
The latter are distinguished by the following common characters : 
rapidity of growth, tendency to infiltrate and to replace the tissues 
of the affected part, tendency to recur after removal by operation, 
tendency to multiply locally and to infect other and remote parts 
of the body ; a tendency to destructive and progressive ulcera- 
tion, inducing fatal exhaustion through pain, continuous dis- 
charges and occasional loss of blood. To any tumor presenting 
these so-called characters of malignancy, the term cancer was 
applied by pathologists of a past generation, but at the present 
time, in consequence of the extensive use of the microscope in 
pathological research, there is a tendency to classify tumors with 
regard more to minute structure than to clinical characters. The 
tumors constituting the maglignant differ much inconsistency, 
and in minute structure, but the great majority of them have been 
referred to one of the following two great divisions : that in 
which the growth is composed of some form of connective 
tissues, and that in which it is made up in great part of cells re- 
sembling in character those found in the epidermis, on mucous 
membranes, and in the ultimate lobules of secreting glands. To 
the former division belong tumors that are called sarcomata or 
fleshy growths, to the latter belong the true cancers or carcino"- 
mata. Structurally the two are distinct ; with regard to clinical 
characters and malignancy, their resemblance is very close, the 
chief distinction in these respects being the facts that cancer 
almost invariably, and sarcoma seldom, affects secondarily the 
lymphatic glands, and that the latter usually appears at an earlier 
period of life. 

Innocent or benign tumors may occur in almost any part of 
the body, and they may vary in character from so simple a 
growth as a wart up to formations which may endanger life or 
require some serious surgical operation for their removal. It would 
be useless to attempt in a work like this any useful classification of 
tumors, as any properly devised system would be unintelligible to 



I094 



DISEASE GERMS. 



the ordinary reader. The question with most people who find a 
tumor is forming is as to its being of a cancerous nature or not, 
and this can only be answered by obtaining the advice of a medi- 
cal man. Much harm is done by the reckless way in which 
patients, to get rid of their malady, fall into the hands of those 
who pretend to cure them, while too often they only hasten on 
the fatal termination. The great majority of small tumors are 
harmless in character, and often cause inconvenience rather than 
any other distress, but in ail cases proper surgical advice must be 
taken before recourse is had to removal. 

Tumors then are swellings, prominences of greater or less size, 
developed by irritation, from either normal or adventitious 
matter upon any part of the body. 

The following division is a most excellent one, the best which 
can be devised under our present light of science : 

They are classified as follows : 

1. Type of fully-developed Connective Tissues — 

Fibroma Type of fibrous tissue. 

Myxoma " macous 

Lipoma " adipose 

Chondroma " cartilage 

Osteoma " bone 

Lymphoma | ■ . , lyr^phoid 

Lymphangioma/ ^ ^ 

2. Type of Efnh}yonic Connective Tissue. 

Sarcoma its different varieties. 

3. Type of higher Tis sites. 

Myoma Type of muscle. 

Neuroma " nerve. 

Angioma " blood-vessels. 

4. Type of Epithelial VYssues. 

Papilloma Papilliie of skin or mucous 

membrane. 

^^^^^^^ ]. Glands. 

Carcmoma / 

K. Mixed Tumors, or I'eratomata. 



Fibrous tumors are growths of 

Tumors. mature connective tissue. Both the 

{hibrorna — Fibrous Tissue) cell and intercellular substance are 

in a state uf complete development, 
and they resemble normal connective tissue. There is usually a 
constitutional predisposition, an excess of over nutrition of these 
elements in the system ; prolonged irritation operates as an exciting 




BACTERICIDES. IOqc 

cause, still a simple hypera^mia is often sufficient when lymph 
channels are gorged or blocked. 

Three varieties are met with, the solid, soft, and cavernous. 

These tumors may originate from connective tissue in any 
situation, at first consisting of embryonic tissue, cells being abun- 
dant and intercellular substances scanty. 
As they develop the number of cells de- 
creases, and the intercellular substances in- 
creases enormously, fibrillated and hardened. 
The cells are smal' and spindle-shaped, and 
hidden amongst the fibres which run irrep"- 

. Ill- • in r 1 Connective tissue is of the 

ularly m all directions; the fibres lorm the most embryonic type- 
greater portion of the growths, being closely —"y a vigorous grower. 
interlaced and often concentrically arranged around the blood 
vessels. The growth of these tumors are slow, gradual, central, 
they are always encapsulated. 

They are liable to inflammation, hemorrhage, mucoid, fatty and 
calcareous degeneration. They vary in consistence from being 
very dense to that of succulent, areolar tissue, and vary in size 
from that of a pea to a massive growth. Innocuous, painless, 
usually single, unless originating from the skin, sheaths of 
nerves; and harmless, unless their size interferes with the func- 
tions of parts. Usually they are non-recurrent after removal. 
Found in all parts of the body. Some contain more blood 
vessels than others, and are pinkish in color, but the majority of 
them are destitute of vessels. This class of tumors is found in 
the womb, breast, bone. They are firm to the feel, free from ten- 
derness, smooth, oval, or lobulated ; of slow growth, lasting an 
indefinite number of yeajs. It often degenerates into a stony 
mass, or earthy salts. 

When no larger than an orange, the application of the ozonized 
clay should be tried, keeping it steadily applied if no erythema is 
produced, and administering comp. saxifraga and phytolacca in- 
ternally. That failing, extirpation is the only remedy. 

Besides the above, there are often found, (i) a subcutaneous 
tumor about the size of a pea, composed of fibrous tissue, which 
affects women, and gives rise to neuralgic pains ; (2) a fibro- 
cellular tumor, made up of bands of firm, white, fibrous tissue, 
infiltrated with serum' ; (3) fibro-plastic tumor, made up of fibrous 
tissue and lymph ; (4) fibrous tumor, composed of filaments of 
fibrous tissue, with naked nuclei. 

Fibrous tissue in the female breast is usually effused in a 
nodule, or mass, in the breast, constituting a tumor of irregular 
shape, hard, dense and fibrous ; it may become large. No pain 
or lymphatic enlargement General health good. ' In some cases 



1096 



DISPIASE GERMS. 



they assume a cartilaginous or bony consistency. They, as well 
as the fatty, depend, the one upon an excess of adipose tissue, 
and the other upon a superabundance of fibrous tissue in the 
blood, owing to some constitutional defect. 

Treatment. — If not very dense or hard, the same treatment as 
for the fatty ; but here alteratives as compound phytolacca, 




Fibroid tumor, where the tubules have 
undergone some proliferation into cysts. 



e^>-i^~^.,>^x->- tf ^^,' 



Fibroid tumor of the breast. 



iodide of potass, glycerite of ozone, play a most important part 
in procuring their absorption. So those remedies should be 
persevered with, and the clay kept on, alternately with bella- 
donna, iodide of potass and muriate of ammonia. Even in cases 







Fibroid in the female breast. 




Fibroma of the cerebellum. 



as dense as bone, they can often be absorped with the above 
remedies. Never tamper with electricity, unless under the care 
of a scientific pnysician. 

Fibrous tissue is often effused in the brain and cerebellum, 
more especially the latter. The annexed diagram is taken from 
the cerebellum of K. Jones, who died in Beverly, N. J, 1878, 
whose case puzzled the entire medical profession of the Uaited 
States as no symptom existed during life upon which to base a 
diagnosis, but intense po^t- cervical pain, which by its agonizing 
vibrations literally caused the death of the patient. 



BACTERICIDES. 



[O97 



Fibrous tiesue is often found in nodules on the spinal cord, 
first lymph which becomes organized. 

Irritation of all kinds, falls, blows, strains, lifts, anything we 
can imagine that would weaken any portion of the cord or its 
membranes, may permit of effusion of lymph which produces 
thickening, or if the 'blood of the patient is highly loaded with 
the germs of the tubercle, cancer, syphilis, rabies, they may 
form a nidus or seat of deposit, and grow and multiply, giving 
rise. to a nodule of tubercle,, an exostosis of syphilis, a cancerous 
infiltration, and may thus, by causing pressure or producing 
atrophy, cause paralysis. 

Symptoms come on slowly but progressively. Paralysis of 
motion precedes that of sensation, often not very decided till 
growth or infiltration is some size. Apt to be pain over seat of 
iuduration, cramps and convulsive movements of the extremities. 
Nature of tumor or thickening is to be inferred from the history 
of case and diathesis of patient. 

Treatment. — General health to be well cared for; nutritious 
brain diet ; bathing with frictions and inunctions of oil into 
paralyzed limbs ; attention to secretions. Persistent use of altera- 
tives and tonics, iodide potassa, tincture iodine, iodide of starch 
and lime, with vegetable alteratives, as phytolacca compound, 
and such tonics, as quinine, mineral acids, occasionally ergot; 
bitter tonics, as kurchicine, gentian, and above all things the 
unremitting applicatign of a two-inch-wide strip irritating plas- 
ter on both sides of the spine, changed every morning ; keeping 
up a free, copious discharge of pus. Firm, determined perse- 
verance will often get rid of the difficulty. 



These tumors consist of mucous tis- 

Tumors. sue, the intercellular substance of which 

{Myxoma — Mucous is homogeneous, translucent, and jelly- 

Tissue) like, containing much fluid, and yielding 

mucia. Pathologically mucous tumors 

contain one or two distinct nuclei. The cells are oval, stillated, 

fusiform, or spherical, and distributed scantily, in which case the 

growth is translucent, but if the cells are very abundant, and 

packed closely, a whitish, brain-like opacity is imparted to the 

growths. 

The growth as a whole is gelatinous, soft, trembling, of a 
grayish white or pinkish color. The cut surface yields a muci- 
laginous, tenacious liquid, in which the cellular elements may 
be seen. 

These tumors arc usually encapsulated, and are met with in 



1098 



DISEASE GERMS. 



the later periods of life, being most common in sub-serous and 
sub-cutaneous fat, inter-muscular, and sub-serous tissue. 

A pure myxoma is rare, met with usually 
mixed or combined with lipoma. 

This class of tumors are liable, when they 
arrive at some size, to rupture of their capilla- 
ries and hemorrhages, or the growth may be- 
come inflamed, ulcerated or necrosed. 

The myxomata are mostly benign tumors, 
but they often attain an enormous size. They 
never reproduce themselves after complete re- 
moval. Often associated with sarcoma in the 
female breast. 

Mucous cysts consist of dilated and expanded gland ducts 
filled with mucus and epithelium. There may be one, or several 
cysts, in one or both breasts. They seldom grow larger than a 




Hyaline Myxoma. 
(Mucous tumor.) 




Inter-cvstic giowth, suirounded 
with fatty molecules. 



Cystic tumor of the breast. 



Cystic tumors of the breast. 



hazel-nut. Most common after change of life. They give rise 
to no pain or inconvenience, but when detected should be re- 
moved by a simple incision. If allowed 
to remain they simply become the seat 
of cancerous deposits. 

Under the head are classed cystic tumors, 
which consist of a .^^ac containing solid or 
liquid substances. They may arise by the 
formation of definite cavities in the meshes 
of the areolar tissue ; by the dilatation and 
growth of obstructed gland-duct or folli- 
cles ; by the erratic development of nu- 
cleated cells, which become exaggerated 
into cysts. Some contain serum ; others a 
jelly-looking substance, some blood, others solid matter. 

M^ens, or encysted tumors, are most common on the head, 
face, and shoulders, and consist of ob.structed sebaceous glands, 




Cystic tumor on neck. 



BACTERICIDES. 



1099 



or else of erratically formed cutaneous cysts. In examining" 
them with a small glass, the orifice, or mouth of the gland, can 
be seen in the centre in the form of a black spot or crust. They 
are all lined internally with a serous membrane, which secretes 
water, epidermis, scales, hairs, nails, oil-globules, and crystals of 
cholesterine, which cause the contents of the sac to resemble 
gruel or suet. The cyst is liable to accidents, which give rise to 
distension, suppuration, ulceration. 

Treatment. — The cause that engenders them is irritation ; so 
they never should be irritated or tampered with, and, as a rule, 
not interfered with if patient is out of health. In all cases they 
should be removed by the knife only by making an incision 
through their centre, and carefully dissecting out their sac, for if 
the smallest portion be permitted to remain, it will give rise to a 
sinus and weeping. Such tumors are common in the breast, 
prostate, parotid, and thyroid glands. As a rule, they are pain- 
less, not tender, moderately soft, elastic, and lobulated. ExMr- 
pation is the only cure. 

The liver is often the seat of myxoma. Encyi-ted, knotty 
tumors, containing a cheese-like substance are found in the 
glandular substance, varying in size from a pea to that of a hen's 
egg. They arise from irritation and inflammation of the hepatic 
ducts ; steatomatous contents composed of irregular granules, 
free oil globules, and occasionally plates of cholesterine. 

Simple serous cysts, with clear watery contents, are sometiiTies 
found scattered over the liver, usually about the size of a small 
bean. 

Sacculated cysts, contdAnmg a glairy fluid, are also met with. 
In some cases they resemble a honey-comb. The liver in some 
cases is crowded with such cavities. 

Ovarian tumors are very generally of this class. 

Those are an invariable result of chronic inflammation of the 
ovary when that condition is not seen to promptly, and managed 
properly. Irritation is the cause of those growths. This irrita- 
tion may spend itself upon the serous membrane and give rise to 
dropsy of the ovary, or on the fibrous tissue, or upon the seba- 
ceous glands, or other tissues of the ovary, thus giving rise to 
different kinds of effusions or tumors. Ovarian dropsy is the 
most common of cystic disease of the ovary. There are three 
forms met with : the simple cyst or bladder, filled with a fluid ; 
then there are the proliferous cysts, in which there are a number ; 
and the dermoid cysts, the lining membrane of which is capable 
of secreting hair, nails, teeth, sebaceous matter, or any substance 
of the body. 

Causes. — It is unnecessary to recapitulate the causes, suffice it 



IIOO 



DISEASE GERMS. 



to say that they are to be embraced under all those of chronic 
inflammation of the womb and ovaries, acute and chronic — 
which see — and placed under one term, irritation. 

Symptoms. — Most cases, if carefully scrutinized, will exhibit 
well-marked symptoms of chronic inflammation of ovary; still 
the irritation seems to be even a little less, so the uneasiness or 




An ovarian dermoid nearly natural size, with 
two nipple-like projections. 




An ovarian dermoid, containing a fold of 
skin resembling a shrunken ntamma. 



pain of that condition is often not well marked, and may, if the 
patient is of a cheerful, sanguine temperament, escape detection 
until the abdomen begins to enlarge. In other cases, the pain in 
the ovary is well marked, and when the ovary fills up, it gives 
rise not only to an appreciable tumor in the affected side, but 
o;ives rise to some irritation of the bladder and rectum ; a sense 





An ovarian dermoid with a spurious 
mamma and a nipple growing 
from its wall. 



Pedunculated dermoid tumors from the 
rectum — removed or rather exfoliated 
entire by the introduction of a je- 
quirity capsule. 



of weight and oppression in the abdomen ; pain and numbness 
down the thigh of the affected side. Besides, there is the usual 
lassitude, weariness, backache, constipation, irritable bladder. 
Menstruation at first may be regular, but scanty or abundant. 

After tumor has attained some considerable size, the symp- 
toms become aggravated ; there is greater pain and tenderness, 
as well as distension of the abdomen. Menstruation now is in- 
terfered with greatly, usually it is disordered, frequent or sup- 



BACTERICIDES. I lOi 

pressed. There is loss of appetite, indigestion, constipation, loss 
of flesh ; frequent micturition ; urine scanty, often suppressed. 
Strength diminishes ; emaciation becomes greater ; hectic spells ; 
no sleep, sense of smothering, cannot go to bed, sits up. Mean- 
time the abdomen increases in size, becomes enormously en- 




A lock of hair, twenty inches long, from an Ovarian Dermoid. 

larged. The swelling is one-sided, it may lay over to the other 
side in the recumbent posture ; the pain is only in front, if it is 
simple, but if it contains cancer germs, the pain will radiate from 
the front to the back ; if it contains a fluid, a sense of fluctuation 
can be detected even if the cysts are like a honey-comb, whereas, 
if it contains any solid constituent of the body, hair, nails, bone, 
teeth, or cheesy matter, it is solid, dull on percussion. As the 
tumor grows it fills up the abdomen, and may cause dropsy of 
the abdomen by ijnravelling its peritoneal fibres ; oedema of the 
legs and thighs. As it progresses, patient's movements become 
impeded from the bulk of the tumor, suflermg is augmented, all 
the symptom's grow worse, the nights are wretched, the difficulty 
of breathing is very great; the swelling or dropsy becomes con- 
siderable, often suppression of urine and f^ces ; uraemic poison- 
ing or fatal prostration is very apt to take place. 

Treatment. — When tumor is smaller than the two closed fists 
of the patient, an effort at absorption is" to be tried, which, \Aith 
our new remedies, is often successful ; and if it fails, it will be no 
barrier to ovariotomy. Every point must be well guarded and 
seen to, as the best of food ; regular evacuations ; good, com- 
fortable sleep ; flannel clothing ; a perfect alleviation of all pain, 
and the best of hopes encouraged for a cure. Then selecting a 
tonic and alterative from the list for a week, then change, and so 
on for another week. 

Among our best alteratives are comp. saxifraga and Phyto- 
lacca, alternated with wine of aleteris farinosa, comp. syrup 
partridge berry, and elixir of apiol. In addition, pastilcs of 
cocaine and boroglyceride, might with advantage be inserted far 
up the vagina several times a day. 

Locally, the ozonized clay over the entire tumor, bound on 
with a firm roller and T bandage. If the clay causes no redness, 
it can be put on fresh every morning ; but if there is the least 
redness, it can be taken off and broken up fine, and water added 



JI02 DISEASE GERMS. 

to it and reapplied for four or five days. The action of this clay 
on this class of growths is most extraordinary ; causes their 
thorough, positive dissolution and disintegration. As this pro- 
cess goes, on, the bowels must be kept open with cascara, and 
kidneys stimulated with cream of tartar lemonade. 

Cover entire tumor with the clay, and no more, and as this 
process goes on, push diet, alteratives, and tonics. 

All other methods of treatment are simply a loss of valuable 
time, such as tapping, aspirating. If the absorption plan with 
the clay, and other drugs fail, then there is only one thing left, 
and that is ovariotomy. In larger tumors than those mentioned, 
the clay will reduce their bulk, and in some rare cases cause 
their disappearance ; but in very large ones we cannot speak 
with the same precision as we do of those of a smaller class. 

In ovariotomy, that is in making an abdominal section in the 
median line of the abdomen, ligating the pedicle of the tumor, 
then dividing it, removing tumor and returning the ligated 
stump into the abdomen, stitching up abdomen, etc., and treat- 
ing for peritonitis, do not wait too long, until there is no recup- 
erative power left in the patient. 



Fatty tumors are growths of adipose 
Tumors. tissue; a general and diffused infiltration of 

[Lip jma— Adipose fat is obesity; a fatty tumor or lipoma is a 

Tissue)) localized and circumscribed formation. 

Lipomata originate wherever fat exists 

normally, being produced by fatty infiltration of existing tissues. 

Their growth is central, encapsulated and lobulated, and at first 

it increases slowly. 

The cells of a lipoma are larger, and the fat they contain is 
more fluid than normal adipose tissue. 

Fatty tumors are liable to glide out from the deepest structures 
and show themselves under the skin. They are all sizes and 
forms. They generally grow in the cutaneous tissue, between 
the skin and the muscles. They are most frequently met with 
below the collar-bone, back, neck, inside of the thighs and some- 
times in or among the muscles. 

In number there is generally one ; it grows slowly, may attain 
an immense bulk, seldom degenerates, is free from pain and is 
easily recognized by its soft, lobulated, doughy feel, which never 
can be mistaken for anything else. 

If the tumor is not large, in some cases (not always), the ap- 
plication of the ozonized clay has a most marvellous effect in 
causing a dissolution. It is worthy of a trial. It may be kept 



BACTERICIDES. 



I 103 



constantly applied, if it induces no redness of the skin ; if it 
causes any redness, off and on at proper intervals. 

Internally, fucus vesiculosus ozonized might be tried, that is 
the fluid extract combined with peroxide of hydrogen, alternated 
with ten or fifteen drops of liquor potassa, as they are the only 
remedies which disorganize the fatty cells. 

Adipose tissue or masses of fat may be freely and evenly dis- 
tributed throughout the entire connective tissue of the gland, or 
in nodules, or aggregation at different points. Its doughy, ine- 
lastic feel and perfect freedom from pain will be good points by 
which to recognize it. They grow slowly, give rise to immense 
bulk and considerable inconvenience. 

Treatment. — Ozonized clay is the only known remedy that 
will cause a dissolution of those growths. Kept on the breast or 
tumor constantly, if no redness of skin is produced ; if redness 
is caused, to be removed, and lotions of peroxide of hydrogen, 
and then the clay reapplied again and again. Internally, altera- 
tives, as in lacteal tumor. 



Tumors. 

( Chondroma — Cartilaginous 
Tissue^ 



cells embedded in fibrillated basic sub 
stance (fibro-cartilage) ; [c) as cells emb- 
edded in a mucoid basic substance (gela- 
tinoid or mucoid cartilage). 

To these may be added an osteoid form. 
The growth in nearly all cases leading to 
ossification. To be found most among 
near joints and on white fibrous tissue. 

Cartilaginous tumors are common in 
the neighborhood of joints. 



Cartilaginous growths or tu- 
mors are often met with and 
exist in three forms {a) as cells 
embedded in a hyaline basic sub- 
stance (hyaline cartilage) ; (b) as 




Calcified cartilage, showing the 
calcification of the intercel- 
lular substance, x 300. 



Bony tumors consist of connective tissue 
in which the bone corpuscle or cell pre- 
dominates. Bone is originally from car- 
tilaginous or fibrous membrane, and event- 
ually from periosteum. 
Osteomata are produced by mechanical or microbial irritation 
of the periosteum or medulla of bone. They are usually divided 



Tumors. 

( Osteoma — Bony 
Tissue.) 



I IQ. DISEASE GERMS. 

into two classes, viz., an exostosis and osteophytes \ the former, 
from proceeding from the bone or periosteum ; the latter, more 
or less remote from the bone. 

A covc\y^2.QX osteoma, which grows from the surface of the bone 
or its periosteum, usually exhibits a line of demarcation, although 
covered by the ordinary periosteum. 

Osteophytes, found in the common connective tissue, tendons, 
cartilage in the interstitial connective tissue of muscles, glands and 
organs, any part subject to chronic irritation ; tumors formed by 
the irregular hypertrophy of bone. Such tumors are hard, pain- 
less and globular, and mostly situated on the long bones. Their 
structure is that of ordinary bone, but usually more dense and 
compact. In some cases they are porous, in others of an ivory 
consistence. They cause no pain unless they press on nerves. 
On the inside of the sIcuU they press upon the brain, and give 
rise to epilepsy ; in the orbit they cause the eye to protrude. 

Their cause is irritation, and effusion of lymph, which becomes 
organized into bone. 

Treatment. — If not too dense, they can often be got rid of by 
absorption, by alteratives and by iodide of potassa, with the local 
application of ozonized clay ; when hard, of the consistence of 
ivory, they can be cut down upon and chiselled off. 



These tumors are growths of lym- 
Tumors. phatic or adenoid tissue, and are 

[Lymplwma — Lymphatic divided into soft lymphomata, in 
Tissue}) which there is a preponderance of 

lymph corpuscles and indurated, 
lymphomata, with preponderance of stroma and microbes. 

The causes of lymphomata are numerous and varied; irrita- 
tion, the microbes of syphilis, tubercle, cancer and other disease 
germs. 

These tumors are to the physician a sort of barometer or index 
of the state of the blood of the patient; enlarged lymphatics, 
soft or indurated, indicate feeble vital force, and excessive micro- 
bial growth. 

Soft lymphomata begins with a proliferation of the lymph cor- 
puscles, and a migration of the disease germ with the white cor- 
puscles. The growth is pultaceous and soft, resembling brain 
substance in color and consistency. The growth of soft lympho- 
ma is rapid; becomes very large, often breaks through structures 
in which it is infiltrated. 

The indurated lymphomata are characterized by an entirely op- 
posite condition of things — being marked by induration with a 
tendency to calcareous degeneration. 



BACTERICIDES. 



1 105 



In what is termed Hodgkin's Disease, there is a progressive en- 
largement of all the lymphatic glands of the body — gradual 
painless enlargement. 

Glands of neck, axilla, groin symmetrically enlarged, not in- 
flamed or fused together ; thoracic and abdominal glands also 
affected. Patient has all the symptoms of ansemia and leucocy- 
thaemia; is very weak, loses flesh and sniffers from great exhaus- 
tion on the slightest exertion. The white corpuscles in blood are 
greatly increased; tightness or constriction of chest and abdomen ; 
progressive increasing debility. 

The spleen is enlarged, filled with spores of tubercular bacilli. 
The glands, when cut into, are uniform in structure, translucent 
arid filled with various microbes, the contents appearing to the 
naked eye as albuminous or lardaceous matter, and precisely the 
same in the spleen, mesentery and pink marrow. It is this 
blocking up of those blood-raising glands that gives us the ex- 
treme anaemia, dropsy, exhaustion and death. In all cases, tuber- 
cle is present, whether the syphilitic or cancer germ is present or 
not. 



Sarcomatous, or fleshy tu- 
mors consist of embryonic con- 
nective tissue, and retain their 
embryonic type throughout the 
whole period of their growth. 
They are classified, and thus named : fibro-plastic, fibro-nucleated, 
re current- fibroid, and myeloid tumors. Many growths, which 



Turhors. 

{Sarcoma — Fleshy or Embry- 
onic Connective Tissue^ 








. thin section of 
lymphomata. 



Another section of 
the same growth 



Round-celled sarcoma in its 
incipient stage. 



W 



Round-celled sarcoma 
more advanced. 



were formerly described as cancerous, are now to be classified 
under this head. 

Cells constitute nearly the entire bulk of the growth, and pre- 
sent great variety of shape, form, and color. They are round^ 
fusiform, myeloid, and pigmented. 

All the sarcoma present an intercellular substance, small in 
amount, but their blood vessels are numerous. 

Sarcoma may be found in the brain, spinal cord, in or among 
70 



iio6 



DISEASE GERMS. 



all the muscles of the body ; in the orbit, parotid, luflgs, liver, 
kidney, spleen, and in all parts of the body. 

Sarcoma. — The term sarcoma, a fleshy tumor characterized by 
the appearance of one of several, usually at first isolated ; pea to 
nut sized and even larger ; smooth, spherical, irregular, as lobu- 
lated, cutaneous or subcutaneous neoplasms, as tumors, pig- 




Sections of sarcoma. 




Sarcoma ; splndle-cells visible in sections of a 
cutaneous nodule removed from one of the 
author's patients. About x 300. 




mented and non-pigmented, having a marked inaptitude for ul- 
ceration, but malignant in character, recurring speedily after re- 
moval, and usually terminating fatally by involvement of the 
viscera. These tumors may be free, movable, but eventually they 
become adherent, both above and below. 

Their characteristics are their white color, rapid growth and 
_^^_ development, with systemic 

tainting of the entire blood. 

Their predisposing cause, a 
hybrid microbe produced by 
the mingling of the proto- 
plasmic elements of the cancer 
germ, and the bacilli of tuber- 
cle in the lymph spaces of the 
blood. 

Once these hybrid germs 
are effused from the blood by 
some irritation in the skin, 
cellular tissue, or elsewhere, 
the weakened patch, the lesion 
becomes swollen, infiltrated, painful, germ proliferation active, 
enormous, skin reddens, ulcerates, often attains an enormous 
size. In a short time, weeks not years, if there are .several 
nodules, they aggregate together, the nodules or neoplasms 
coalesce, degenerations by ulceration, and participates in the 
process of destructive metamorphosis going on. 

Death speedily results, exhausting fever, with sarcomatous 
involvement of the viscera. 






section of a sarcomatous nodule wirh the spindle 
cancer germ interspersed throughout its sub- 
stance, magnified 300 diameters. 



BACTERICIDES. 



I 107 



This germ deposit may take place in any weakened parts of 
the body. 

All tumors of this class are abundantly supplied with blood 
vessels, lymph canals, and the germ with mottled tubercles inter- 
spersed through it, exhibits a net-work of spindle-shaped, spher- 
oidal, branched, with one or more nuclei, with connective tissue 
and basement membrane. 

Its correct diagnosis rests upon the microscopical examina- 
tion of the growth. Up until a very recent period, the treatment 
was very unsatisfactory, even its surgical ablation, is followed by 
a speedy return of the tumor, so far as germicide remedies 
are concerned. 

The Chian turpentine mistura has effected most wonderful re- 
sults in the cure of this form of growth. This preparation differs 
from all others in the molecules of the turpentine, being in a fine 
state of subdivision, being dissolved by the ethereal peroxide of 
hydrogen, resorctn, thallin, and other germicides being added. 
In some cases ihe glycerite of ozone, or the comp. saxifraga, or 
the glycerite of sulphur, were used in alternation. 











Sarcoma found in the bladder. 






Sarcoma in the liver. 



The general symptoms of sarcoma of the bladder are very 
similar to those met with in other varieties of vesical growths, 
consisting of haematuria with signs of irritability of the bladder, 
viz., pain and increased frequency in micturition ; in most cases 
evidences of obstruction to the escape of urine are sooner or 
later produced, micturition becoming difficult and attended by 
straining efforts. In addition, attacks of retention and inconti- 
nence of urine are sometimes present in the later stages, and in 
some instances distinct evidences of the existence of the growth 
can be detected upon a physical examination of the bladder. 

Haematuria is usually a prominent and often an early symp- 
tom. It frequently precedes the signs of irritability of the blad- 
der, so that in this respect sarcoma resembles papilloma — a pain- 



iio8 



DISEASE GERMS. 



less hemorrhage often continuing for a considerable period, 
sometimes for several years, without any other symptoms, is 
generally characteristic of the latter affection. As in papilloma, 
the bleeding at first occurs in attacks separated by intervals of 
varying duration, during which the urine is quite clear. As the 
disease progresses the attacks last longer and become more fre- 
quent, until, after a certain time, there are frequent, excessive 
attacks, which speedily undermine the vital forces of the sufferer. 

Numerous cases of different forms of sarcoma have been diag- 
nosed cystoscopically during the last year. Embryonic connec- 
tive tissue, or sarcoma, is also met with in the liver. 

The Chian turpentine mistura is really the only remedy of 
value in sarcoma of the bladder ; it certainly, by its microbicide 
action, has a decided effect in arresting germ evolution. 

The pipssisewa is a drug of intrinsic value, has a specific influ- 
ence upon the walls of the bladder; it not only checks the ravages 
of the microbe of sarcoma, but prevents the ingress of the cancer 
germ. 



Muscular tumors, consisting of 
non-striated muscular fibres, always 
arise from muscular tissue, espe- 
cially from the walls of the uterus. 
In this organ as they enlarge, they push aside the normal tissue 
and protrude into the cavity of the perinaeum or uterus. 



Tumors. 

{Myoma — Muscle Tissue.) 




View of tumor, showing 
the adventitious tissue, 
muscular, glandular, 
from walls of the uterns. 




Myoma ot the walls of the uterus. 



Becoming pedunculated in the latter organ form fibroid poly- 
pus of the uterus. They are often found in the prostate, oesoph- 
agus, stomach, intestines. Their growth is slow, central, often 
multiple or compound. The myoma form the great bulk of all 
uterine growths, very liable to become calcified, forming in the 
uterus a hard, stony lump, the so-called womb stone. 



BACTERICIDES. 



IIO9 



As a general rule, the myoma are elastic, pear-shaped and 
spheroidal. Their firmness depends upon the age and amount 
of connective tissue present. Their color varies from muscular 
redness to pinkish or grayish white. 

Their presence gives rise to exhaustive hemorrhages. Mucoid 
degeneration often takes place leading to a cyst-like formation in 
the growth. As a rule, these tumors are innocent. 

General Treatment. — Improve general health by every possible 
means — tonics, alteratives, as comp. saxifraga and phytolacca, 
alternated with distillation of aleteris farinosa, and comp. syrup 
partridge berry. Where the myoma involve the walls of the 
uterus, the use of the ozonized clay is often of great utility. 

The best local treatment is by electricity, mild uninterrupted 
currents, so as to stimulate absorption, not growth. This must 
be performed by one having the highest scientific attainments, 
and who thoroughly appreciates the subject.* 



These tumors are growths of 
Tumors* nerve tissue, very rare outside of 

{Neuroma. — Nerve Tisstie.) stumps. Their substance re- 
sembles the cerebro-spinal nerves. 
With the nerve fibres there is usually associated a certain amount 
of connective tissue. 

Their growth is slow, seldom become of large size, usually 
exist in single nodules, they are quite innocent, although very 
painful. 

They always spring from a cut or lacerated nerve. Solid or 
cystic. The solid growths have a deal of fibrous tissue inter- 
spersed through them, making them, dense and plastic, implicat- 
ing the neurilemma of the nerve. 

Occasionally nerve fibres merely spread over tumor without 
being involued in its texture. A nerve, when divided, if its two 
ends are placed in apposition, will unite like bone, and sensibility 
and motion be restored. If not placed in apposition, their ex- 
tremities will become bulbous, or may aid in the formation of 
these growths : so they are common after lacerations, wounds, 



*In 1870, Prof. John J. Siggins, M. D., of Philadelphia, Pa., introduced a chemico- 
clectrical method of exciting absorption, and thus curing a large percentage of these 
tumors. Indeed it was a brilliant success. This same modus operandi in all its varied 
details and with numerous improvements, is carried out by the following scientific 
physicians: A Park, M. D., 517 W. Twenty-third street, N. Y. ; F. L. Tuttle, M. D., 
233 Main street, Springfield, Mass. ; J. J. Jones, M. D., Philadelphia, Pa. ; S. H. 
Plati, M. D., Waterbury, Conn., and numerous others. It consists essentially in keep- 
ing one electrode over the tumor moist with specially prepared peroxide of hydrogen. 



II IQ 



DISEASE GERMS. 



injuries, amputations. There may be one or several, and vary in 

size from a grain of barley to a melon. 

Symptoms. — These growths are found in the course of a 

nerve ; grow slowly but steadily ; of an oval or oblong form ; 

long axis in the course of the nerve ; darting, lancinating pains 

in paroxysms. 

Treatment. — Excision is the only hope of cure ; tumor to be 

carefully dissected out, and, if possible, the ends of the divided 

nerve to be brought into appo- 
sition, and an effort at least, 
made to keep up continuity, so 
that the function of the nerve 
be, if possible, restored. 

We meet with- tumors of 
nerve tissue on both brain and 
cerebellum, also on the cord, 
which give rise to grave or- 
ganic lesions. 

This diagram represents a 
true neuroma of the skin, cov- 
ering the shoulder and arm. 

Cases similar to this, have 
been recently cured by the 
application of the ozonized je- 
quirity powder made into a 

paste with butter of coca, and glycerine ; a perfect exfoliation 

was effected. 




Neuroma in the skin. 



Tumors. 

Angioma — Made up of Blood 
■ Vesse/s.) 



The angiomata are a class of 
tumors or growths, consisting 
of blood vessels held together 
by a small amount of connec- 
tive tissue. 

Under this heading are included nsevi, aneurism by anasto- 
mosi^s. They are usually divided into two varieties. The simple, or 
capillary angiomata, and the cavernous, or venous. 

All the angiomata originate from blood vessels, and occur 
chiefly on the skin and mucous membrane. Their growth is 
slow, rarely large, very liable to ulceration. 

Usually they are of a bluish hue, pulsate. Occur in skin, sub- 
cutaneous tissue, and are found in the orbit, muscles, liver, spleen, 
kidneys, and are usually what is termed mother's mark. 

Where abnormal conditions, such as naevi, or angiomata, exist, 
which are of large dimensions or lie in situations that are not 



BACTERICIDE^ 



I I I I 



readily within reach of the knife, there can be little doubt that 
few p'ans afford us such an effective mode of treatment as a gal- 
vanic battery. To work such a plan successfully the operator 
must thoroughly understand the construction of his instrument, 
so as to able in a minute to rectify any temporary stoppage of 
the current. Almost equally essential is the need for a galvano- 
meter, without which it is difficult to detect the variations in in- 
tensity of the current, and sometimes quite impossible to' ascer- 
tain whether the current is passing or not. A neglect of these 
two precautions is almost certain sooner or later to result in a 
disastrous failure, which is ascribed to a fault in the pi'ocess, and 
not to its true source, the neglect of proper precautions by the op- 
erator. Without a galvanometer, it is perfectly true that an ex- 
perienced operator will form a shrewd guess what is going on in 
his patient, by the visible signs of the procedure, viz , the bub- 





Dilated capillaries filled with red corpuscles 
at umhilicus, known as capillary angioma 
of umbilicus. 



Capillary 



iorna at the umbilicus, 
a few leucocyte^. 



bles of gas and fluid that emanate from the growth. In a similar 
manner an experienced physician will predict the course of a 
disease from the symptoms that he can observe without the aid 
of a thermometer, but with instriiments of exactitude at hand, 
the treatment proceeds with greater ease and a readier precision. 
Most galvanometers which are to be employed in such operations 
are graduated in milleamperes, so as to determine exactly the 
strength of the current to be employed. 

With some simple battery at hand, the patient is placed under 
an anesthetic, for the process is often a prolonged one, and by no 
means devoid of pain. If the naevus is a large one, and placed 
in a situation where the presence of a scar is of no importance, as 
for example, in the middle of the back, half a dozen needles from 
each pole are introduced at various points of the growth, care 
being taken that they do not touch one another, and in determin- 
ing that no contact arises during the procedure, a galvanometer 
is of the greatest value, for if they do touch the current at 
once chooses the easiest route through the needles, and no 
longer subjected to the resisting action of the tissues of the body. 



I 1 1 2 DISEASE GERMS. 

causes a rapid deflection of the galvanometer needle. If the gal- 
vanometer is doing its work satisfactorily, the naevus soon com- 
mences to swell up, and gas exudes from the small punctures 
made by the needles, while no perceplible rise in temperature 
takes place in the part. The gas issuing from the negative pole 
is hydrogen, and that from the positive oxygen. By these mani- 
festations of chemical decomposition it is rendered abundantly 
clear that the process in question is a true electrolysis, and not 
of the nature of burning as it has been often wrongly termed. It 
the process of destruction is carried far enough, the tissues are 
so far destroyed and undermined that death of the part ensues, 
and a true slough separates a few days later, quite as extensive 
in character as if the galvano- cautery had been employed, and 
quite indistinguishable from a slough so produced. 

It is, however, quite possible, and by the aid of the galvano- 
meter very easy, to modify and restrict the process of tissue-de- 
struction with so much nicety and exactitude that no more tis- 
sue need be destroyed than is absolutely necessary to effect a 
cure ; but if this result is to be obtained a weaker current and a 
shorter sitting must be employed, and the process of destruction 
can be still further minimized by using only negative needles in 
the nerves, and placing the positive pole on a distant portion of 
the body. The novice will very soon determine how far it is de- 
sirable to go on making his first attempt with diffidence, and by 
gradually increasing the length of his sitting, will at length suc- 
ceed in removing the growth without leaving more than a slight 
discoloration of the skin, where before lay an unsightly and ex- 
tending mass of veins and capillaries. There are other plans by 
which the scarring is reduced almost absolutely to a vanishing- 
point ; the needles should be insulated to within an eighth of an 
inch of their point with gutta-percha, and they can be introduced, 
say, a quarter of an inch into the growth to be destroyed, so that 
the skin at the seat of puncture is protected from the action of the 
current, and the electrolytic process is limited to the subcutane- 
ous tissues. 

When the first operation is over due time must elapse before a 
second is attempted, in order to insure that full contraction of the 
cicatrix has taken place; five or six weeks, or two months, when 
it can be given, is not too long a time to allow. On a subse- 
quent occasion, should it be advisable to produce a small slough 
in any portion of the growth, the positive pole, with a stronger 
current, can be employed, and all the needles concentrated in the 
one situation. Such methods as these are capable of almost in- 
definite application, whilst they can be employed in situations 
where no other plan of treatment is possible, and with results 
which cannot be equalled for precision by any other method. 



BACTERICIDES. 



III3 



Tumors. 

{Papilloma — made up of 
Papillce of Skin and 
Mucous Membrane }j 



Papilloma, tumors resembling or- 
dinary papillae. Irritation may cause 
existing papillae to sprout out, from 
either the mucous, serous, or cuta- 
neous surface. 

The simple papillae are usually 
small and conical. 

Papillary growths are not infrequent in the bladder, uterus, 
urethra and intestines. Under this head are to be classed all 
warts and horny growths. 

A simple papilloma may become an epithelioma. 

A large number of growths are developed from the walls of 
the bladder ; warty, or polypoid fibrous bodies ; villous, or 
vascular growths, and cancerous deposits. 

Whatever the nature of the growths, they give rise to symp- 
toms that resemble calculi — frequent micturition, a painful sense 
of inability to empty the bladder ; ^^^^^.^s-^^^l^ 

urine may be bloody, or purulent, 
or ammoniacal, or loaded with 
mucus. 

Cancerous deposits are the most 
numerous; medullary, epithelium, 
more common than scirrhus ; suffer- 
ing great ; easily recognized by the 
pain anterior and posterior, the 
cachexia, and germs in urine. 

Papilloma in the urethra is often 
mistaken for stricture. Tumors or 
growths resembling in their struc- 
ture ordinary papilla, springing from 
the ordinary papilla of the mucous, 
serous, or cutaneous surface. They 
may also arise from the sub-epi- 
thelial connective tissue, as that of 
the stomach and larynx. 

Even in its simplest form there is present the bacterium porri, 
a pathogenic microbe, in and around the vessels of the connec- 
tive tissue — most numerous where the vessel turns, or ascends 
to the apices, or turns to form a plexus. 

These papilloma owe their origin to irritation, and gradually, 
as the bacterium become active, give rise to ulceration and 
hemorrhage. 

Papillary growths upon the skin include horny growths and 
warts. 

Larger and more vascular papillary growths are formed 




A bladder fungus ; present in chronic 
catarrh of the bladder, and in condi- 
tions where the micrococci urinarii are 
found, also in papilloma of the bladder. 



H 



DISEASE GERMS. 



when the bacterium porri unite or mingle with other microbes, 
as the venereal, in the formation of venereal warts. 

CHnically, the papillomata, accompanied with their pathogenic 
microbe bacterium porri, are innocent growths, but often prove 
fatal by ulceration and hemorrhage. 

Papilloma of the bladder presents nothing special at the outset, 
unless it be a little undue frequency of micturition, which is 
probably the only sign which excites suspicion. But early in the 
progress of'the papilloma, or all villous growths, there in an im- 
portant sign, characteristic of it, throughout its entire course, 
and common to most other tumors at a later period, namely, the 
appearance of blood in the urine. Hemorrhage occurs after exer- 
cise, much more abundant than what would come from the pres- 
ence of a calculus, and it is unaccompanied with pain and irrita- 






Papilloma as seen by the 
endoscope on the walls of 
the bladder, cured by per- 
oxide of. hydrogen and 
salicylate soda. 



Papilloma as seen by the 
endoscope on the walls 
of the bladder, radically 
cured by injections of 
thuja and peroxide of 
hydrogen, alternately — 
very weak injections. 



Papilloma as seen by the 
endosf-ope on the walls 
of the bladder, radically 
cured by injections of 
peroxide of hydrogen 
twice a week, and daily 
inserting a thallin gela- 
tinized bougie into the 
bladder and retaining it 
one hour. 



tion of the bladder. As the papilloma increases in size, hemor- 
rhage becomes more profuse; still pain is absent. A microscopic 
examination of the urine will reveal the characteristic appearance 
of papillomatous structure and the presence of a fungus. 

The bladder should, in all cases, be washed out with a tepid 
solution of boroglyceride ; an examination made with a sound, 
which reveals a soft, flimsy tissue, springing from a thick base. 
On those outgrowths, papoid or trypsin has a well-defined action 
as solvents, and much better adapted to the location than either 
lactic or acetic acid. Oil of thuja answers well, both locally and 
internally, and probably is our best drug. As an injection into 
the bladder it is of great efficacy, diluted half an ounce to four 
of tepid water. 

Probably thuja internally to sterilize the blood, and papoid as 
a digestive agent for injecting the bladder. 



BACTERICIDES. 



III5 



Tumors. 

(^Adenoma — made up or 
Glaudidar Tissue^ 



Adenomata are tumors or growths 
of gland tissue, and they usually re- 
semble tubular or racemose glands 



m 



consisting of saccules or acini, 



lined by epithelial cells. 

The adenoma proper is an innocent tumor, its favorite seat is 
the female breast and lung, in pulmonary phthisis. 

Adenoma of the Bi'east. — Irritation of various kinds, as corset- 
bones, dress ; mechanical violence, as blows, contusions, etc.,. 




The female breast, dissected back to show adeno-fibroma of the nipple, showing the racemose 
arrangement of the acini or saccules lined with epithelial cells. 

often cause a sort of glandular growth in the interstitial structure 
of the breast. In one variety of partial hypertrophy of gland 
structure, we find the tumor dense, compact, lobulated, and pro- 
vided with a fibrous capsule ; with ducts and sinuses developed. 
In another class, there are cysts with growths attached to their 
walls and floating in a fluid ; while, in still another class, dilated 
ducts are converted into cysts, with growth of gland springing 
from their sides. 

These glandular tumors, made up of the substance or out- 
growths of the breasts, occur in healthy women, between puberty 
and the thirtieth year of age; and single women are much more 
liable to them than the married. Their growth is slow, pro- 



iii6 



DISEASE GERMS. 



gressive, and an enormous size may be attained. In some cases 
they grow considerable, then cease, and often disappear; in 




Section of an adenoma of the breast, magnified 750 diameters. 

Other cases, after growing to a certain size, they remain station- 
ary and breasts disappear. There is never pain nor lymphatic 
enlargement. 

Symptoms. — The tumor begins as a small, movable growth ; 
seems to be isolated from gland tissue ; never painful ; nor does 





Adenoma of the brea?t. 



Gummy growth in the kidney, with an 
adenoid formation. 



it involve the skin nor cause enlargement of the lymphatics of 
the axillary space. As it grows, breast may atrophy. Rate of 
growth depends on irritation. If it becomes very large the 
coverings might ulcerate, and the tumor protrude through. 

Treatment. — The application of the ozonized clay during the 
day, and the belladonna ointment during the night, with a 
general vegetable alterativ^e and tonic course, is the best treat- 
ment. 

If the case is stubborn and resists these remedies, then apply 
a complete casing or covering of iodol in gelatine and gly- 
cerine, and internally administer ozonized iodine. 



BACTERICIDES 



I I 17 



During its activity, that is, 
Tumors. secreting milk, the female breast 

{Mixed Cancer Germs and is most obnoxious to what is 
other Microbes}) termed a milk or lacteal tumor, 

generally due to violence or 
blows, which cause a rupture of a lacteal tube, which permits of 
the escape of the milk into the surrounding connective tissue ; 
or it may take place from an occlusion of the orifice of a milk- 
duct, by inflammation of the nipple, and various other mechani- 
cal conditions. It occurs only during the activity of gland in 
lactation. 

Symptoms. — A round, oval, or cystic swelling, varying in size 
from a walnut to that of a large orange or pear, can be felt, 
which, when recent, is elastic and fluctuating, but as its watery 
portion becomes absorbed, it becomes firm and solid. There is 
an absence of pain, and the general health is unaffected. So 
very little annoyance does it give rise to, that the patient may 
not discern the enlargement for quite a while, or by accident, and 
when she does so, becomes greatly alarmed, fearing cancer. If 
the patient is tubercular, the coagulated caseine in the lobule, or 
in connective tissue, sometimes become a concretion, like chalk. 

Treatment. — If infant is old enough, or not near the approach, 
or during the summer heat, wean the child ; arrest secretion of 
milk by belladonna ; administer saline purgatives ; and subse- 
quently apply ozonized clay to the breast, and place patient upon 
an active course of alteratives, as compound phytolacca ozonized, 
iodide in stillingia compound, glycerite of ozone. If there is 
suppuration, incision and same treatment as for abscess. As a 
rule, there should be no interference with the coagulation until 
gland-tissue becomes inactive. 

Mixed class of tumors are found in the antrum. They consist 
of bony matter, exostosis, and fibro-plastic tumors of the con- 
sistence and form of brain or liver; often the color of the latter, 
and difficult to recognize from cancer. Others have the color 
and consistence of kidney. We meet with fibrous tumors, very 
dense and encysted tumors, and other deformities, that may be 
mistaken for enlarged antrum. 

With all diseases of the teeth and nose, the antrum has much 
to do. The incessant tinkering about old stumps ; filling with 
amalgam loaded with mercury, sets up irritation and effusion. 
The ignorant extraction of teeth has also much to do with it. 
Catarrh, and its diseased germ, amoeba, often block up the nasal 
opening. The trouble seems to be that when its lining mem- 
brane becomes irritated, that it will secrete an endless variety of 
substances, which, when liquid, semi-liquid, and glandular, are 



iii8 



DISEASE GERMS. 



easily got rid of by an opening, stirring up the contents, and 
washing out the' antrum daily with a stimulating wash. The 
kidney or liver deposits are often mistaken for cancer by the 
great pain they occasion. In all cases, besides the removal of 
contents, an alterative and tonic course. From the number of 








Adenona-fibroma. 



Adeno-fibro-sarcoma. 



ignorant men entering the dental profession, it is highly prob- 
able the diseases of the antrum will be much increased. 

We respectfully direct attention to the fact that the tissues, 
which are the seat of malignant neoplasms (cancers, sarcomas, 
epitheliomas, etc.), may, at a given moment, be invaded by divers 
microbes, the origin, species and nature of which, it has, so far, 
been impossible to determine. This invasion, the causes and 
mechanism of which are alike unknown, may remain latent for 
an indefinite period, but in certain cases, in the evolution and 
nutrition of the tumor, it may lead to several modifications, such 
as the rapid enlargement, the softening, or the ulceration of the 
part affected. Microbes are not to be found in all neoplasms, or 
even in all neoplasms of the same kind, nor yet in every portion 




Adeno-fibroma, where the secretions from 
the glandular tubules have collected in 
them and given rise to numerous small 
cysts. 




Adeno-fibroma, having a dense fibrous stroma, 
which includes newly-formed glandular or ad- 
enomatous matter, with increased prolifera- 
tion. 



of the neoplasm invaded. They are not to be found, for instance, 
in lipomas or in pure fibromas ; they cannot be found in the early 
stages of sarcoma or cancer, in which the progress is slow, and 



tJACTERICIDES. 2 1 lo 

the growth is covered by healthy skin ; on the other hand they 
are nearly always to be found in softened and ulcerated tumors. 
These microbes, besides their irritant, phlogogenic and pyrogenic 
action, which they exercise locally even on the diseased tissue 
possess other pathogenic properties, which may affect the whole 
system. Thus so far as an* opinion can be found, they may give 
rise to a more or less intense and irregular febrile condition, 
whilst they are pent up in a tumor about to grow rapidly or to 
soften. Moreover, during the removal of a tumor, they may im- 
pregnate the fluids contained in the softened parts, infect the 
operative wound, and so inoculate it as to develop septicaemia, 
which may lead even to death. The knowledge of this last fact 
pleads strongly in favor of the removal of malignant neoplasms, 
so desirable from every point of view, and suggests forcibly to 
surgeons the necessity of adopting preventive measures, both 
during and after operations, for the extirpation of tumors infected 
with microbes. 

Any form of tuinor may have black pigment matter in its in- 
terstitial tissue to which the term melanosis has been indiscrimin- 
ately applied to all tumors or deposits containing black pigment 
matter. Pigment is of frequent occurrence in the human body, 
and consists in a deposit in jthe form of the minutest sepia-colored 
granules, of a dark-brown or black appearance. 

These granules may be free, or collected into masses, with a 
cell membrane around them, or they maybe added to any morbid 
growth whatever. The chemical composition is not accurately 
settled, but nearly all forms contain from eighty to ninety per cent, 
of pure carbon. The division into true and false is a good one — the 
true being an animal matter, the spurious, carbonaceous matter 
from without that has found its way into the body, or the action 
of chemicals on the l5lood, or the stagnation of blood. 

(^.) True melanosis is a diathesis or cachexia, in which large 
quantities of pigment may be deposited or infiltrated through 
many organs in the same individual, either alone or in conjunc- 
tion with other elements. The primary growth is likely to arise 
from some pigmentary tissue, as the choroid, or a cutaneous 
mole. The secondary desposits are mostly found disseminated 
in the connective and adipose tissue, in muscles, tendons, mu- 
cous membrane and bone. The bones of the cranium, ribs and 
sternum, most frequently affected. The organs which it generally 
affects are the spleen, liver, lungs, pancreas, lymphatics, brain, eye, 
kidneys, testicles, uterus, ovaries, rectum, mammae. It may be 
associated with cancer. 

When melanotic tumors, or nodules, are on the surface there 
is no difficulty in their recognition. When deposited on or in 



1 1 20 DISEASE GERMS. 

internal organs, symptoms are obscure. In all cases there is 
great languor and sinking of vital power. The cachectic appear- 
ance is a dusky, or ash-colored countenance; emaciation, dropsy, 
night-sweats, exhaustion. 

Treatment. — Same as for tuberculosis. 

{B) Spurious forms : inhalation^ of coal dust in miners, in 
bronchi and lungs. From the action of chemical agents on the 
blood, and also from the stagnation of that fluid. It may not 
appear for twenty-four hours, or several days. Ecchymosis may, 
besides being due to injuries, be a symptom of purpura, scurvy, 
fevers, or of gangrene in inflammation. 

Treatment. — The object in treatment is to check extravasation 
of blood, prevent inflammation and procure absorption of the 
effused blood. For this purpose the bruised part should be 
placed in a raised position, and if about the eye, a few leeches 
might be applied, and then a poultice of Solomon seal. If it 
occurs on other parts of the body, tincture of arnica or mari- 
gold should be used. Arnica or marigold has the property of 
astringing and contracting the walls of the capillaries, and also 
promoting the absorption of the effused blood. The ordinary 
garden marigold is an unexcelled agent. This should be taken 
when in full-bloom, flowers, leaves and stem, and put to steep in 
common whiskey for a month, pressed well down with whiskey 

^ enough to cover. It is much 

superior to arnica. Either of 
the two may be administered 
internally, but their effects are 
very doubtful in that way. 

Pigmented or black cancer, 
usually begins as hempseed, to 
pea-sized, single or numerous, 
soft or dense nodules, which 
develop in time to tumors of 
considerable size, and are stain- 
ed in various shades of color. 

Black pigment matter as found in a rare frnm a crrai/iQli Krown c\r a claf^ 

form of epithelioma on the Up. irom a grayisn orown, or a siare 

color to a dead black ; the pig- 
ment being occasionally displayed irregularly in streaks or bands, 
over the suiface of the growth. They occur anywhere, the eye, 
skin, etc., starting as moles, marks, naevi. 

The pigment is deposited in the protoplasm of the cancer mi- 
crobe in the epithelium, and connective tissue frame work of the 
cancer. 

All melanotic cancers are remarkable for their speedy growth, 
malignant career and noteworthy tendency to degenerate into 




BACTERICIDES. Ij2i 

ulcers. Often such verrucous masses are surrounded by grayish 
or blackish papules or by diffuse cancerous infiltration of the in- 
tegument, exhibiting irregular pigmentation of the surface. 

The local application of lactic acid about twice a week and 
the internal administration of the Chian turpentine mistura are 
our best remedies. 



Breaches of continuity of the surface are either 
Ulcers. the result of inflammation or some unrepaired 

{^Cutaneous}) injury. Ulceration consists in the gradual disin 
tegration and separation of tissues, the healthy 
nutrition of which has been disturbed by local inflammatory 
changes, by impoverishment or poisoning of the blood, or by an 
injury to one or more of the nerves of the affected region. In 
this process the destroyed tissues break down into minute parti- 
cles, or undergo liquefaction ; in gangrene, to which ulceration 
is closely connected, the open sore is formed by the separation of 
the dead tissues in sloughs or large and visible masses. Ulcera- 
tion may attack any organ or tissue ; it is often met with in bone, 
and sometimes in teeth ; the tissues most disposed to it are the 
skin, mucous membrane, and connective or areolar tissue. Nerves 
and blood vessels resist longer than other tissues the ulcerative 
process, and may, m cases of rapidly-increasing and sloughing 
ulcers, be seen isolated in the midst of discharge and slough. 
The cornea is a frequent seat of ulceration, which too often causes 
blindness or serious impairment of vision, by resulting in opacity 
or perforation of the membrane. Within the body ulceration 
very frequently occurs in some part of the alimentary canal. 
Ulcer of the stomach, ulcer of the duodenum, after severe burn, 
typhoid and tubercular ulceration of the small intestine, syphilitic 
and dysenteric ulceration of the colon and rectum, and fissure or 
painful ulcer of the rectum are all well-known affections. 

The pathological process of ulceration occurs in many different 
diseases of the skin, but for the presence of special microbes and 
application of remedies, it is best to keep them apart from all 
other cutaneous diseases. 

In ulceration there is always a loss of substance, a molecular 
death, disintegration and discharge of tissue. 

As a rule, ulcers heal slowly, for in all breaches of continuity, 
there are disease germs present, and the molecular destruction 
hinder the formation of granulations. 

The nomenclature of ulcers is exceptionally bad ; we have the 
healthy or simple ulcer, the fungous ul:er, the weak ulcer, the 
inflammatory ulcer, the irritable ulcer, the varicose ulcer, the ec- 

71 



^ 12:2 DISEASE GERMS. 

zetnatous u!cer, and many others. These names are little better 
than jargon, but are nevertheless in common use, and are likely 
to remain so. Such names as varicose ulcer, eczematous ulcer, 
and gouty ulcer may be regarded as a kind of conventional short- 
hand writing, and may possibly be justified on that ground. 

Etiology and Pathology. — Simple ulcers of the leg always 'arise 
from some previous inflammation of the skin ; they are, as it 
were, a pathological accident of the inflammatory process. There 
are many causes which may give rise to them, but three only re- 
quire especial mention : (i) varicose veins ; (2) chronic eczema ; 
(3) blows or other injuries to the skin. Ulcers of the leg are sel- 
dom met with in the young ; they are most common in middle 
and advanced life, and their production is much favored by any 
occupation that involves much standing. With regard to heal- 
ing chronic ulcers of the leg, a prejudice exists among the pub- 
' lie, and even amongst some members of the profession, against 
stopping a discharge, on the supposition that the ulcer gets rid 
of some morbid material out of the system, and that if the ulcer 
ceases to discharge, this will be retained, and the patient's health 
suffer in consequence. But the pathological changes which 
sometimes occur in other parts of the body coincidently with 
the healing of a chronic ulcer of the leg, cannot possibly be ex- 
plained in this way ; the morbid discharge from the ulcer is cer- 
tainly not drawn as such from the body generally, but is simply 
morbid in connection with the ulcer itself; its morbidity is en- 
tirely local. 

All ulcers, or breaches of continuity, are germ depots, and 
must be treated with microbicides. All cases, no matter the 
cause, should be placed upon a general alterative and tonic course 
of remedies, with the best of diet, and regulated secretions. 

With a breach of continuity existing, no matter whether it be 
superficial or deep-seated, it invariably creates a neurosis of the 
nerv^gus systmi at large; consequently an essential point in the 
treatment of all u'crrs is sedation, a tranquillized nervous sys- 
tem ; nothing aids a local treatment so much as the regular ad- 
ministration of opiates in all cases. This is not incompatible 
with any form of treatment. 

The local treatment of ulcer must depend on the amount of ir- 
ritation present in the surrounding tissues ; when this is great, the 
parts must be kept as quiet as possible, and lotions of boroglycer- 
ide or creolin applied on lint, changed often, covered with oiled 
silk, never permitted to become dry. As soon as the inflamma- 
tion has subsided, a bandage, if the parts admit of it, should be 
applied from the extremity upwards. Taken off every night and 
re-applied in the morning; this is always of utility. Strapping 



BACTERICIDES. 



II23 



with salicylate rubber adhesive plaster above and below the 
ulcer, sometimes strips over it, so as partly to cover it, drawing 
the edges toward each other, allowing open spaces for pus to dis- 
charge ; over and above this a bandage. 

Those most liable to ulceration are the debilitated, the intem- 
perate, mercurialized, or those whose blood is loaded with the ba- 
cillus of tubercle and syphilis. 

Healthy Ulcer. — In constitutions, or parts predisposed to it, the 
slightest irritation may be sufficient to excite ulceration. In the 
vigorous it requires more irritation ; but when produced, it may 
be what is termed a healthy ulcer, and present a sore free from 
pain with a fine granulating surface, with smooth, white, milky 
edges, and its pus thick and creamy. A healthy sore is smooth, 
covered with a transparent pellicle, or scum, which is lost on the 
margins of the granulations. 

. Treatinent. — In all ulcers or breaches of continuity we must 
recognize a degradation of healthy, living matter, or diseased 
germs. In a healthy sore we find nothing but the bacteria, and 
streptococcus pyogenes, and those in very small numbers, so 
that it is important that all dressings exclude air completely, be 
somewhat stimulating, and invariably antiseptic. Ozone oint- 
ment, or black salve, should therefore be kept constantly applied, 





Bacteria as seen in simple ulceration. Living mass of working germs in irritable ulcer. 

spread on fine old linen or lint, about one-sixteenth of an inch 
thick, a little larger than the sore, changed twice or thrice daily. 
The dressing on each occasion to be fresh. Before any dressing 
is applied, the limb should be bandaged from the extremity up, 
leaving a space for the application of the ointment, and over and 
above that a few turns of the bandage. 

The limb should, if possible, be kept at rest, and in an ele- 
vated position. The constitutional treatment required here is 
tonics, cinchona, and a liberal, generous, blood-forming food. 

Irritable Ulcer. — This term is applied to an ulcer when it is 
hot, tender, very red and painful ; bleeds easily, and the discharge 
is thin, irritating ; in some cases foul and copious, and heavily 
loaded with bacteria. 

The cause of this is some malassimilation, perverted nutrition, 
or derangement of the general health. 

The treatment should consist in opening the bowels, correcting 



1 1 24 DISEASE GERMS. 

the malnutrition with tonics, as comp. tincture of matricaria; 
plain, unstimulating food. After a free action of the bowels, the 
irritability of the sore should be removed by applying a saturated 
solution of boroglyceride covered over with oiled silk, this will 
speedily exhaust the irritability and reduce it to the condition of 
a simple ulcer. If not, the ulcer might be sprinkled over with 
ozonized jequirity pulv. which will cause a complete exfoliation 
to take place, and stimulate it into a healthy condition. Then it 
might be healed up with ozone ointment. 

In the case of irritable ulcer it is indispensable that anodynes 
be administered freely, tonics and alteratives pushed. 

Indolent Ulcers. — Old ulcers of ten or twenty years' standing 
have generally a smooth, uneven surface, of a pale ashy color, 
like a mucous membrane. In some cases it may display a crop 
of weak fungus granulations. The edges are raised, thick, white 
insensible, either inverted or everted ; discharge scanty and thin 
and contains a few bacteria. Those ulcers may remain stationary 
for years, or take on at attack of irritability, and become in- 
flamed ; or may heal, and then suddenly give way. An irritation 






Bacteria in indo- Tubercular ulcer. Another form of tubercle 

lent ulcer. bacilli in an ulcer. 

in the body existing for years gives rise to a cachexia which is 
essentially tubercular. 

Treatment. — Before interfering at all with the ulcer, the patient 
should be placed upon a very active alterative and tonic treat- 
ment, with a varied diet, rich in blood elements, for a month or 
two. If the patient is feeble, the stramonium ointment and 
iodide of potass should be applied to the ulcer to soften and 
absorb the granulations and indurated edges. If he is in average 
health, the powdered or distillation jequirity might be applied to 
cause an exfoliation of its surface. 

Ointments made either of hydrastin, lycopodium, or pinol, or 
naphthaline, or aromatic sulphuric acid, or resorcin. 

Tubercular Ulcer. — The microbe of tubercle often blocks up 
the lymphatics in the neck, axilla, groin. Usually the bacilli 
crowd into the chain of lymphatics, two, three, or more ; they 
aggregate together in nests, first in an albuminous form, then as 
they die in the lymphatics, they become milky, cheesy, and 
lastly calcareous ; generally inflammation is excited at several 



BACTERICIDES. IJ25 

points in the lymph canals, cellular tissue, skin, giving rise to 
numerous openings, through which the curdy or cheesy matter 
exudes. These perforations communicate with each other in 
the cellular tissue, forming ugly puckered cicatrices on the 
neck or elsewhere, where they discharge and heal up. 

In all cases, the general treatment for tuberculosis should be 
enforced : glycerite of ozone, iodized oil, or ozonized iodine, sul- 
phur water, avena sativa. 

Locally to the sores, ozone ointment, sozoiodol, iodol, per- 
oxide of hydrogen, benzoin ointment. 

Varicose Ulcer. — An ulcer dependent upon a varicose condi- 
tion of the veins of the limb. The consequent venous conges- 
tion weakens the already debilitated parts, and renders them 
prone to ulceration. The ulcers are generally three or four in 
number, situated above the ankle. Oval in shape, indolent in 
their progress, neither extensive nor deep, but attended with 
considerable pain of an aching character. 

Treatme?it. — Get the general health into good order by tonics 
and alteratives, with abundance of good food and fresh air. 
Keep bowels regular, and attend to the skin by daily sponging. 
The internal and local exhibition of the witch hazel to tone up 
the veins ; an infusion answers the purpuse. The patient should 
wear an elastic stocking or bandage during the day. Before it 
is applied in the morning, limb to be bathed first with soap and 
water ; then either tincture or infusion, or ozonized distillation 
of witch hazel applied ; sore dressed with either black salve, 
vaseline or ozone ointment ; over the dressing a piece of oiled 
silk ; then an ordinary stocking, and, above all, the elastic stock- 
ing. The same should be repeated in the evening, but the 
elastic stocking need aot be kept on during night, unless case is 
very bad one. Infusion of oak bark, alcohol, and salt, and other 
remedies are of no importance when we have the witch hazel. 
A cerate of calendula, or pinus, or of hazeline, are most effectual. 

Fistulous Ulcer. — Consists of a tube or narrow channel, lined 
by a false membrane, which is a secreting membrane, and 
which may, or may not, lead to a suppurating cavity. In old 
cases, the walls of the tube are dense and semi-cartilaginous. 
Fistula may be produced by a deep-seated abscess, not healed 
from the bottom, or by caries, or necrosis of bone ; or by the 
perforation of tissue by a mechanical irritant or obstruction, as a 
foreign body perforating through the walls of the rectum to the 
external parts. 

If there are several openings, or fistulae communicating with 
dead bone, it is folly to try to heal them. If the parts permit, 
they should be run into one opening, so as to give nature as little 



I I 26 DISEASE GERMS. 

work as possible in throwing off the dead bone ; or if due to the 
imperfect healing of an abscess, it should be slit up from the 
bottom and injected with peroxide of hydrogen. (See Fistula in 
A?io.) 

Phagedenic Ulcer. — This term is used to express a variety of 
ulceration which destroys the tissues more rapidly and to a 
greater extent than ordinary forms of ulcer. The subjects of 
this local affection are usually individuals who have been debih- 
tated by some severe febrile disorder of a typhoid character, or 
who have been subjected to the influence of cold and wet, foul 
air, bad and insufficient food, fatigue, and excessive indulgence 
in spirits. It is generally preceded by some sore or wound, and 
its local causes a^'e irritation of the open surface, and gross neg- 
lect of cleanliness. A vx;ry superficial sore, such as that formed 
by the application of a blister, may under the above-mentioned 
constitutional and local influences, rapidly become phagedenic 
and produce much destruction of the soft parts. It has been 
most frequently met with in connection with venereal ulcers, 
especially in those cases in which the parents have been submit- 
ted to a prolonged and excessive use of mercury. Phagedena 
varies in intensity in different cases ; it is somes so mild as to be 
scarcely distinguishable from ordinary ulceration, and in other 
instances it spreads with so much rapidity and destroys so great 
an extent of the surface of the body, that there seems to be very 
little difference between it and the affection 
■{.:f^-:m^ known as hospital gangrene. This latter form 

tfi^^Pl^j^A oi phacredena is met with in noma, can- 

^K|^^^ crum oris, and the sloughing throat of scar- 

^^^P^ latina. It is believed by some surgeons that 

^^gre°ife^and'^''ta"edeni''"' phagedenic ulccration is caused by poison- 
in^ of the blood, in consequence of the ab- 
sorption of putrid matter. 

In phagedena there is a large and rapidly spreading ulcer, 
the edges of which are formed of sharply-cut, indented and 
undermined skin. The surface of this ulcer is uneven and of 
grayish color, and is covered by a dark-colored, thin and very 
fetid discharge, which is often marked by streaks of blood. The 
integument surrounding the ulcer is swollen, and of a dusky-red 
color. The ulcerative process is attended with severe gnawing 
pain. 

In the treatment of this affection it is necessary that the patient 
be supplied with good nourishment, and that alcoholic stimulants 
be given freely, but at regular intervals. Opium is generally ad- 
ministered for the purpose of relieving the severe pain, and of 
allaying nervous irritation. The patient should kept in bed in a 



BACTERICIDES. 



1127 



large and well-ventilated room. The bowels should be kept open 
by mild purgatives, but great care must be taken to avoid diar- 
rhea, as the subjects of phagedena may rapidly sink under any 
excessive drain upon the system. The local treatment consists in 
cleansing the surface of the ulcer by frequently syringing it with 
some disinfectant lotion, as a solution of carbolic acid, of per- 
manganate of potass, boroglyceride, or peroxide of hydrogen, 
and in relieving the pain by the application of poultices or poppy 
fomentations. In severe cases, where the ulceration, in spite of 
this treatment, is spreading with rapidity and attacking important 
parts of the body, the surgeon often finds it necessary to apply 
the actual cautery, or some strong caustic. Of caustic applica- 
tions, fuming nitric acid seems to be the most in favor. 

Bed-sores are large unhealthy ulcers formed over the hips, but- 
tocks and the lower part of the back of bedridden persons. They 
are due to long- continued pressure on these parts, to a vitiated 
state of blood, and to general debility, and are met with in the 
subjects of fever, paralysis, broken back and in very old people 
who have been in bed for a long time. In cases of paraplegia, 
bed-sores are very large and deep and spread with rapidity. A 
bed-sore commences as a dusky-red patch on the skin, which be- 
comes excoriated. After the separation of the cuticle the sur- 
rounding soft parts become swollen, and the inflamed integu- 
ment is converted into a gray or black slough, from the under 
surface of which there is a discharge of thin matter, and the mi- 
crobe of phagedena. This sloughing process extends both su- 
perficially and deeply until a large cavity is formed, which, in 
some instances, exposes bone. In old or very debilitated sub- 
jects death is frequently the result of this affection. Except in 
cases of palsy and broken back the existence of a bed-sore bears 
witness to the incompetence or carelessness of the nurse. In 
cases of long continued illness and confinement to bed injurious 
pressure on the back and hips may be prevented by the use of 
soft pillows and air and water cushions, and by a constant atten- 
tion to cleanliness. 

Same treatment as phagedena. 

Gangrenous Ulcer — Hospital Gangrcjic. — Gangrenous and ul- 
cerative processes which attack wounds and stumps after ampu- 
tation, when the patients are collected together in .great numbers 
and are placed under faulty hygienic conditions. Hospital gan- 
grene in all its forms is both contagious and infectious, and seems 
in some instances to be due to epidemic influences. It is very 
prevalent among armies during military operations, and when 
large numbers of wounded soldiers are collected together in 
buildings unsuitable in size and internal arrangements for hos- 



1121 



DISEASE GERMS. 



pital purposes. The disease has often made its appearance with- 
out any known cause in one or more American hospitals. It at- 
tacks small as well as large wounds, and even blisters and leech- 
bites, but is never met with in perfectly sound individuals. In 
the most severe form of hospital gangrene a small livid spot or 
bleb makes its appearance on a stump, or near the margins of a 
wound, which had previously been closing favorably. This bleb 
increases rapidly in size, and converts the extremity of the stump 
or the whole of the wound, with the surrounding healthy skin, 
into a black and swollen gangrenous mass. The disease spreads 
rapidly, and is associated with. constitutional symptoms of a low 
typhoid character. At other times a stump swells and becomes 
hard and very pale, and its surface is marked by large blue veins. 
This form is also attended with severe general symptoms and 
much pain. Like the preceding one, it is generally fatal. In the 
less severe forms the surface of a wound is covered by a thick, 
yellow, and adherent crust, which increases rapidly both in depth 
and superficial extent. This disease has been met with chiefly in 
Europe, and is there known by the name of diphtheria of wounds. 
The constitutional symptoms are not so severe as those of the 
strictly gangrenous forms, and the fever, if it be present, is gen- 
erally high and of an inflammatory kind. The general treatment 
should consist in supporting the strength of the patient by tonics, 
stimulants, germicides and nourishing diet. In the diphtheritic 
form, however, the diet should be moderate, so long as there is 
high fever, and alcoholic drinks should not be given freely. The 
local treatment is generally directed towards arresting the spread 
of the gangrene by the application of bactericides of great power, 
charcoal, yeast, resorcin, chlorinated soda, boroglyceride. 

Syphilitic Ulcer. — A breach of continuity in which the venereal 
bacillus appears. When not due to a specific inoculation, they 




The venereal bacillus eating the dorsum of the 
hand — forming a duplicating ulcer— which 
healed kindly under resorcin and ozone 
ointment. 







Pus from syphilitic ulcer with the 
venereal bacillus and streptococ- 
cus pyogenes, magnified 1250 



diameters. 



are usually met with on the legs, occasionally on the thighs and 
arms. The annexed diagram was photographed from a living 
subject, made a rapid cure under saxifraga and resorcin oint- 
ment. 



BACTERICIDES. 



1 1 29 



Malignant Pustule (Anthrax). — Becoming very common, from 
importation of foreign wool, hides ; and the operatives in such 
are often fatally affected. It begins as a little -rx \ 



dark red spot, with stinging or pricking pain, ^' A '^ "^ , 

on which a vesicle and then a pustule, seated ' W j(y^^ 

on a hard, inflamed base. When this is opened v V^ \ "^f^ 

it is found to contain a slough as black as gpores of the badiius 

charcoal, which is a mass of giant bacteria. amhrax from a pustule 

—,, 1-11,1 .1 1 , on the hand of a wool- 

rhere are likely to be more than one, and to sorter, magnified 750 
spread with great rapidity, and the system diameters. 
becomes affected ; or there may be systemic poisoning first, from 
the workers breathing in air loaded with the diseased germs. 
Butchers are often affected. 



The stomach, from its important functions, con- 
Ulcer, trolling the whole system of nutrition, merits 

{Gastric}) greater consideration than it \s, apt to receive at the 
hands of many. Any disease of such an organ 
implies so much interference with all other functions as to pre- 
clude, in great measure, their proper fulfilment. Even the func- 
tions of the brain are intimately dependent on those of this organ. 
Common acute inflammation, such as often affects other organs, 
is rare in the stomach, except when excited by some powerful ir- 
ritant swallowed. On the other hand, the slighter form of irrita- 
tion, commonly called gastric catarrh, is much more common 
than is supposed, and is, indeed, the ordinary form in which the 
stomach resents ill-treatment; ordinarily, this form of malady is 
reckoned as indigestion merely. 

Dyspepsia, as well as inflammation, is productive of ulcer. 

The two most important maladies of the stomach are simple 
and malignant ulceration, the latter commonly going by the 
name of cancer. Cancer of the stomach — a painful and intract- 
able malady — commonly affects one or other of the orifices of that 
organ, and of the two, by far the most frequently that next the 
bowel called the pylorus. Disease in this region interferes sadly 
with nutrition, prevents the half-digested food from passing on- 
wards in the digastric tract, and so starves the patient. As a 
consequence of this obstruction, too, the organ commonly be- 
comes dilated, the food, only half digested, collects and putrefies, 
and so vegetable organisms form in it. After being retained in 
the stomach for a time, giving off foul-smelling gases, the whole 
contents are ejected — a foul-smelling, black-looking mass, often 
resembling coffee grounds. The pain at these times is severe, 
but not at others, the great want felt being really a want of 




I 130 DISEASE GERMS. 

food. In the simple ulcer of the stomach there is also, as a rule, 
vomiting, but the part most frequently affected being the poste- 
rior wall at some distance from either orifice, there is not that 
regularity in its occurrence there is in cancer. In simple ulcera- 
tion of the stomach there is one serious danger always possible, 
that arises from bleeding. 

The shape of the gastric ulcer is mostly round ; if several 
make their appearance and coalesce, it is irregular, and occasion- 
ally belt-shaped. The shape at first is nearly 
always round ; after existing for a time the 
ulcer becomes elliptic or gets small notches, 
and thereby becomes irregular. The ulcer 
spreads mostly in an oblique direction, there- 
by occasionally encircling the whole stomach 
like a belt. 
Perforating ulcer of the jf ^hc ulccratcd proccss p;oes ou Until 

stomach. ^ o 

the ulcer reaches the deeper and larger blood 
vessels of this organ, it is quite possible for one of these 
to give way before it is closed at either extremity, and so 
the blood is poured out from it so rapidly that life is endan- 
gered. Most frequently under such circumstances the blood 
is vomited, and this vomiting of blood may be the first symp- 
tom ot" danger. At the same time, however, the blood will in 
part pass into the bowels, and being there partly altered and 
blackened, is so discharged. This constitutes melaena, vomiting 
being termed hsematemesis. Often it is not easy to diagnose 
between the simple and malignant variety of ulceration, though 
this is important, the simple form being tolerably amenable to 
sound treatment, the malignant not at all so. When bleeding 
does occur it constitutes a danger so serious as to demand 
instant attention, for if the bleeding does not stop the patient 
will die. Frequently, too, it will be found that the bleeding 
recurs again and again, tasking the resources of the physician 
and the strength of the patient to the uttermost. Here are the 
rules to be adopted. The patient must be kept at absolute rest, 
and ice given freely. Let the patient crush the ice roughly with 
the teeth, and swallow it in lumps. Let ice be placed outside 
the body over the stomach. The best thing to give is dry cham- 
pagne, in small quantities, well iced ; if that is not to be had, iced 
brandy and soda, only the smallest quantity of brandy. The 
best medicine is gallic acid, made into a paste with water, twenty 
or thirty grains for a dose, with perhaps ten or twenty drops of 
dilute sulphuric acid. There are a score of other remedies, but 
these are the best, and as a rule will succeed if any will. But as 
regards food — there is the real difficulty. Well, it is best to face 



BACTERICIDES. 1131 

it from the beginning, and give no food by the mouth, but only 
nutrient encmata. If the case is severe, that is the best plan ; \\ 
sHght cases a Httle milk, iced, is best to be q-iven. But in ail 
cases of real difficulty, there is nothing like nutrient enemata — 
strong beef tea. The bowels ought, however, to be well washed 
out with soap and water before administering the injection. 

Disease germs are productive of ulceration of the stomach, and 
it is quite certain that by lavage of the stomach thev can either 
be discharged or washed out. This is a valuable aid to medical 
treatment. 

It is well to bear in mind that the symptoms of gastric ulcer 
in middle-aged persons, differ very considerably from those 
which have occurred early in life, though the symptoms consist 
chiefly of pain, tenderness, vomiting, and haematemesis. The 
individuals are no longer simply anaemic, but are often cachect'c 
and wasted. The pain is often much less acute, and the sickness 
much more frequent and distressing. There is generally great 
tenderness over the region of the stomach, and the matter which 
is brought up is intensely acid, and contains quantities of blood, 
sometimes in the form of clots, but more often presenting the 
coffee-grounds form. In such cases there is often great difficulty 
in distinguishing between gastric ulcer and malignant tumor of 
the stomach, and indeed the diagnosis can only be arrived at 
with certainty after the case has been for some time under treat- 
ment, and the absence of a tumor has afforded further indications 
of the non-malignant character of the disease. At the prcst^nt 
time it is rare to find death occurring from perforation in cases 
of gastric ulcer, and yet it has been estimated that the propor- 
tions of death by perforation is something like fifteen per cent. 
Largely, this result is due to improved methods of treatment, 
and to early recognition of the disease, but it may be doubted, 
even at the present day, whether as much is done in the shape 
of treatment, as might possibly be accomplished. One of the 
most important points to be borne in mind is to insist on the 
importance of simple physical rest. A physician is very com- 
monly called upon to deal with two very distinct classes of in- 
dividuals ; those occupying a bed in hospitals, and those who 
either go to his out-patient room, or consult him at his own 
house. The greatest rapidity of recovery is always to be found 
amongst those who are kept quietly in their own beds. 

It is extremely difficult to convince people that this is really 
an advantage. So long as individuals can move about at all, 
and more especially if they can move about with any ease and 
comfort to themselves, they are extremely loath to lie quietly in 
bed. It is only a very few who will place such complete reli- 



II32 



DISEASE GERMS. 



ance on the instructions of their physician, as to allow him to 
carry out to his heart's content, treatment by rest. It is ex- 
tremely difficult to lay down what particular forms of food should 
be taken or rejected, but most experience shows, though of 
course many instances to the contrary might be quoted, that all 
forms of uncooked food, meat, stimulants, and things generally 
known to be indigestible, must be prohibited. Some can take 
milk, some eggs, some farinaceous foods, whilst some seem to 
be specially irritated by them. As far as possible, it is desir- 
able to insist on rectal alimentation. The value of the treatment 
of drugs depends largely upon the amount of an accompanying 
gastric catarrh. It is very much the fashion at the present day 
to give alkalies, usually in the form of carbonate of soda, com- 
bined with a little iodide of potassium, and possibly some opium. 
__ If symptoms of hemorrhage supervene, it 

~ ' "^ ^ is obvious that all the more need exists 

for care in treatment ; but the subject of 
treatment is so large a one that we must 
briefly epitomize it. 

First, as to the alimentary canal. In 
their abnormal conditions, the digestive 
organs present a nidus peculiarly favor- 
able to the development of the lower or- 
ganisms, and I believe that many, if not 
most, of the annoying phenomena of in- 
Ducts and acini similar to the digcstion depend on fermentation and 
pyloric glands and the fine, putrefaction of their coutents. An in- 

richlv cellular connective tis- ,. . . . ,, . , 

sues formino the inter-tubular digestion Originally dependent either on 

stroma in microbes. . ,.^. r ,^ 

some passmg condition of the primae 
viae, or on some solitary indiscretion in diet, is often indefi- 
nitely prolonged by the development of torulae, sarcinae, and 
other (microphytes. The acids and gases evolved by their 
baneful activity confirm a condition that otherwise would 
be evanescent. The delayed digestion of the so-called atonic 
dyspepsia, I am convinced, is often due to the excessive acid- 
ity of the stomach contents, which, in its turn, is due to the 
growth and activity of torulae and sarcinae. By the destruction 
of these microphytes, or even by the temporary inhibition of 
their activity, we greatly relieve, if we do not cure, the dyspeptic ; 
and certainly in those cases not dependent on incurable organic 
lesions, we make a long stride towards cure. 

But how destroy these microphytes, or inhibit their activity ? 
Chiefly by the internal use of germicides. Those best adapted 
to this purpose are, so far as my observation extends, peroxide 
of hydrogen in the fluid ext. of hydrastis or columbo, or liquor 
ceni. 




BACTERICIDES. 1133 

Of these, the liquor cerii is probably the most suitable in the 
majority of cases. It is efficient. It is a digestive as well as 
a general tonic. By its gradual solution, its action is prolonged, 
and even extended into the intestine. It is easy of administra- 
tion. Thus we see that it answers a number of indications most 
admirably. It should be administered in about thirty-drop 
doses, three times a day, and always after meals. 

Hand in hand with this, of course, should go the proper se- 
lection of foods, their thorough mastication, and the use of di- 
gestive and general tonics, such as pepsin, the vegetable bitters, 
and especially moderate quantities of alcoholic stimulants. 

In dilatation of the stomach, the administration of the appro- 
priate germicide should be preceded by a thorough washing-out 
of that viscus. 

Authorities recommend the use, before meals, of the mineral 
acids in cases of excessive acidity, and of the alkalies, in deficient 
acidity, of the stomach contents. This advice, as they say, is 
based on the physiological fact that alkalies increase the secre- 
tion of the stomach acids, while, on the contrary, acids diminish 
it. This explanation has always seemed to me a little strained, 
and especially so, since the demonstration of the germicidal 
power of the mineral acids. Were it the true one, excessive 
acidity should be its own remedy. The excessive presence of 
the normal aeid, I believe, is very rarely a cause of acid indiges- 
tion ; on the contrary, the acid of acid indigestion is the acid ot 
fermentation. With this view, the explanation of the efficacy of 
the mineral acids before meals, and of their failure after, is very 
simple. Administered on an empty stomach, their degree of 
concentration is sufficient to be germicidal, while on a full stom- 
ach, it is insufficient, and so the would-be remedy aggravates 
the trouble by adding its own acidity to that already existing. 

The value of the mineral acids in this condition is not solely 
dependent on their germicidal powers; muriatic acid and nitric 
acid in a less degree assist in the digestion of the albuminoids, 
and by their astringency give tone to the debilitated mucous 
membranes. 

Muriatic acid before meals, therefore, is one of our most valu- 
able resources in the treatment of acid dyspepsia. 

The bisulphite of sodium in full doses or in divided doses, re- 
peated as necessary, is especially adapted to the treatment of 
those cases of acute septic indigestion, otherwise known as 
bilious attacks. It occurs to me that perhaps in these very 
cases it was, that calomel, as an unsuspected germicide, acquired 
its false reputation as a cholagogue. If administered in the very 
outset, both experience and observation assure me that bisulphite 



I 134 DISEASE GERMS. 

of sodium will often abort these distressing attacks. Here it is 
best given in drachm doses, dissolved in mint-water to mask its 
abominable taste. 

It must be fresh so as to contain an excess of sulphurous acid, 
wliich is liberated in the stomach, and on which its efficiency 
depends. 

Lavage is an important element in the treatment of gastric 
ulcer. 

Lavage is thus performed. An oesophageal tube, with a blunt 
double-e)'ed extremity, made of flexible-rubber, 28 inches in 
length, and from a ^ to ^ an inch in diameter, is attached to a 
small section of glass tubing, which is also attached to a yard of 
soft rubber tubing, into the free extremity of which, a glass 
funnel capable of holding ei^ht ounces should be inserted. 

This oesophageal tube well- warmed and oil, should be passed 
down the oesophagus in the usual manner, the patient aiding all 
he can by attempts at deglutition. When the stomach has been 
reached the funnel is raised above the patient's head, and from a 
pint to a quart of the lavage solution is slowly poured in, ob- 
struction or regurgitation being noticed by the glass tube joining 
the two tubes. When sufficient of the lavage solution has been 
introduced, the funnel is lowered and inverted over a basin. While 
making this change compress the tube ; when the change is made, 
relax it ; freed from the pressure, the tube becomes a syphon, and 
the contents of the stomach is rapidly removed. 

If there be irritability to the passage of the tube, smear its 
edges with cocaine ointment, and if patient be very nervous, ex- 
tract of musk-root to be given. 

With regard to the solutions used ; as simple lavements, infu- 
sion of slippery elm and resorcin ; boroglyceride ; creosote, one- 
per-cent. ; carbon bisulphide ; charcoal ; creolin ; naphthaline. 

The strength of the various solutions must be carefully regu- 
lated. 

In some cases, as with slippery elm, or wild indigo infusion, 
they may be permitted to remain. Any irritability must be over- 
come by painting the fauces and throat with cocaine. 



The different forms of ulcer of the larynx 
Ulcers of the may be embraced under the following heads : 
Larynx. Catarrhal; follicular; diphtheric; tubercular; 

syphilitic, and other forms due to the micro- 
organisms of the eruptive fevers. The tubercular and syphilitic 
are the most common. 

Catarrhal ulcers are not infrequently associated with nasal ca- 



BACTERLCIDES. 



II35 



tarrh, and are usually superficial, as they are round, then oval, 
and gradually, as the germs burrow (amaeba), become more exten- 
sive in size, and more numerous ; often coalesce, become large 
with irregular outline. 

The folliciilar tilcer as a rule, is superficial with a limited area 
of extension. 

The tubercular ulcers are either superficial or deep ; most com- 
monly met with at the inter-arytenoid commissure, generally 
associated with laryngeal tuberculosis. The deficient vascularity 
of the pale and thickened arytenoids favors the occurrence of 
those ulcers. They have their inception in a neurosis, a general 
bankrupt state of the nervous system, the evolution of the bacil- 
lus tuberculi which causes deep destruction, calcification and ne- 
crcsis of the laryngeal structures, which is usually aggravated by 
discharges from the bronchi or lung, independent of degenera- 
tive changes and tubercular nodules. 

Syphilitic ulcers of the larynx depend greatly on the general 
health, if vital energies are greatly exhausted, the mucous mem- 









d^m^i 



mi^ 



K^^^ 



Syphilitic microbe as found in the 
scooped-out coppfr-coiored ul- 
cers on the larynx. 




© .^m 



r-.^Sffi: 



■ <m^ 



Section of the mucous membrane of the larynx 
of a patient who died of leprosy, in which the 
syphilitic microbe also existed. 



brane of the entire larynx may be involved, general destruction 
of tissue ; if not so much prostrated, there may be simply ulcers, 
with everted edges, with a yellow hue in their 
excavation, owing to the presence of the 
syphilitic germ. 

Diphtheric, and ulcers due to the germs 
of variola, measles, scarlatina, are easily diag- 
nosed by the attendant malady. 

Symptoms. — All forms of laryngeal ulcera- 
tion are attended with symptoms of irritative 
catarrh. " The patient has a hard stridulous 
cough of long standing, the expectoration 
containing microbes, blood and the debris of 
laryngeal tissue, with hoarseness amounting at times to complete 
aphonia. Patient usually complains of a burning smarting, 
pricking sensation in the larynx, with tenderness on pressure, 




Ulcers on the mucous mem- 
bran'- of the larxnx of a 
child that died of scarla- 
tina. 



1 1 36 DISEASE GERMS. 

which is increased by the use of the voice ; painful and difficult 
deglutition attended by wavy laryngeal respiration. 

If such things exist there is reason to suspect the existence of 
a laryngeal ulcer, but a positive diagnosis cannot be made from 
these symptoms alone, as extensive ulceration may exist, and all 
those symptoms be wanting ; there may be laryngeal catarrh 
with inflammation, etc. 

An examination of the parts with the laryngoscope clears up the 
matter and makes us able to give a positive diagnosis. 

Our prognosis of all cases except the tubercular and syphilitic 
is good, in those two latter most uncertain. 

The general principles of treatment in all cases are a general 
alterative and tonic course ; everything calculated to improve the 
general health. 

Since the introduction of the peroxide of hydrogen, ulcers 
dependent on the presence of the bacillus of tubercle and 
syphilis are more amenable to treatment. A spray of glucozone, 
which is simply the peroxide reduced in strength by the addition 
of glycerine, is more energetic in killing the spores of both bacilli 
in the ulcers than any remedy ever introduced. Ozonized iodine 
in one or two drop-doses internally every four hours operates 
well. 

Kephaline and oats act well on the larynx ; so does the ozon- 
ized coca wine, which is of all drugs a laryngeal stimulant. 



By this is meant a chronic sore within the rectum, 
Ulcer on anywhere between the internal sphincter and the 
Rectum, sigmoid flexure. The ulceration may be so superfi- 
cial as to be wide-spread, or so deep that it may pene- 
trate or perforate the rectal walls. It may be limited to one point or 
consist of several small or large patches. But generally there is 
only one, usually located from one to three inches above the sphinc- 
ter. Some of them discharge large quantities, more or less 
mixed with blood. In some cases it flows from the rectum or 
oozes away ; more frequently, there is no appreciable discharge. 
The inflammatory products are absorbed into the circulation. 
On careful examination of the stools from day to day, there 
will be seen, if not always, that they are streaked with blood, pus, 
or an albuminous substance like the white of egg. 

Ulceration is very common, much more so than is gener- 
ally supposed. Fissure and irritable ulcer make their presence 
known by pain, but ulceration above the sphincter may exist un- 
suspected for months or years, the attention of both physician 
and sufferer being direct to some reflex symptom. 



BACTERICIDES. 



II37 



Ulcers in the rectum are usually classified according to their 
appearance; catarrhal form, in which the entire mucous mem- 
brane is involved ; traumatic, from a wound ; dysenteric, when it 
arises from that affection ; tubercular, when the bacilli affect a 
germ-eaten rectum ; syphilitic, cancerous ; that peculiar to the in- 
sane ; gangrenous, in which the oidium albicans are present. 

Causes. — A general feeble state of health, with a catarrhal state 
of the rectal walls, originates more ulcers on the damaged mucous 
membrane than all other causes. A nervous temperament, with 
special brain lesions, in which the vibrios are present in the alvine 
discharges ; the bacilli of tubercle ; the 
micrococci of syphilis and cancer readily 
find a location in a relaxed tissue to 
breed. Dysentery is a fruitful source of 
ulceration. 

The agents which produce ulceration 
are very numerous, such as fruit stones, 
hardened faeces, foreign bodies accident- 
ally swallowed, often lacerate the mucous 
membrane ; child-birth, piles, fissure, 
polypus, and other states often cause 
u Iceration. 

Symptoms. — Rectal ulcers, being 
usually unaccompanied by pain, are often 
unsuspected until they have made great 
progress ; until they have caused destruc- 
tion of tissue, or penetrated to other 
organ. The remarkable absence of pain 
is due entirely to the absence of sentient 
nerves above the sphincter. 

But although nearly painless, it has a certain train of symp- 
toms, as itching about the anus, a slight protrusion and smarting 
at stool, occasionally experienced in the coccyx ; not infrequently 
is there trouble with the urinary organs, ovaries, and uterus in 
females, and the prostate and kidneys in males. There is al- 
ways less or more blood poisoning from absorption of purulent 
products of the ulcer, and the re-entering of disease germs into 
the circulation. 

The direct symptoms which indicate rectal disease are gener- 
ally manifested by a morning diarrhea, or diarrhea alternating 
with constipation, severe pain in the lower extremity of the 
coccyx, radiating through the hips and down the thighs, passing 
of mucus, blood, pus during stool ; burning, itching in rectum ; 
inclination to remain at stool, after a movement has been effected ;. 
burning sensation for some time. 
72 




The species of bacteria found 
rectal ulceration due to catarrh. 



II38 



DISEASE GERMS. 



The reflex symptoms cause disturbance of the enth'e body, 
reflected from the plexus of nerves around the rectum ; these 
symptoms are giddiness, loss of memory, pain in the back of the 
head, indigestion, bloating of the bowels, functional disturbance 
of the liver, kidneys, bladder. 

One of the most diagnostic symptoms of rectal ulceration is 
morning diarrhea, the discharge consisting of mucus, matter like 
coffee grounds, hardened faeces and watery discharge, a pressing 
desire to continue at stool, a sensation of weight and weariness 
in the hips and legs ; various pains that are usually referred to 
the region of the rectum and anus. 

The constancy of the hip and leg weariness is a good point in 
diagnosis. In men, the. bladder and prostate seem to suffer 
greatly, as there are often seminal emissions, the result of adja- 
cent irritation often unsuspected, from the ulcer being within half 
an inch of the seminal vesicles. 

In women, bladder and womb dyspepsia should be carefully 
guarded in a diagnosis. 

Treatment. — This will vary in character and energy, according 
to the extent and complications of the disease. In all cases an 
alterative and tonic course of medication are indispensable, with 
a dietary rich in blood elements. Special rectal tonics should be 
given in all cases, so as to excite or stimulate a renewal of life in 
the rectum. This will embrace the persistent use of that great 
rectal tonic, Viriginia stone crop, collinsonia, mineral acids. 

The results of rectal ulceration are exceedingly variable, both 
in their nature and intensity. They are inveterately chronic, and 
often hold on with varying degrees of fluctuation, now nearly 
well, at another time ulcerating deeply and widely, dependent on 
the state of the general health. 

So it is necessary in the management of those cases to have a 
direct treatment for the actual state of the ulcer. As a rule, 
those ulcers are generally found on the posterior portion of the 
bowel, but may be found anywhere. In making any applica- 
tion, the bowel should be washed out with castile soap and warm 
water, or a solution of boroglyceride ; subsequently the applica- 
tion should be applied by the physician, if possible, through his 
speculum, not oftener than twice or three times a week. 

The following will be found useful formulae for direct medica- 
tion : 

Salol, sugar of milk, of each one drachm. Mix. Apply by 
dusting. 

Salicylate soda, one drachm ; sugar of milk, two drachms. 
Apply by dusting. 

After each stool, the patient should wash out the bowel by 



BACTERICIDES. I I ^q 

injecting a teacupful of warm water ; after this has been retained 
for a short time, and then passed off in either catarrh or ulcera- 
tion, a small piece or quantity of either of the following formulae 
should be injected, and repeated as long as it may be necessary. 
The formulae may be utilized according to the nature of the case, 
as they are useful in any of the forms of rectal disease : 

Carbolic acid, two and one-half drachms ; balsam of Peru, 
two drachms ; ext. matico, two drachms ; lac sulphur, three 
drachms ; vaseline, sixteen ounces. Mix. 

CarboUc acid, fifteen grains ; pulverized opium, fifteen grains ; 
tannic acid, twenty grains : muriate of cocaine, two grains ; 
lanolin, one ounce. Mix. 

If there is much soreness and irritation, wash out the bowel 
and insert a piece of the following, two or three times a day : 

Submuriate of mercury, thirty grains ; pulverized opium, sixteen 
grains; solid ext. belladonna, five grains ; elder-flower ointment, 
one ounce. Mix. 

For night treatment, from twenty to thirty drops of either of 
the following mixtures should be added to a small quantity of 
starch and water, and injected into the rectum with a syringe on 
going to bed, and permitted to remain over night ; if constipation 
be predominant, pulverized slippery- elm should be used instead 
of starch : 

Fluid ext. hamamelis, five drachms ; Monsul's solution of 
iron, one drachm; carbolic acid, two grains; glycerine, two 
drachms. 

Fl. ext. hamamelis, six ounces ; fl. ext. hydrastis, two ounces ; 
phenol sodique, four ounces ; glycerine, three ounces. 

Carbolic acid, thirty-five grains ; simple cerate, one ounce ; 
vaseline, one-half ounce ; oil of wintergreen, fifteen drops. 

Carbolic acid, three grains ; sulphur, eight grains ; lanolin, one 
ounce. 

Carbolic acid, fifteen grains ; black pitch, one ounce. 

Those formulae are excellent, and one cannot go wrong with 
any of them. They should be alternated, and if the bowel is 
washed out before they are applied, and they retained, splendid 
and gratifying results will be effected. 

A very frequent result of ulceration is stricture, the ineffectual 
attempts on the part of nature to heal the ulcer results in a de- 
posit of plastic lymph, which thickens the mucous and muscular 
coat, thus lessening the calibre of the canal. 

Nature is most provident in rectal ulceration, the ulcer being 
generally found on the posterior part, the perforation is not such 
a grave affection, unless very high up, when it is apt to burrow 
and form a fistula, or abscess ; whereas, if it was common anteri- 
orly, the bladder and vagina would be liable to be perforated. 



II^O DISEASE GERMS. 

As these ulcers are chiefly due to the presence of microbes, all 
remedies, to be of signal efficacy in treatment, must be germici- 
dal, such as the cocaine suppository, or some one of the following 
may be selected. 

lodol and resorcin, of each, sixty grains ; pulverized opium, 
ten grains ; butter of coca, sufficient quantity to make ten sup- 
positories. Insert one morning and night. 

Ozonized distillation of the witch hazel, one ounce ; resorcin. 
half an ounce; morphia, two grains. Mix. Inject one table- 
spoonful thrice daily. 

Peroxide of hydrogen in glycerine is a most effective agent in 
rectal ulcer. 



Irritable Ulcer on the Rectum. — This is very similar to fissure, 
and it is really fissure extending above the internal sphincter, 
which has expanded into an oval or rectangular shallow rare 
sore. Properly speaking then, irritable ulcer is but an extensive 
fissure. Whatever its source or cause, it is usually found on the 
mucous membrane covering the internal sphincter. It is not so 
intensely painful as fissure, as oftentimes patients are not aware 
of its existence. The cause is the same as fissure. 

In the treatmient of this form of ulcer, belladonna ointment 
should be smeared over the external parts, around the sphincter, 
so as to paralyze it; castor oil or fluid extract of juglandin should 
be taken in sufficient quantity to move the bowels, then the rec- 
tum should be washed out with a solution of boracic acid, a 
speculum introduced and an examination made. Thoroughly 
cleanse the exposed parts with a sponge and soap ; then a piece 
of sponge or absorbent saturated with the following : 

Nitrate of silver, thirty grains ; distilled water, one ounce. 

Salol weakened somewhat by triturating it with pulverized 
gum arable might be used instead. The following yields most 
beneficial results : 

Distillation of witch hazel, twelve ounces; fluid extract hydras- 
tis, six ounces ; aqueous extract of opium, four ounces. Haifa tea- 
spoonful to two teaspoonfuls of water injected before retiring at 
night. 

While pursuing this course, the sphincter should be kept re- 
laxed and a good rectal tonic, like stone crop, should be adminis- 
tered internally, and one to three tablespoonfuls of the following 
injected into the bowel twice daily : 

Aromatic sulphuric acid, one ounce ; sulphate of quinine, half 
an ounce ; water, sixteen ounces. 



BACTERICIDES. 



II4I 



Ulceration of the 
Rectum. 



There is a proneness to the occurrence 
of inflammation about the lower end of 
the rectum, which is attributable in a 
great measure to the structure of the 
part; the looseness of the skin, the large size of the veins, and 
their liability to become irritated or inflamed by sluggishness of 
the Hver and the irregularity of the func- 
tion of the bowels. The abscesses and .,. _^^ , . 
ulceration may vary much in character, p|' ^^ ) '^ 
size, depth, and their degree of connec- ~^ 
tion with the bowel. They form in the 
mucous or subcutaneous tissue. Apt 
to occur when there is a derangement of 
the general health, and disease germs in 
the blood. They often have no traceable 
origin, are indefinite in their duration, 
and if large are to be looked after with 
care. 

A very large percentage of rectal ab- 
scesses terminate in fistula in ano. It 
matters little how an abscess arises, it 
may be a foreign body penetrating and 
ulcerating through the rectal walls ; dis- 
ease germs eating through the structure, the thickness of struc- 
ture necessarily causes it to be slow, as it perforates matter 




Rectal ulcer, following an abscess, 
with ragged edges, often met 
with in syphilitic subjects. 



^ 





The discharge from the same 
ulcer, magnified. 



bS?^f-^ 



The pus of the same ulcer, magnified 
1250 diameters, showing the germs 
actively engaged in the work of de- 
struction. 



all the time being regurgitated into the rectum, and nature 
in order to protect herself forms a sinus. 

An excellent illustration of syphilitic ulceration of the poste- 
rior portion of the rectum, extending several inches up, the 
syphilitic microbe eating and burrowing in all directions. Pack- 
ing the ulcer with iodol ; rectal bougies cf boroglyceride most 
successful. 



1 142 



DISEASE GERMS. 



By the movements of the integuments and sphincter, and the 
anatomical construction of the parts, and by other means, a 
closure is arrested, and the tube or opening is lined with a firm 
fibrinous deposit, variable in different cases. Abscesses may be 
associated with hemorrhoids. 

Fistula is always preceded by an abscess, which having dis- 
charged its contents, may remain open or close up. 

An abscess at this point is attended with great pain, owing to 
the density of structure and the large supply of sentient nerves. 
The pain is augmented when the patient sits or walk, and during 
an evacuation of the bowels, but the subsidence of the swelling 
by the escape of its purulent contents is attended with instant 
relief. 

A breach of continuity of, or on, 
Ulcers on the Neck the os or neck of the uterus, may be 
of the Uterus. the result of some injury, but more 

generally it is the result of conges- 
tion, effusion of lymph, breaking down of the lymph in the folli- 
cles of the mucous and muscular tissue. Ulceration of the neck 
of the uterus is not nearly so common as ladies are led to imagine ; 
true, there is much induration or thickening, much congestion, 
and often papilloma on the mucous tissue, but real solid ulcera- 
tion is rare. 

It is indispensable in the coming age that the physician be a 
Christian gentleman of the highest possible scientific attainments 
and skill ; a man incapable of exaggeration, or deviating from 
the truth ; the true physician should be honest, straightforward ; 
he should have none of the characteristics of either a sneak or a 
cur, or a vulture, or a prevaricator, but he should be magnani- 
mous and honest ; a man above a falsehood, one who, when con- 
sulted regarding a headache, defective sight or hearing, or indiges- 
tion, or ingrowing toe-nail, will bluntly tell what it is and not insist 
upon a vaginal examination, and pronounce these affections as 
arising in all cases from the uterus. In the gynecological epi- 
demic which pervades the medical profession, all, everything, 
is due to ulceration of the uterus os, or neck; an examination is 
called for, it is made, the case is pronounced obscure ; another is 
called for, and another, and too frequently are a chaste, refined 
female's affections alienated from their proper source. 

There are no isms or pathies in medicine to the bacteriologist, 
he sees nothing but the best means of killing germs, sterilizing 
the human blood, raising the standard of vital force by any and 
all means ; every honest Christian physician is a social benefac- 
tor, irrespective of his school ; he does not, like some charlatans,, 
coin new names for trifling maladies and invent disease. 



BACTERICIDES. 



I 143 



Women are sensitive and imaginative, know little of physi- 
ology, but feel keenly any ache, pain or irregularity, and attach 
more importance to it than there is any need to. So, if she has 
dyspepsia, or dysmenorrhcea, and a slight bearing-down, she is 
much impressed, and consults one of those mountebanks; her 
fate is at once sealed, by the designation '^ ulceration of the 
neck of the uterus," when nothing is the matter but fatigue. It 
is the fashion, they live by it, it is their bread and butter. Poor 
lady, three times a week she trudges to his office, and has his 
applications applied for a disease that does not exist, and, if it 
did, should be cured without such a mess of degradation. This 
is an everyday game. 

We have another class, meaner still, who go for ulceration and 
displacement. This class assert that there is scarcely a woman 
living whose uterus is where it ought to be. It is antiflexed, re- 
troflexed, or verted this way or that way. An examination by 
speculum must be made ; and as he gets a large percentage from 
some unprincipled " uterine supporter" patentee, or manufacturer, 
there will be a variety of contrivances tried, but none answer till 
his favorite is reached ; and, oh ! the fitting-in, the adjusting and 
readjusting, in order to cure the headache, irritation of the blad- 
der from the uric acid, or pretended albuminuria, and a thousand 
other ills that do not exist ! 

Now, where this is done by an educated gentleman, a Christian, 
one who knows what he is doing, and what difficulty he is deal- 
ing with, if there be one, much good may be accomplished; but 
when imitators, pretenders, rascals, go at it for cash, nothing but 
harm follows. With these fellows there are muddling and med- 
dUng of the most disreputable kind, and patients get tired of it, 
their money and patience become exhausted, they give it up ; 
and if there is something the matter, become chronic invalids, 
and are a nuisance to themselves, relations and friends. 

In all cases of chronic inflammation there should be no let-up 
in treatment until the the thickening of the neck, produced by 
effusion of lymph is removed by the application of the jequirity 
paste, by packing the vagina with boroglyceride ; copious injec- 
tions of ozonized iodine, etc. 

Effusion of lymph, if permitted to remain in the interstitial 
structure of the neck of the uterus, is liable at any time the 
health becomes slightly impaired to become the streptococcus 
pyogenes. 

Simple Ulcer, or an excoriation, or erosion of the lips of the 
neck of the uterus, is the simplest form of ulceration. The epithe- 
lium is simply removed from the part ; the villi, the fine net- 
work of capillaries, can be felt, velvety to the touch, or it can be 



1 144 



DISEASE GERMS. 




Induration with ulceration of the neck of 
the uterus, ail round. 



seen through the speculum. Usually little hardness, scarcely any 
perceptible redness. 

^ Symptoms. — There is a general depression of the health ; head- 
ache, and languor; leucorrhoea, pain in pelvis and sacrum, irrita- 
_ tion of ovaries, bearing-down, 

aching in thighs, indigestion, flatu- 
lence, with irregular action of 
bowels. Menstruation is likely to 
be disordered in some way. Vagi- 
nal secretion acid. 

In the treatment of simple ulcer 
of the neck of the uterus, the 
bowels should be regulated with 
cascara sagrada lozenges, or kola 
nut paste, or some other mild 
stimulant; then the appetite should 
be fostered and invigorated with 
tonics, as comp. tincture matricaria; 
American columbo ; aromatic sul- 
phuric acid and quinine ; gentian 
and coUinsonia ; best of blood- 
forming diet prescribed, beef, mut- 
ton, poultry, milk, cream, eggs, and if slow or retarded, ozonized 
pepsin. 

Patient should be placed upon uterine tonics and restoratives, 
as the wine of the aleteris farinosa ; comp. syrup of partridge 
berry ; ozonized elixir of apiol. 

Locally, after it has been ascertained to exist by a careful 
speculum examination made in either the presence of the mother 
or husband, and details of treatment arranged. 

What is to be the treatment ? Not a depleting, antiphlogistic 
course, assuredly not by any caustics. We grant the proposition, 
the ulcer is but a mass of living, working germs, but we can do 
better than apply the solid stick of nitrate of silver and destroy 
tissue. This ulcer can be stimulated by blowing ozonized pow- 
dered jequirity over it; or by brushing a paste of the same, or 
inserting a capsule close by it filled with the same powder. This 
w^ill cause the ulcer to exfoliate, peel off, leaving soft delicate but 
healthy tissue behind, which in a few weeks becomes very vital. 
Still a milder but effectual plan is dusting or blowing on the 
ulcer the anti-microbe powder. 

Still another excellent plan is to pack the vagina with borogly- 
ceride over night for one or more nights in succession. 

At the same time rest in the recumbent posture ; hip baths 
thrice daily; vaginal injections by or through a two-quart foun- 



BACTERICIDES. 



1 145 



tain syringe, tepid fluids. Before using any medicated injection, 
it is well to run through the vagina a quart of castile soap suds, 
to wash out ; then follow with either solutions of boroglyceride 
or resorcin, lime water and tincture of iodine.* 

Pastiles inserted on retiring are of great utility, those com- 
posed of boroglyceride and cocaine are most efficacious ; so are 
those composed of white pond lily, and other vegetable astrin- 
gents. 

If married, sexual congress for a few weeks should be rigidly 
forbidden. 

Irritable or Inflamed Ulcer involves the os or the lips, but is 
vascular and very red ; the loops of the capillaries have given 





Hj'pertrophy, with ulceration, 
highly inflamed. 



Inflamed cervix uteri, causing general irri- 
tation of the uterus. 



way, and there is an excavation ; there is considerable redness and 
ichorous discharge. 

Symptoms. — All the symptoms are much aggravated, more 
debility, even mental depression ; the leucorrhceal discharge is 
profuse, and muco-purulent, and greenish ; great headache, 
tongue coated, no appetite, anaemia, neuralgia ; dirty, sallow hue 
of skin ; bowels irregular, usually constipation ; pain in the back, 
hips and thighs, aggravated by exercise ; reflex irritation of blad- 



* Out of one hundred thousand physicians in the United States, the most successful 
in the treatment and cure of all forms of ulceration of the neck of the uterus, are 
Phebe Low, M. D., Liberty, SulHvan Co., N. Y. ; E. Thompson, M. D., Romeo, 
Michigan ; Ahce A. Benton, M. D , Spokane Falls, Washington. The remedies used 
by these three learned ladies are chiefly those above enumerated, together with other 
bactericides, with which they have each had such brilliant success. 




I 1 46 DISEASE GERMS. 

der, rectum and breasts. There is often menorrhagia in this 
variety. 

The treatment of the inflamed ulcer mi-'- be much more ener- 
getic than the simple ulcer. General alteratives and tonics, com- 
pound saxifraga and phytolacca alternated with wine of aleteris 
farinosa and compound syrup partridge berry. 

To the ulcer, either powdered jequirity or a paste, or pastile of 
the same, causes a complete exfoliation of the ulcer without 
leaving a trace behind, followed by copious slippery elm injec- 
tions, and subsequently boroglyceride 
and resorcin. 

Rode7it Ulcer. — In the simple and irrit- 
able ulcer there are usually present in 
the ulcer the common microbe bacteria 
and pus germ ; but if an ulcer takes on the 
** rodent type," we find in addition the 
oidium albicans, the streptococcus of 
diphtheria and phagedena is present in 

Intrauterine catarrh, with ulcera- largfC COlonlcS. 

tion of the os uteri, just assum- ^, t • i • • i • 

ing the rodent form ; numerous i hC CaUSCS WhlCh glVe riSe tO thlS 

points of beginning ulceration. ^^^.^ ^^ ulceration are a general break- 
ing down of vital power, coupled with great irritation and in- 
sanitary conditions, bad food, filth. 

Symptoms. — It is to be regarded as a perforating, eating ulcer, 
with a bloody exudation ; ulceration gradually and slowly ex- 
tending. As it eats away, burrows and perforates, complaint is 
made of heat, pain and discomfort; thin, watery discharge 
streaked with blood. The constitutional symptoms are those or 
great prostration ; headache, want of appetite, pallor, indigestion, 
constipation, great physical weakness ; pains in back, thighs, 
hips ; burning pain in uterus, and attacks of hemorrhage. On 
examination, an irregularly-shaped, eating ulcer, with ragged or 
indurated edges. There may be several ; they all look excavated. 
They may be dry, or glossy, but there is always blood dripping 
from their edges. When vital force is very low, they may eat 
away the neck and body of the uterus, and give rise to dreadful 
hemorrhage. It is often mistaken by the inexperienced for can- 
cer. It often destroys life, if not seen to and treated correctly 
before it eats into uterine vessels. 

In the treatment of rodent or phagedenic ulceration of the neck 
of the uterus, the patient should be removed from the insalu- 
brious locality in which she is placed ; her apartments thoroughly 
disinfected. She should be placed upon full doses of compound 
conium pill so as to relieve all pain, all sense of irritcvtion ; com- 
pound saxifraga and phytolacca, in alternation with wine of the 



BACTERICIDES. 



II 47 



aleteris farinosa and compound syrup partridge berry ; bowels to 
be freely opened. The vagina should be thoroughly washed out 
with a strong solution of castile soap in tepid water. Parts 
carefully examined, if the ulcer, or ulcers are small, either 
the ozonized jequirity powder or paste, would perhaps be suffi- 
cient to cause exfoliation ;. if the ulcer or ulcers are very ragged, 
uneven, a perfect mass of disease-eaten germs, then it might 
either be brushed over with C. P. lactic acid, or a ten-per-cent. 
solution of ozone paste or chloride of chromium ; following any 
of these three remedies a thorough vaginal douche of borogly- 
ceride, or simpler and easier still, pack the vagina with either 
boroglyceride or resorcin or thymol jelly. Any of these appli- 
cations will destroy the germs in the ulcer and stimulate the 
sound tissues. 

Bactericide injections thrice daily, consisting of either boro- 
glyceride or resorcin, or creolin, or hydronaphthol, or lime-water 
and tincture of iodine, or a solution of 
sulphide of lime. 

Ulceration of the internal cavity of the 
uterus is a frequent result of abortion. 
The ulceration follows a previous condi- 
tion ofvillosity; the villosity is destroyed 
and ulceration takes its place, or it may 
begin with ulceration. It is not common 
in the young, but in the old, the result of 
abortion. There are slight bleedings 
when ulceration extends into the cavity 
of the uterus. If seen early, treat it by 
introducing thallin bougies into the cav- 
ity of the uterus, with the same remedies 
internally as in other uterine ulcers. 

Syphilitic Ulcers are often met with on the os or neck of 
the uterus ; entire colonies or nests of the syphilitic germ are 
found lodged about the labia, on all sides, within the canal of 
the neck. 

Symptoms. — The copper- colored appearance of ulcers and 
mucous membrane ; thickening and induration ; the muco-puru- 
lent discharge is excessive from both uterus and vagina ; patches 
of abrasions, or ulcers, are to be seen on the labia of the uterus. 
Menstrual function is irregular ; most frequently menorrhagia. 
Besides, there will be syphilitic cachexia, loss of hair, enlarge- 
ment of post-cervical glands, copper-colored mucous membranes,. 
pain in the breast-bone and other bones at night, copper-colored 
eruption, nodes, mucous patches, etc. 

Same treatment as for rodent ulcer and syphilis. 




Ulceration of the internal walls. 
In this case the fundus of the 
uterus was converted into a 
tumor, somewhat separated 
from the general tissue. 



I 148 DISEASE GERMS. 

Sexual intercourse, excessive, loose 

Ulcer on the Vulva, or varied, has a most exhausting effect 

on the mucous membrane of the vulva 
and labia, so much so that when this condition is combined with 
feeble vital force, filth, great depravity, overcrowding and insani- 
tary states, a peculiar form of corroding or eating ulcer makes 
its appearance. 

The microbes of this form of ulceration are extremely 
diversified, and are all pathogenic of squalor, uncleanliness, 
phagedena. 

Symptoms. — It usually exhibits itself in the form of an intract- 
able ulceration of the labia, and extends over vulva and vagina ; 
surrounding structure usually becoming indurated. As ulcer 
heals in one direction, it extends to another ; process of repair 
accompanied by the formation of a firm, horn-like cicatrix, which 
has a tendency to cause a puckering, or contraction of the vaginal 
walls, or anal orifice. As a rule, patient does not experience 
much inconvenience from it for a longtime; not until the vaginal 
orifice, or neck of the bladder, becomes fissured by it; then the 
patient experiences great pain after micturition. For a long time^ 
it seems not to interfere much with sexual congress or men- 
struation. By-and-by general health becomes greatly impaired, 
appetite fails, the body wastes, there is diarrhea, night-sweats, a 
profuse discharge from the parts, very offensive, and a general 
breaking-down of the health. 

In such a case the most active treatment possible with our 
most powerful bactericides ; perfect rest must be enjoined ; secre- 
tions and excretions regulated ; the functions of the skin stimu- 
lated with baths ; appetite must be stimulated with tonics, and 
the very best of food given, and every possible means taken to 
improve the general health. 

At once, without delay, the patient should be placed upon 
alteratives, tonics and bactericides ; the latter to sterilize the 
blood. 

No caustic or irritating application should be made to the ulcer 
or ulcers. The vagina should be thoroughly washed out three 
times a day with either a saturated solution of boroglyceride, 
or creolin, or some other germicide ; these injections should be 
copious, two quarts or so. 

Lotions of either lime-water and tincture of iodine or peroxide 
of hydrogen, or ozonized sulphur water or aromatic sulphuric 
acid and quinine ; lotions are best if they can be kept moist ; if 
they cannot be thus maintained, ointments ; then boroglyceride, 
creolin, resorcin should be tried.' 

The building up of the general health and the surrounding the 
patient with every element calculated to vitalize. 



BACTERICIDES. U^q 

This term denotes an excess of urea in the 

Uraemia, blood. In healthy states of the body this sub- 
stance is present in the blood in very small quan- 
tities, but under any circumstances in which the renal functions 
are impaired, it accumulates in large quantities, especially in 
structural disease of both kidneys, or where the ureters are 
occluded. 

The symptoms of uraemic poisoning relate chiefly to the 
nervous system, consisting of neuralgia, delirium, blindness^ 
coma, convulsions, vomiting and diarrhea ; pallor and pufiiness 
of the face, due to anaemia and oedema. 

The symptoms are not due to the retention of urea alone, for 
the urine contain substances a thousand times more poisonous 
than this. 

In health all the poisonous substances formed during tissue- 
change are excreted chiefly in the urine ; but when the kidneys 
are diseased, or have been in any way rendered functionally inac- 
tive, the alkaloids may accumulate and give rise to those symp- 
toms of poisoning which are usually known by the name of 
uraemia. In cases of disease of the kidney where such a condi- 
tion has been threatening, an exclusively milk diet proves of the 
greatest service, and probably does so in a great measure by 
washing the poison out in the way I have just mentioned, 
although it is also likely that such a diet tends to limit their pro- 
duction. The objection may be raised that there is no very 
obvious relation to chemical constitution. This is quite true. It 
has been pointed out that most of the alkaloids obtained are 
either amines or diamines, or else more complicated compounds 
of nitrogen and carbon allied to uric acid, yet the chem.ical struc- 
ture of many of those formed in the body either in health or dis- 
ease has yet to be discovered. When we know their chemical 
nature we may be able, in a case of u'raemic poisoning, at once to 
administer an antagonistic remedy and save our patient, instead 
of standing, as at present, almost helplessly by. A knowledge 
of the relation of chemical constitution to physiological action is 
likely to guide us also in our investigations regarding the nature 
of the poisons in uraemia. One set of poisons is probably allied 
to uric acid, and may include guanidine, methylguanidine and 
other derivations of urea. 

In health the greatest parts of the products of albuminous 
waste are excreted by man in the form of urea ; uric acid occurs 
only to a small extent. But in various disturbances of nutrition 
we find that the quantity of uric acid is greatly increased, and 
that sometimes along with it oxalate of lime makes its appear- 
ance. We might, therefore, naturally look for compounds of 



ffi5o 



DISEASE GERMS. 



oxalic acid as among the substances likely to give rise to symp- 
toms of poisoning if retained in the body. 

Symptoms of Urcemia. — For my own part, I have sometimes 
been struck with the extremely rapid pulse in cases of uraemia, 
although there was no rise of temperature to account for it. This 
rapidity could hardly occur unless the vagus were either para- 
lyzed or inactive, and resembled so much the effect of atropine 
that I have been inclined sometimes to think that an atropine-like 
body was giving rise to the symptoms. 

Hypothesis as to the Nature of the Poison in Urcemia. — Now 
there is a substance allied in its chemical constitution to oxalic 
acid, namely, oxalethylene, which has the power of paralyzing 
the vagus and producing great rapidity of the pulse, just like 
atropine, which it also resembles in its action upon the pupil and 
brain, dilating the pupil and exciting the brain. When one atom 
of hydrogen in this body is replaced by chlorine so as to form 
chloro-oxal-ethyline, we obtain a body which no longer dilates 
the pupil, acts upon the brain like morphine, but still paralyzes 
the vagus. We thus have a group of symptoms w^hich closely 
correspond with those occurring in certain cases of uraemia. 
Should this substance, or any one nearly aUied to it, be found to 
be present in cases of uraemia, experiments could readily be in- 
stituted with a view of finding antagonistic compounds, and the 
end we desire might be attained. In some cases of uraemia the 
injection of pilocarpine has arrested the convulsions, and it ap- 
pears to me more likely to have produced these effects by antago- 
nizing the convulsing compound than simply by producing pro- 
fuse sweating, although such an action might possibly tend to 
help elimination. This appears to be more from the observation 
of Sanger that pilocarpine is only of use before the occurrence 
of coma, for this symptom probably indicates either the pres- 
ence of another alkaloid not antagonized by pilocarpine or an 
accumulation of poison to an extent which cannot be neu- 
tralized. 



The urine in health is a clear, amber-colored 
Urine, liquid of slightly acid reaction, saline taste, and of a pe- 
culiar aromatic odor. The amount voided in twenty- 
four hours ranges between thirty-five and sixty ounces. Its 
specific gravity varies from loio to 1030, the average being 
from 1015 to 1020. After exposure to the air, the acidity of 
the urine, which is chiefly due to the acid phosphates, continues 
for a few days ; then fermentation takes place, which changes its 
character according to the amount of uric acid or urate of soda 



BACTERICIDES j j r j 

that may be present. The alkaline change is due to the growth 
of a fungus, the micrococcus urea, which gives rise to the decom- 
position of the urea and the formation of the carbonate of ammo- 
nia and triple phosphates. 

The frequency of micturition depends on quantity, as in dia- 
betes and the waxy form of Bright's disease ; in all inflammatory 
states of the prostate, bladder, pyelitis and nephritic calculi, urine 
is frequently voided. 

In enlarged prostate, the cirrhotic, or contracting form of 
Bright's disease, the calls to micturate are frequent, and occur 
during the night. 

Normal CoJistitiients of the Urine. — These may be regarded as 
the products of the metamorphosis of the various tissues of the 
body ; the most important organic constituents are urea, uric acid, 
hippuric acid, phosphates and chlorides, oxalic acid, kreatinin, 
xanthin, and a number of basic substances, the product of oxida- 
tion and coloring matter; also, disease germs and their pto- 
maines. 

Urea. — This substance is the ashes of the tissues, the retro- 
grade metamorphosis of the fibrine of the blood and of muscles, 
of the nitrogenous body tissues and the excess of the nitrogenous 
elements of the food. It is due to the wear and tear of structure, 
taken up by the blood, filtered by the kidneys, and appears in the 
urine to the amount of from 500 to 600 grains daily. 

Urea or ashes of the tissues is increased by excessive muscular 
exercise, hard physical labor, excess of animal food, febrile, and 
inflammatory, and exhaustive diseases ; it is abnormally increased 
or diminished in anaemia, cholera, starvation, yellow atrophy 
of the liver, cirrhosis, amyloid and fatty degeneration. 

The liver is the chief organ concerned in the formation of urea. 
The tissues in their oxidation or disintegration constitute but a 
small portion. 

The chief source is the red corpuscles which are broken up in 
the liver, the coloring matter of which goes to form bile, and 
subsequently that of urea ; the rest of the protoplasm of the 
blood cells form urea. Derange the structure or disturb the 
function of the liver and you cause an increase or diminution in 
the urea. 

The urea excretion is affected by the administration of drugs. 
Phosphorus undoubtedly increases the elimination of urea, as do 
all diuretics ; whereas morphia, quinine, and iodide of potass 
diminish its quantity. 

The quantitative estimation of urea is of much importance. It 
may be carried out in either of two ways, either by a solution of 
the nitrate of mercury or by a solution of the carbonate of soda. 



II52 



DISEASE GERMS. 



U 



'^^ 






^ 



Uric acid, its origin the same as urea ; generally found in the 
urine combined with some base, such as Hmeorsoda. In health 
6 to 9 grains of uric acid are usually passed in the 24 hours ; 
this amount is somewhat variable, depending on the^kind, quality 
and quantity of food, a beef diet increases the amount, out-door 
exercise decreases it. It is increased in the many hepatic affec- 
tions, in leucocythaemia, in acute rheumatism, indigestion. 
Uric acid appears in the urine as a crystalline deposit. 
Small quantities of kreatinin, hippuric acid and xanthin are 
also found which represent oxidized products of tissue change. 
The strong acids which appear in the urine, during the stage 
of acid fermentation speedily decompose 
the urates and set the uric acid free. 

This is deposited in the form of yel- 
lowish red colored crystals which 
assume an infinite variety of forms^ 
(constituting what is known as red 
gravel). To the naked eye they re- 
semble grains of cayenne pepper. Mi- 
croscopically these crystals vary much 
in shape. They take the form of four- 
sided tables, or six-sided rhombs, or 
they may be lozenge-shaped, ovoid, or 
barrel-shaped, or still more elongated 
and arranged in a stellate fashion. In 
whatever form uric acid appears, the 
crystals are always more or less yellow; 
and as no other crystal which sponta- 
neously separates out from the urine is 
so tinted, there can be no difficulty in its recognition. 

Uric acid is readily separated from the urine by the addition 
of hydrochloric acid, which deposits it in a crystalline form. 

It can be readily detected by the microscope, but this is not 
always convenient. 

Uric acid may always be detected thus : a small quantity of 
the sediment of the suspected urine is dissolved in a porcelain 
dish with a few drops of nitric acid, and the solution so obtained 
is evaporated. To the reddish residue a few drops of dilute am- 
monia are added, when the beautiful reddish purple color develops 
itself; by dropping on it a few drops of caustic potassa it passes 
into bluish purple. 

It is more difficult to estimate the quantity. A quantity of 
urine is taken, pure hydrochloric acid added. Let it stand 48 
hours, then filter. Wash with a little cold water and weigh. 
Coloring and Extractive Materials. — The normal coloring of 




Uiicacid. The most common form, 
with disintegrated crystals and 
formation of rounded masses. 
X 250. 



BACIERICIDES. IIC3 

the urine is due to the presence of a pigment, a substance closely 
allied to the coloring matter of the bile, derived from the blood 
by the action of the spleen and liver. Another normal pigment 
of the urine is indican; when the quantity of indican in the urine 
is excessive, it indicates that albuminous matters are under-going 
rapid decomposition ; that bacteria are active. 

Kreatinin is a normal constituent of urine, and its presence in 
somewhat larger quantity than uric acid. Its presence is readily 
detected by adding to a small quantity of urine a few drops of a 
very dilute solution of nitro-prusside of sodium, when, on the 
further addition of dilute caustic soda, a beautiful ruby-red color 
develops itself, which soon passes into deep straw yellow. 

Ptomaines. — The excreta of microbes are most abundant when 
fever is high ; they appear as a white crystallizable substance, 
which give all the reactions of an animal alkaloid. 

Albumen. — When albumen appears in the urine, its common 
origin is the blood and the kidneys ; from the former when the 
microbe of diphtheria, scarlet fever, erysipela, variola are present 
in the lymph spaces ; lead-poisoning, epilepsy, goitre; in the 
latter to partial death of the kidneys, structural lesions, blood 
pressure; albuminous urine is generally of a low specific gravity. 

Before testing for albumen, the urine in question must be 
rendered clear by careful filtration, and neutral, by the addition 
of an alkali or acid. Of the many methods in use the boiling 
test is probably the best. 

Fill a test-tube one-third full, and heat in the flame of a spirit- 
lamp to the boiling point ; the albumen, if present, will separate 
as a white cloud, which on standing, collects at the bottom of the 
tube in fine flakes. If the urine contain much earthy phosphates, 
these are apt to separate when the tube is heated, and the cloud 
so formed may be mistaken for albumen. It is, however, dis- 
solved, on the addition of a few drops of acetic acid. 

The ferrocyanide test is very handy. To a test-tube nearly 
filled, add a few drops of acetic acid, then a small quantity of a 
solution of ferrocyanide of potassium. If albumen be present 
a white flocculent precipitate will separate out in the cold ; albu- 
men present in urine never fails to be indicated by this teste. 

Albumen in the urine is indicative of kidney disease, chronic 
interstitial nephritis, it is greatest in this form, much less in the 
cirrhotic and waxy forms. It is of great importance to distin- 
guish correctly whether it is persistent or liable to remissions ;. 
renal tube casts and epithelium are most abundant in chronic in- 
terstitial nephritis. 

Albuminuria occurs in cardiac disease, after an epileptic fit ; 
in goitre ; in lead-poisoning, and sometimes in pregnancy. 

n 



154 



DISEASE GERMS 




The albumen in the urine in certain ca^es may be deiived Irom 
the blood from the presence of disease germs in the kidneys. 

Urinary Sugar. — When the urine contains much glucose or 
grape sugar it is of a pale, yellow color, sweetish taste, and vast 
in quantity. Its specific gravity is nearl} 
always high, generally between 1030 to 
1065, an isolated case, one in a thousand, 
where it is as low as 10 10. When persis- 
tent, large in quantity, it indicates a grave 
pathological legion, diabetes mellitus. It is 
often met with temporarily in nervous 
shock, chronic alcoholism, eczema. 

In normal urine a minute quantity of 
grapie sugar is present, but it is so very 
small that none of the ordinary tests can 
Glucose fungus. ^^^^^^ -^ 3^^^^ j^ ^^ abnormal amount 

constitutes the pathological condition termed glycosuria. 

The qualitative tests for urine containing sugar depend upon 
the coloration caused by boiling with caustic potassa ; upon the 
power grape sugar possesses ot reducing hydrated oxide of cop- 
per ; and upon the evolution of carbonic ac'd gas, when fermen- 
tation is set up by the yeast plant. 

In all cases, if albumen be present, it must be got rid off by 
coagulation by heat and filtration, before any other test is 
applied. 

/. The Caustic Potash Test. — Mix one ounce of urine with 
the same quantity of caustic potassa, boil the mixed fluids in a 
test-tube over the flame of a spirit lamp. If sugar is present it 
will assume a dark brown color. 

2. ."sulphate of Copper Test. — Take a certain quantity of urine 
in a test-tube, add to it one-third of its volume of liquor potassa, 
and then a drop or two of a saturated solution of the sulphate of 
copper, the precipitate which falls will re-dissolve if sugar be 
present, and more of the copper solution must be added, until a 
small quantity of the hydrated oxide remains as a precipitate. 
On boiling this mixture, a yellow color will show itself if sugar 
be present, and will pass into a reddish yellow granular precipi- 
tate of the sub-oxide of copper. 

^. Fermentation Test. — Under the influence of yeast, grape- 
sugar breaks up into alcohol and carbonic acid, and this evolution 
of carbonic acid has been made the basis of a test for sugar. It 
is readily performed. Take two test of equal size, fill one with 
the suspected urine and the other with water, adding to each a 
s-'iall piece of yeast, cover them with saucers, and then invert 
l:i_'m. If sugar be present in the urine, carbonic acid gas will 



BACTERICIDES. H^^ 

collect at the upper part of that test-tube. A few bubbles of gas 
may come from the yeast itself, but the second test-tube contain- 
i iL^ water, will show these also, so that any mistake is hardly 
po-<ible. This test is not very sensitive, as it only shows sugar, 
when it is largely in excess of two grains to the ounce. 

4. Fi'lilings Test Solution for Sugar in Urine. — It is prepared 
in two solutions No. i. Dissolve 17.32 grams (267 grains) pure 
crystals copper sulphate; water 250 c. c. (6 fl. ozs ) No. 2. Dissolve 
86.5 grams (1328 grains) pure crystals Rochelle salts; sodium 
hydrate solution sp. gr. 1.12 250 c. c. (8 fl. ozs.) These two solu- 
tions are mixed in equal volun^e when used. This is the most 
delicate and reliable test for sugar in urine, being quantitative and 
qualitative. The copper in 100 c. c. (25 o) is precipitated as 
cuprous oxide by 0.5 grams (7^ grains) of glucose. 

How to Use It. — About 20 c. c. (5 5) of Fehling's solution are 
put in ci test-tube of four or five times this capacity, heat it slowly 
over spirit lamp to the boiling point, then gradually add the sus- 
pected urine slowly in quantities often to fifteen minims, let boil 
after each addition. If sugar is present the following changes in 
the color of fluid takes place : it first becomes slowly yellow, 
turns to red, the beautiful green of the normal fluid is rapidly 
disappearing, during the whole the red cuprous oxide is being 
formed and precipitated ; after standing half an hour when the 
heat is discontinued the precipitate falls to the bottom of the tube, 
and the fluid is nearly colorless if the reactions have been so com- 
plete as to have converted all the copper and all the sugar in the 
urine has been used up in the process. These reactions are de- 
veloped in fulness in proportion to the quantity of sugar in the 
urine. If the quantity is very considerable it is advisable to 
dilute the urine with an equal volume of water. It is best to test 
this urine for albumen, which, if present must be taken out 
by precipitation and filtration, then the clear urine is tested for 
sugar. It is always in order lo test Fehling's solution by heating 
to the boiling point ; if it remains clear and free from any precipi- 
tate it may be trusted. It is well to recollect the worst cases we 
have to treat are those in which the quantity of sugar continues 
considerable while the patient is on a pure nitrogenous diet ex- 
clusively. Those cases in which the quantity of sugar daily 
pas^eJ m the urine is decreased in proportion as amylaceous and 
saccharine food are withheld, and the effect of medicaments is 
satisfactory, are curable. Never lose sight of the vast import- 
ance muscular exercise, and plenty of it, is to such patients. 

Take a small quantity of that solution in a test-tube, heat it to 
boiling, and then add a few drops of the suspected urine. If 
sugar be present, reduction of tlie copper in Fehling's solution 



II56 



DISEASE GERMS. 



will at once take place, giving rise to a red precipitate. If the 
solution be always boiled previous to the addition of the urine, 
no error can occur as to the result. 

It is somewhat difficult to estimate the quantity of grape-sugar 
in a given amount of urine either by any method of analysis or 
even by the polarimeter. 

Bile. — Urine containing bile varies in color from a deep red- 
dish brown to a dark green, acid reaction, high specific gravity. 
The coloring matter of the bile, such as bilirubin, biliverbin, 
biliverdin are the portions which appear in the urine in disease. 
It is found in jaundice and all morbid states of the liver or 
gall-duct. 

Its presence is very easily detected when the urine, which con- 
tains the pigment bile, comes in contact with nitric acid in a play 
of colors. Place some of the pigmented urine in a conical glass, 
permit it to stand a little while to settle, then drop gently down 
the edge of the glass a little nitric acid, when a series of colored 
rings will form in the following order : Yellow, violet, blue, 
green. 

Bile acids are found in the urine in considerable quantity in 
hepatogenic icterus. 

In a small quantity of this urine dissolve a little sugar, then 
dip in it a strip of filter paper and permit it to dry. If now a 
drop of sulphuric acid be allowed to fall on the paper a purple 
ring will appear round it. 

Lactic acid is found in the urine in diabetes, yellow atrophy o{ 
the hver, trichinosis, osteomalacia. 

Fat. — Fat is occasionally met with in the urine, when present 
it gives that fluid a milky appearance; as it is generally associated 

with abumen it forms an 
emulsion, a sort of coagu- 
lation, and in a short time 
standing it rises to the top 
and disappears by the ad- 
^ Q I . ^<^MO dition of ether. Under the 

^ ^ Oo^ fs \[U^^Jj^y^ microscope minute globules 

^ O ^O ^H^^^^^^Ja^ of fat are seen, usually in- 
U o o o » ostoM^^^^I^^ terspersed with lymph and 

^ o '^ /'[^JN^^Tf^ blood corpuscles. 

Fat globules from Leacin and Tyrosin. Leilciu aild JyVOSin.—Tv^O 

chylous urine. ^, globules of leucin ; substances, found in the 

urine, often in large quanti- 
ties, due to the prolonged action of the pancreatic ferment upon 
the nitrogenous elements of the food. 

Leucin appears either in the form of white crystalline scales, 




BACTERICIDES. 



II57 



freely soluble in water, or as small round yellow bodies, looking 
like fat cells. 

Tyi'osin is in the form of white masses consisting of long shiny 
needles arranged in star-shaped groups. Leucin and tyrosin ap- 
pear in those diseases in which oxidation is very greatly impaired, 
such as acute yellow atrophy of the liver, typhoid fever, small-pox 
and in hepatic diseases generally. 

Urates. — The amorphous deposit of urates which is so fre- 
quently met with even in healthy urine, consists chiefly of urates 







"u^ 



'J"^A 



Urate of soda. A, amorphous gran- 
ules in clusters, resembling moss : 
B, granules in strings, sometimes 
mistaken for granular casts, x 250. 







Urate of ammonia. 



of soda, of potassa. magnesia, ammonia. To the naked eye the 
deposits of amorphous urates has a reddish brick dust color, due 
to pigmentation with uroerythrin. When the urine has been 
allowed to stand in a glass for some time, 
and deposits those urates, a peculiar bloom 
may be seen on the sides of the glass 
when it is bent over at an angle of 45 
degrees, which is a characteristic, and un- 
mistakable sign of the presence of urates. 
Microscopically this deposit appears amor- 
phous and finely granular. On warming 
the microscopic slide, the sediment be- 
comes dissolved, and it separates out again 
on cooling and the same reaction can be 
seen in a test tube. 

In health, a deposit of urates often oc- 
curs a'"ter profuse perspiration and violent 
exercise. It is abundant in all febrile and inflammatory affec- 
tions, in organic disea.se of the heart and liver. 

Oxalate of Calcium. — Calcium oxalate is often held in so- 
lution in the urine, but when it is precipitated it takes one of 




Oxalate of Calcium ; the oc- 
tahedra, most frequently 
present, are seen on the left. 
The comparatively rare 
form of dumb-bells is also 
bhown. X 230. 



158 



DISEASE GERMS. 



two forms, either a small, colorless, sharp-edged octahedra crys- 
tals, or dumb-bell shaped crystals. To the naked eye the deposit 
appears as a white, undulating, clearly defined layer, resting upon 
a grayer deposit beneath. 

Oxalic acid is much increased by the consumption of sugar 
and of such vegetables as contain it, as rhubarb. 

It is the last stage of the decomposition of effete tissue, the 
result of impeded metamorphosis. Oxaluria or oxalate of lime 
in the urine is accompanied with a well marked train of symp- 
toms. The affected individual is emaciated, very nervous, ex- 
tremely hypochondriacal and irritable — pain in the loins, irritability 
of bladder, muscular weakness. 

The crystals of oxalate of lime are found in ca^es of disturbed 
respiration, emphysema of the lungs, rachitis, epileptic convul- 
sions. 

Cystine. — A white crystalline body derived from the liver, is 
not often found in the urine, but when it is present, it presents 
itself in the form of hexagonal plates, which are of a neutral re- 
action and can be dissolved by caustic mineral alkalies. When 
this substance appears in the urine it is apt to give rise to cal- 
culus. The pathology ot cystinuria is very obscure. 

Mucus. — A small quantity of mucus is present in normal urine ; 

but in such affections as catarrh of the bladder, prostrate, urethra, 

it is greatly increased. It is of importance always to distinguish 

between mucus and pus in the urine. This is readily done by 

^ filtration, when, if pus be present, the fil- 

s& !L. ® m^ trate will give the reactions of albumen ; 

^ but if it contain mucus, it will give that 

"S* which is characteristic of mucin, that when 

% A ^^ acidulated with acetic acid a precipitate of 

^©# mucin separates out in the cold. 

@ Pzis corpjLScles when present in urine 

^B (J) give it the appearance of having a deposit 

C\^ ® & of white }'ellow flocculent substance, 

/s^ easily recognizable to the naked eye ; mi- 

® croscopically, as a rule, present their normal 

^, pus corpuscles as ordina- appearancc ; but if the urine be stronorly 

rily seen in unne ; B, the r^r ' \ 

same, treated with acetic alkalme, they tcnd to run together and 
''^°°' form a homogeneous mass. To ascertain 

whether it is pus or not, it is only necessary to add either a small 
piece of caustic potass or liquor potass, stir with a glass rod ; if 
the sediment be formed of pus it will become tenacious, glassy, 
and semi-solid. 

Another test for pus is, bring a few drops of peroxide of hy- 
drogen into contact with the pus, an effervescence will take place. 



BACTERICIDES U^q 

This action continues tiU all the pus is destroyed so that it cannot 
be recognized microscopically. 

The presence of pus in the urine is a sure sign that there exists 
either an acute or chronic inflamniation at some part of the uri- 
nary tract, as a stone in kidney with renal abscess, pyelitis, c\-stitis, 
or urethritis. 

Earthy Phosphates. — The earthy pho-phates are the most com- 
mon sediment met with in the urine, when the urine is alkaline 
they are never absent ; they present themselves as the ammonio- 
magnesium, or triple phosphates, or as the phosphate of lime. 
During the stage of alkaline fermentation the ammonia produced 
combines with the phosphate of magnesium present, and the result 
is that the crystals of the triple phosphates, being insoluble in an 
alkaline fluid, are thrown down in large quantities, as are also the 
crystals of the phosphate of lime ; the separation of the latter de- 
pending upon the presence of the fixed alkah'es as the carbonate 
of soda. The crystals of the triple phosphate vary according as 
they are the result of rapid or slow crystallizatio.i ; in the former 
they assume a feathery form, looking like two 
crystals crossing each other at acute angles ; in 
the latter they appear as triangular prisms witii 
be\-elled edges. 

The phosphate of lime forms a whitis', 
flocculent deposit, which is not dissolved b\ 
heat, but passes into solution by the addition of 
a drop or two of nitric or acetic acid. Under yf'^^^' 

the microscope this deposit is seen to consist of pho-phatc of lime. 
fine crranules, usuallv arranged in irregular 
groups. In microscopical appearance they closely resemble 
amorphous urates, but the reaction of the urine will at once in- 
dicate their nature. 

A sediment of the earthy phosphates does not of necessity 
show that there is an abnormal amount in the urine, but it shows 
an alkaline state of the urine, and points out in most emphatic 
tones a too rapid metamorphosis of brain and bone, and the pos- 
sible danger of the formation of phosphatic calculi. 

Chlorides. — The chlorine which is contained in urine exists in 
combination with potassium, sodium, ammonium, magnesium or 
calcium. 

The presence of these chlorides may be detected by adding to 
a small quantity of urine in a test tube, a few drops of nitric acid, 
and thtn a small quantity of a solution of nitrate of silver. 

A white flocculent precipitate at once falls, containing mainly 
chloride of silver, but also containing combinations of silve-, 
with uric acid, creatinin, xanthin, and urinary pigments. 




I i6o 



DISEASE GERMS. 



The average quantity of chlorine excreted in the urine in 24 
hours is about 100 grains. It is increased by the consumption 
of salt and copious drinking of water. 

The diseases in which we have the largest diminution of chlor- 
ides are all fevers and inflammations, except those caused by 
malaria. 

Sulphates. — The sulphates which are found in the urine are 
derived from the breaking up of albumen, either that of the tis- 
sues, or that which is contained in the food. Sulphuric acid ex- 
ists in the urine in two forms ; either in combination with the 
alkalies, or in the form of aromatic ether-sulphuric acid. Both 
of these aromatic bodies, when heated with hydrochloric acid, 
break up into phenol or indigo and sulphuric acid. Acetic acid 
does not cause this decomposition. 

To detect sulphates, acidulate a portion of urine strongly with 
acetic acid, then add the chloride of barium in solution, then 
there will be immediately precipitated the sulphate of barium, 
representing the sulphuric acid, which was combined with the 
alkalies. 

The amount of sulphuric acid passed daily is about 30 grains. 
It is increased and diminished according as more or less albumen 
is broken up, and therefore corresponds with the quantity of 
urea and uric acid, both in health and disease. 

Phosphates. — In nora^al acid urine phosphoric acid is met with 
in the form of phosphates of the alkalies, sodium and potassium, 
and calcium and magnesium. It may appear in the form of 
glycerin-phosphoric acid and lecethin. 
About 50 grains of this acid are elimi- 
nated in the urine every 24 hours. It is 
enormously increased in all nervous dis- 
eases and also in morbid states of bones ; 
much diminished in all fevers and inflam- 
mations, and excessively so in pneumonia 
and interstitial nephritis. 

When the urine loses its carbonic acid 
by being heated, the earthy phosphates 
separate out as a white flocculent precipi- 
tate, which becomes re-dissolved on the 
addition of acid. The addition of am- 
monia to urine causes an amorphous pre- 
cipitate of the phosphate of lime, while the 
phosphate of magnesium unites wath the 
ammonia-magnesium-phosphate (triple phosphate), which appears 
in a crystallizable form. 

Phosphates in the urine represent the precise amount of tissue 




Triple phosphate. 



BACTERICIDES. I £6i 

change or waste of braia and bone ; in other words, they are but 
the ashes of the nervous and osseous system. In chronic bone 
and nervous diseases the phosphates are increased excessively. 

The food consumed has a marked effect, an animal diet giving 
rise to more excretion than vegetable. In constipation the earthy 
phosphates are much increased. 

To estimate the quantity of phosphates, take a given quantity 
of boiled urine, say four ounces, then add a solution of nitrate of 
silver, which will precipitate the phosphates. Then either per- 
colate through blotting paper, or evaporate the watery portion ; 
the remaining powder, well dried, and weighed, will give the 
phosphates. 

Epithelium. — The epithelial cells in the urine are best seen 
when stained with eosin or fuchsin. They may be derived from 
any portion of the urinary tract. The 
epithelium of the urinary tubules consist of 
round or polygonal cells, each having a 
large and sharply defined nucleus. Those 
of the pelvis of the kidney are conical, with 
one, or sometimes two tail-like processes. 
The large irregular pavement epithelial 
cells, which are often seen in the urine, 
come from the bladder or vagina. 

Peptone. — The presence of peptone in the 
urine is in yellow atrophy of the liver, en-, 
teric fever, pheumonia, systemic syphilis, 
phosphorus poisoning, cancer of the stom- 
mach, and in abscess, phthisis. 

The appearance of peptone in the urine 
is to be explained on the supposition that 
when it passes into the blood it does not 
undergo the usual change, and so reaching 
the kidneys as peptone, it is excreted as Epithelium from urinary 

h-^ ^ deposits. 

To detect peptone in albuminous urine, the albumen must be 
completely separated by means of acetic acid, boiling and filtra- 
tion, and then by the addition of hydrated oxide of lead, the lead 
being subsequently removed by sulphuretted hydrogen. This 
process must be repeated until no trace of albumen can be 
detected by the ferrocyanide test. The peptone in the filtrate is 
then precipitated by means of a solution of tannin, the precipi- 
tate collected and washed, the tannin removed by means of the 
hydrate of baryta, and the baryta by means of dilute sulphuric 
acid. 




ii6. 



DISEASE GERMS. 



Renal Tithe Casts. — Before examining the urine for tube casts, 
a specimen should be allowed to stand in a conical glass foi- 
twenty-four hours, at the end of which time, a few drops of ihc 
sediment may be raised by means of a pipette, and examined 
microscopically. Staining with eosin will make the tube ca>:s 
more distinct. 

Renal tube casts are almost always associated with albumi- 
nuria, or Bright's disease, although they often appear when no 
albumen can be detected in the urine. They are, as their name 
implies, casts of the renal tubules, in the majority of cases of the 
convoluted tubules of the cortex. The 
chief forms of tube casts are the follow- 

1 . Epithelial Casts. — In these the fibrin- 
ous cylinder has become covered over 
with epithelial cells, which have been de- 
tached or exfoliated from the lining mem- 
brane of the tubule. These cells ma}- b^,- 
more or less cloudy and swollen. Such 
tube casts are peculiar to Bright's disease. 

2. Pits Casts. — Casts containing in them 
pus corpuscles, are diagnostic of glomerulo-nephritis. 

3. Fatty Casts. — Very frequently in fatty degeneration of the 
kidneys, do we find oil globules studded in the casts. 





^^ 




Fatty c.ists. \ 25c. 



Grai.ular casts. y4, large granular 
casts; ^, small finely granular casf;. 



4. Granular Casts. — Dark opaque granular casts are also the 
result of epithelial degeneration in the renal tubules. 

5. Blood Ozj/j.— Many consist wholly or partially of blood; 
the corpuscles being closely adheient to one another, or fibrinous 
casts may be seen containing one or two blood corpuscles im- 
bedded in them; such casts point to capillary rupture, as in acute 
nepritis. 

6. Hyaline Casts, are structureless, transparent cylinders, 
having a tendency to fracture transversely, and are derived from 



BACTERICIDES. 



I 16^ 



the fibrinous exudation which has passed through the degene- 
rated walls of the renal vessels and coagulated in the tubules ot 





Blood cabts. A, collecting 
tube blood casts ; j9, mu- 
cous casts. 



Hyaline casts. ^,delicat<: 
hyaline casts; B, ccvkt 
so-called waxy cast<. 



»^°-?S 



O O 



the kidneys. Small hyaline casts are present in the incipient 
degenerative stage of Bright's disease, whereas, the larger ca^^ts 
are to be seen in the chronic form. 

Occasionally hyaline casts may be found, which exhibit the 
amyloid reaction, becoming reddish brown on the addition of 
iodine, and dirty violet on the further addition of sulphuric acid ; 
and giving a beautiful violet, with methyl green. Waxy and 
amyloid casts are more strongly refractive than the ordinary 
hyaline varitty, and being less flexible, they ex- 
hibit deep fissures where they have been torn 
asunder in passing through the straight tubules. 

Blood. — Blood may be found in the urine as 
such (haematuria) or blood corpuscles, or blood 
pigment may be present (haemoglobinuria), and 
these two conditions are readily distinguished 
by the fact that in the former case blood cor- 
puscles are found on microscopical examination, 
while in the latter they are absent. A very 
small quantity of blood in the urine gives it a 
peculiar smoky appearance. When blood is 
present in a larger quantity the urine becomes 
bright red or dark brown. Small quantities of blood are best 
detected by the microscope, but when no corpuscles or crystals 
ofhsematin are present, recourse should be had to the spec- 
troscope. 

In cases of haematuria it is important to ascertain from A\hat 
point in the urinary tract the blood comes, and this is not usually 
difficult. The hemorrhage may come : 

I. From the urethra. — The blood is mixed with the first por- 
tion of the urine voided — often being expelled as a long clot, and 
it continues to flow in the intervals of micturition. 



o o < 
00 o 



Blood. y4,S\voll-:n red 
corpuscles seen in 
urine of low specific 
gravity; B. Crena- 
ted corpuscles from 
dense urine, x -z-o. 



I 1 64 DISEASE GERMS. 

2. From the neck of the bladder, or prostatic portion of the 
urethra. In this case, the blood usually appears at the very end 
of micturition, when the sphincter vesicae begins to contract. 

3. From the bladder. — The blood is usually coagulated, and is 
passed in clots as large as the calibre of the urethra will allow to 
escape. 

4. From the ureters. — In this case, the blood often appears in 
the form of long worm-like clots, which are casts of the ureters. 

5. From the kidneys. — When the blood comes from the kid- 
neys, it is generally equally diffused through the urine, very 
rarely in large quantities ; when the urinary sediment is exam- 
ined, there are found tube casts, usually containing blood-corpus- 
cles. 

Hemoglobinuria appears in the urine in such diseases as pur- 
pura, scurvy, pyaemia, typhus, small-pox, etc. Results from a 
breaking down of the red corpuscles in the bloodstream, and the 
consequent liberation of the hemoglobin they contain, when it 
escapes into the urine. In malarial germ-laden blood it is often 
periodic, its appearance ushered in with a chill. 

Micro-organisms. — Living matter, degraded bioplasm, disease 
germs, or microbes, lower class of organism are found in the 
urine; passed in the urine as it leaves the body. In all diseases 
due to the presence of a micro-organism, as measles, scarlatina, 
variola, cancer, tuberculosis, syphilis, typhoid and other fevers, 
etc., the urine has a peculiar condition, termed bacilluria, in 
which it is opalescent when passed, from the enormous number 
of bacilli present. The reaction is acid, and when the urine has 
stood for some time, the microbes sink to the bottom of the 
glass, leaving the supernatant fluid clear. 

Very rarely do we find the embryonic form of parasites which 
infest the blood present in tiie urine. 

Fully-developed hydatids and echino- 
coccus, or only portions of these, may 
appear in the urine, having been devel- 
oped at some portion of the genito- 
urinary tract. The microbe of malaria, 
the sarcinae and yeast plant of gastric 
catarrh, the former in the ha^maturia of 
malaria, the latter in fungous sugar 
urine. 

Spermatozoa are occasionally found 

in urine. They preserve their normal 

^^ appearance for a long time. If the urine 

Spermatozoa. , ^ 1 1 1 • ,1 1 

be very alkalme, they may even be seen 
in active motion, but those movements are soon lost. Urine 
which contains spermatozoa becomes alkaline very rapidly. 




BACTERICIDES. 



165 



Urticaria may be defined as an acute non- 
Urticaria, contagious affection of the skin, characterized 

(NettlcrasJi}) by the development of wheals, and accompanied 
by sensations of stinging, itching and burning, 
like those produced by the stinging of a nettle. 

In the wheals 'of the eruption can be detected a bacterium, re- 
markable for its easy culture in acidulated beef-tea ; so far it has 
not been proved to be pathogenic. 

Nettlerash is remarkable for its variable and fugitive character, 
and for the great variety of circumstances and conditions under 
which it is developed. In all cases, however, the presence of 
wheals or some equivalent eruption is pathognomonic of the 
disease. The size, form and general appearance of the wheals 
vary greatly ; sometimes they are no larger than a split pea, 
while at other times they may occupy a considerable extent of 
surface and cause much swelling of the skin. In typical ex- 
amples they are round, raised and circumscribed spots, with a 
white centre and a reddish border, closely resembling the erup- 
tion produced by a nettle sting. In other cases they may take 
the form of streaks, ovals, or irregularly shaped patches ; some- 
times the only eruption consists of a diffuse erythematous-looking 
bright red blush ; but whatever be its form, it is very evanescent 
and liable to appear and disappear almost suddenly, leaving no 
trace behind. In all cases the subjective phenomena are nearly 
the same, and consist in excessive itching, tingling, stinging, and 
burning sensations ; sometimes the itching preponderates ; at 
other times perhaps the stinging or burning sensations are the 
most marked, for like the eruption itself, they are subject to 
constant changes. The rash often appears with a sudden burst 
all over the body, while at other times it is developed more slow- 
ly and appears successively on different parts. The subjective 
sensations invariably cause the sufferer to scratch and rub the 
skin ; this greatly aggravates the symptoms, and brings out 
fresh wheals wherever the finger-nails are applied, and in severe 
cases small excoriations and little spots of coagulated blood may 
be seen scattered about the skin as the result of scratching. The 
eruption is roughly symmetrical and may appear on any part of 
the body, but is most common on the trunk, face and upper ex- 
tremity. An ordinary attack of urticaria may last from a few 
hours to several days, but always with partial remissions and ex- 
acerbations ; it is usually associated with very slight febrile dis- 
turbance. It must not be forgotten that the mucous membrane 
sometimes participates in the changes which occur in the skin ; 
this is especially the case about the fauces and throat, which 
become suddenly swollen, so as even to threaten suffocation. 



I 1 66 DISEASE GERMS. 

The circumstances under which urticaria is most Hkely to oc- 
cur require a brief notice, as having some bearing on diagnosis, 
(r) It is extremely apt to complicate other irritable affections of 
the skin, such as scabies, phthiriasis, prurigo, and eczema; this 
is especially the case in children, who are more liable than 
adults to this affection ; the production of nettlerash under these 
circumstances is due to a reflex nervous action set up by scratch- 
ing. (2) Urticaria produced by the irritation of some part of 
the mucous tract is not uncommon, and belongs also to the group 
of reflex nervous actions. We often meet with examples of this 
kind dependent on uterine irritation from pregnancy and other 
causes ; also in children who suffer from worms. (3) The bites 
and stings of poisonous insects and the hairs of stinging plants 
will produce in some people pretty severe local attacks of urti- 
caria, so that the face or arms become much swollen and very 
painful. (4) Certain kinds of food are apt to produce nettlerash ; 
amongst these may be specially mentioned shell fish, mushrooms 
and many kinds of fruit ; but in these cases much depends on 
the idiosyncrasy of the individual. (5) There is a nervous form 
which occurs in individuals whose nervous systems are utterly 
broken down. (6) Certain drugs give rise to it as copaiba, cap- 
sicuni, turpentine, cubebs. 

In its diagnosis great care must be exercised so as to assign 
it its proper type — a great variety of forms, as urticaria papulosa, 
lichen urticatus, purpura urticans, urticaria vesiculosus. 

Uricaria may take the form of simple, roundish, red patches, 
or it may be white, or a buff copper color. 

Urticuria is undoubtedly associated with a weak digestion and 
mal-assimilation of food ; in its treatment therefore, our attention 
should be specially directed to a suitable diet. As a rule, fruit, 
vegetables, pastry and sugar should be avoided, together with 
any other food that seems to produce indigestion ; the sufferer 
should, in fact, adopt the simplest form of a plain and nutritious 
diet, such as milk, meat (once cooked), toast or bread, light pud- 
dings and cocoa. Wine, beer, coffee and most other stimulants 
should be avoided, but in some cases a little weak brand}' and 
water may be required, and is the form of stimulant which is 
generally the most suitable. No rules as to diet can be laid 
down which are applicable to all cases ; it is only possible to in- 
dicate the general plan of dietetic treatment ; the idiosyncrasy 
of the individual must, of course, be studied. F'or example, with 
some people milk always disagrees, and it would be the height 
of folly under these circumstances to insist on a milk diet with a 
view to improve a weak digestion. The conditions of the teeth 
and the proper mastication of food, regular and suitable exercise 



BACrii:RlClDES. ,i5 



and a sufficient amount of rest, are all points that demand atten- 
tion. With regard to medicines, those are most useful that pro- 
mote the processes of digestion, correct an excessive secretion of 
acid, and prevent an unhealthy decomposition of the food. By 
far the most generally useful is a mixture containing bismuth, 
carbonate of magnesia, bicarbonate of soda, and small doses of 
nux vomica taken before each meal. Sometimes small doses of 
Fowler's solution with alkalies do great good, chiefly by im- 
proving the powers of digestion. Nux vomica and carbolic acid 
pills are occasionally useful. 

A large proportion of the cases of urticaria are distinctly of 
neurotic origin, indicated by other disturbances of the nervous 
system. This especially applies to that form which recurs at a 
fixed hour in the day, and which sometimes replaces an attack 
of neuralgia. Quinine and tonics are both useful in dealing with 
urticaria of this kind, but thorough change of air is of all re- 
medies the one which is most certainly beneficial. The malady 
is, however, often very obstinate. 

Acute urticaria of the ordinary kind is generally produced by 
poisoning from shell-fish, fungi, or some other poisonous food. 
Under these circumstances it is often associated with vomiting 
and diarrhea, which relieve the most serious symptoms. The 
best treatment in these cases is free purging and a simple emetic, 
if the latter can be administered soon enough to remove any of 
the offending matter from the stomach ; this treatment is particu- 
larly applicable to children, who usually bear emetics well ; fol- 
lowed with resorcin, or naphthaline, or with 24-grain doses of 
salicylate of sodium, every two hours. 

Acute febrile urticaria is a rare affection, and occurs without 
any assignable cause except perhaps some severe shock to the 
nerv^ous system ; it should be treated by rest in bed, a light un- 
stimulating diet, mild saline purgatives, followed by tonics, espe- 
cially quinine. As the suffering is very considerable, soothing 
external treatment must be adopted ; warm alkaline or bran 
baths, and alkaline and sedative lotions are the most useful. 
Ver)' severe symptoms sometimes occur in consequence of the 
sudden swelling of the mucous membrane of the throat ; when 
thi-s happens, a sharp quickly acting purgative is always indi- 
cated. 

Lichen urticatus, which is a form of urticaria almost confined 
to children, is a most troublesome affection to deal with. In 
many cases it does not in any way yield to treatment ; the af- 
fection, however, usually dies out in a few years. The most 
generally useful medicine, I find, is carbonate of magnesia and 
soda with a little bromide of potassium ; the bowels should be 



I 1 68 DISEASE GERMS. 

kept open and the diet carefully regulated ; soothing lotions 
should be applied to the skin, and amongst the many that have 
been tried, one containing bicarbonate of soda and hydrocyanic 
acid dilute is excellent. 

Among the myriad of remedies for those troublesome af- 
fections, we have no other which affords such complete and in- 
stantaneous relief as a solution of menthol. Not only is the 
itching relieved for a time, but a cure seems to be effected. In 
pruritus and in eczema, moistening the parts with menthol solu- 
tion causes an immediate cessation of the pain. The solution 
should contain from two to ten grains of menthol to the ounce 
of water. 



Vaginal alimentation has been thoroughly 
Vaginal tested, and the absorbing powers of that canal 

Medication, have been proven to equal that of the rectum. 
Suppositories containing various animal and 
vegetable foods have been used, capsules containing peptonized 
foods have been introduced into the vagina at regular intervals, 
and it is asserted by the experimenters that the results were bet- 
ter than when the same foods were introduced into the rectum. 

Moreover, the vagina has many advantages over the rectum. 
The necessity of an alvine evacuation every day, a tight sphincter 
ani, the presence of hemorrhoids, an irritable rectum, render the 
vagina less objectionable as a receptacle for food or medicine 
than the rectum. 

The absorbents of the vagina are much nearer the uterus, 
ovaries, and other tissues connected with the genital apparatus 
than the stomach. Physiologically, all medicinal substances 
ought to act more promptly on the pelvic organs when placed 
in the vagina. 

In my gynecological practice for nearly twenty-five years, I 
have practiced applying to the uterus and vagina the remedy 
indicated by the symptoms and condition of the organs affected. 
Whenever I could induce the patient to allow the proper appli- 
cation of such remedies, or apply them herself, I have found the 
curative process to proceed much more rapidly then when medi- 
cines were given by the stomach. Some medicines when applied 
in the vagina to the os and cervix, will act as quickly as when 
given hypodermically. 

To those not accustomed to observe the action of medicines 
applied per vagina, I will say that I have repeatedly observed the 
general temperature to fall 2° in as many hours after the appli- 
cation to the OS uteri of a tampon wet with aconite 2x dil. I 



BACTERICIDES. 



I 169 



have seen severe uterine pain relieved quickly by the local use of 
belladonna 3X dil., and uterine spasm by the use of cannabis 
indica, ergotin, hamamelis and *sabina. Cinnamonum will ar- 
rest chronic hemorrhage as soon or sooner when topically applied. 
I have arrested the violent vomiting of pregnancy with tampons 
moistened \vith ipecac, cocaine, bromide of soda and ozonized iodine, 
when they had failed otherwise. Every gynecologist has observed 
when applying iodine, carbolic acid, iodoform, argentum nitrate 
and mercurial agents to the os and cervix, that the woman has 
complained or observed the taste of these agents immediately. 
I have known the mouth and tongue to become dry and the 
pupils dilate in one minute after the application of a too strong 
lotion of belladonna or atropia to the cervix. 

Innumerable instances could be mentioned proving the rapid 
absorption of medicinal agents into the general system, when 
placed in the vagina. By this method we can sooner get the 
tonic and haematic effects of iron, manganese, aurum, argentum, 
hydrastin, cinchona and quinine as well as cod liver oil, cocoa 
and other nutrients. 



This consists in dilatation and a convoluted state 
Varix. of the veins, due in most instances to an obstruction 
of the current of blood towards the heart. It occurs 
very often in the lower part of the rectum, where it constitutes 
haemorrhoids ; and in the affliction known as varicocele, the veins 
of the testicle are thus affected. The most frequent seats of 
varix, however, are the lower extremities, a condition being there 
established which is commonly termed that of " varicose veins." 
In a well-marked case of " varicose veins " the inner surface of 
of the lower limb, from foot to groin, is studded with a number 
of soft, bluish swellings, varying in size and shape, and which are 
formed by a tortuous and dilated condition of the large saphena 
vein, which extends along the Avhole length of the limb. These 
swellings become more prominent when the patient stands up, 
or after constriction of the knee or thigh. The skin covering the 
tumors is generally thin and distended. This condition gives 
rise to stiffness and aching pain in the affected limbs, and even 
slight exercise is soon followed by a sense of fatigue. The skin 
about the ankles is puffy and is marked by purple patches of 
small veins, arranged in an arborescent form, etc. The feet are 
generally cold, and the toes of a- bluish color. The skin of the 
leg is generally dry and itches very much ; it is very often red 
and inflamed, and the seat of an eczematous eruption. In old 
people, and in cases where the varicose condition is of long stand- 

74 



1^0 DISEASE GERMS. 



ing, large ulcers may form on the lower third of the 
tilting the so-called varicose ulcers. An occasional serious result 
of varix is thinning and giving way of the skin over a distended 
vein and hemorrhage, which, so long as the patient remains in 
the erect position or allows the leg to hang down, continues, 
and may speedily become fatal, but which may be readily arrested 
by placing the patient on his back, elevating the limb, and ap- 
plying slight pressure with a pad of lint and a bandage over the 
bleeding point. 

The predisposing causes of varix are an inherited tendency and 
debility, due to old age, over-work, or long illness. It is believed 
by some that the distension of the veins is occasionally preceded 
by a gouty condition of the blood. The chief exciting cause is 
obstruction to the venous circulation applied either directly to 
the lower limb, as in the case of w^earing tight garters, or indi- 
rectly, as in disease of the heart, congestion of the liver, or con- 
stipation, with overloading and distension of the large intestine. 
Varix may be caused by the pressure upon the veins of the pelvis 
of tumors, or of the pregnant uterus. Pursuits necessitating much 
standing or walking very often give rise to the affection. It has 
been stated that cooks and soldiers are the people most especially 
prone to the formation of varicose veins. 

In all cases of varicose veins, an effort should be made to 
strengthen the whole body ; tonics, best of diet, rest. The patient 
should avoid as far as possible the standing posture. 

When the veins of the limbs are affected, they should be bathed 
every night, well rubbed and then the ozonized extract of witch 
hazel rubbed well in and permitted to dry. 

In the morning the same proceeding is gone through, and 
before the affected individual is permitted to get up, either the 
limb should be bandaged from the toe to the groin, or else an 
elastic stocking should be applied. If this does not cure it will 
at least prevent such complications, as eczema, ulceration. 

The essential elements of all sound treatment are to strengthen 
the various tissues of the body by every possible means ; the 
most generous diet, massage, electricity, change. 

The internal as well as the local exhibition of hamamelis is 
of great utility. 

Indeed the witch hazel in alternation with cinchona and 
avena sativa form about all the reliable remedies for varix, and 
they should be perseveringly given. 

Many operations have been recommended for the purpose of 
producing permanent obliteration ot the distended v^eins. Of 
these none of them can be recommended as safe or reliable. 
Neither ligation nor sutures are of any real permanent benefit. 



BACTERICIDES. 



I 171 




External appearance of the 
parts in vai icocele. 



A condition of \'arico.sity of the veins of 
Varicocele, the spermatic cord, usually of congenital 
origin, resulting in or associated with deficient 
development, or functional imperfection of the corresponding 
testes in the majority of cases. The varicose condition is al- 
ways well marked, and is altogether,, from that temporar)^ ful- 
ness which may from to time occur in the spermatic veins 
of any healthy individual from intro-abdomi- 
nal pressure. 

In the large majorit}^ of cases the affec- 
tion is only on the right side ; in a certain- 
number of cases both sides are affected. 
When limited to the left side, the disease 
may be the only evidence of varicosity in 
the body, when it occurs on both sides, 
there is usually more or less varicosity of 
the veins of both lower extremities. 

The causes then of varico^cele ma}' be inherent weakness of 
organization, direct or from maternal impressions during intra- 
uterine life, or masturbation pr-or to and subsequent to puber- 
ty, or for indiscretion of the 
newly married, or men ad- 
vanced in years who push 
their failing powers too far. 

The sexual appetite — the 
faculty to perpetuate the 
species is impaired by work, 
by suffering, confinement, 
sedentar}' habits, worry and 
care — anything that tends 
to wipe out the typical 
fissures of thought — as alco- 
hol, tobacco, opium and chlo- 
ral ; any element of partial 
death will give us varicocele, 
with undeveloped or wasted 
or mis-shapen parts, as twist- 
ing or cur\ing, with a per- 
fect avalanche of nervous symptoms. 

Varicocele, a dilated, tortuous, relaxed, knotty, hard condition 
of the veins of the cord, feeling like a bag of worms, dilate on 
couf^hing, diminishes or disappears when the afflicted individual 
lies down, gives rise to burning, aching in and along the cord 
and testicle, great dragging in the back with partial or total im- 
potency, great nerve prostration. 




Natural testicle. 



Section of healthy- 
testicle. 



72 



DISEASE GERMS. 




The habit of masturbation is very damaging, of most dis- 
astrous effect upon mind and body, producing a mental and 
physical wreck, must be discarded before any treatment can be 
effective or a debilitated organ restored to its integrity. 

Varicocele invariably gives rise to seminal weakness, nervous 
exhaustion, shattered mind and body, wasting of testes, and 
latent spermatorrhoea, as weeping, draining of life (without erection 
or pleasure) in the urine. This very loss, this abnormal waste 
causes the organs to waste still further, until perfect atrophy qn- 
sues. One testicle, generally the left, at first becomes soft and 

flabby, and both become 
similarly affected. A tes- 
ticular waste or atrophy 
soon becomes identical 
with castration, but more 
disastrous to th^^ mind. 
The reflex state of dwarf- 
age of the genital or- 
gans gives rise to greater 
despondency, deeper de- 
spair, more profound 
gloom and mental dis- 
order. 

In the cure of varico- 
cele, the irritable condi- 
tion of the seminal vesi- 
cles, and seminal losses, 
must be got rid of, sexual 
vigor restored, and a 
speedy positive cure es- 
tablished. There must 
be a general appreciation 
of the true physiology of 
the reproductive organs. 
The entire profession 
keenly appreciate the 
tincture of the green 
root of gelsemium and the ozonized extract of black wil- 
low in the cure of varicocele — the former a genital sedative of 
the highest order; the latter, one of the most profound sedatives 
and astringents to the spermatic ducts and veins of the cord, it 
contracts, soothes. For varix within the range 
urinary organs the black willow operates w^ell. 

All members of the profession are agreed on the utility of 
well-regulated secretions, local baths, local application of witch- 




Varicocele, the result of mas- 
turbation after puberty. 



Varicocele, the result 
of masturbation be- 
fore puberty. 



of the genito- 



tJACTERICIDES. 



II73 



hazel, and mechanical support with a suspensory bandage, bath- 
ing with the ozonized extract of witch-hazel, and a general al- 
terative and tonic course of remedies. 

No remedy ever presented has been so favorably received by 
all members of the profession for the cure of all weaknesses of 
the generative organs as the saw palmetto — the sales of this 
drug have been immense, and the most satisfactory, unprecedent- 
ed success has attended its exhibition. It has been thoroughly 
tested and extensively used, and as an exciter of glandular 
p^rowth found to be unexcelled. 

Nearly all cases of varicocele are associated with seminal weak- 
ness, emissions or leakages, due to irritation of the prostatic por- 
tion of the urethra and an inflamed or relaxed state of the 
ejaculatory ducts ; these must be checked, blotted out by use of 
the cocaine suppository or a urethral bougie. Physiological 
rest should be obtained, so as to allow the parts to regain their 
tone and normal strength, and all unnatural losses of leakages 
arrested before a cure can be effected. 

As soon as this is accomplished, the patient, dilapidated and a 
wreck, should be placed upon those great brain essences or 
fertilizers kephaline and phosphated tincture of oats ; then the 
dilated and sagging veins become emptied, the testes begin to 
grow larger, the parts regain their tone, strength, contractility. 
Relief is prompt with such remedies. 

Vascular Excrescences and Erectile Tumors of the Female 
Urethra. — These are mostly composed of bunches of capillaries, 
distended and varicose, covered with a highly sensitive mucous 
membrane, are essentially warts. They are generally met with 
at the orifice of the urethra, and extend back a little distance. 
They grow in size, extend in numbers, become exquisitely sensi- 
tive, cause great untold agony to many ladies, so much so that 
the reflex effect of it breaks down and shatters their nervous 
system. 

Severe, often acute and prolonged pain accompanies micturi- 
tion ; the suffering is often protracted after the act. Pains pass 
back into the rectum, cause straining and bearing down, so that 
hemorrhoids soon appear. 

The uterus suffers ; there is often a constant congestion of the 
organ, owing to reflex irritation. The bladder symptoms are apt 
to overtop all others. The irritation extends up from the urethra, 
causing bladder tenesmus, sometimes retention, then frequent 
desire to p^ss urine, of whith but a few drops are passed. The 
pain attending the act is often fearful. 

Treatment. — The first thing to be done is to quiet the irrita- 
bility of the urethra and anesthetize the mucous membrane and 



1 174 



DISEASE GERMS. 



the growths. This is best accomplished by applying a lO or 20 
per cent, solution .of hydrochlorate of cocaine, then apply the 
thuja occidentalis. Give the same remedy internally. This is 
superior to all known agents as a local and .internal remedy to 
those painful erectile tumors at the orifice of the urethra. 



Whenever sexual intercourse is loose and varied, 
Venereal few women among many men, there takes place a 
Disease, change, an alteration or degradation of the living 
elements concerned in the nutrition of the genital 
organs of both sexes into a diseased germ. This change in the 
embryonic cell or primary elements of nutrition is the direct 
result of a violation of natural -and divine law. This degrada- 
tion of biophasm may result in the evolution of an immature or 
perfect germ. This naturally leads to the description of the 
venereal disease under two distinct divisions — the immature^ im*- 
perfectly developed germ, which, when applied or deposited on 
any mucous membrane, especially that of the urethra or vagina, 
will give rise to a specific form of inflammation, with a profuse 
muco-purulent discharge, or if applied to a crack, or fissure, or 
abrasion, will cause follicular inflammation, or soft, non-infecting 
chancre or sore ; whereas the mature germ, the perfectly formed 
microbe, may localize, by aggregation, in the urethra, or vagina, 
and give rise to a very slight inflammation with a scanty muco- 
purulent discharge, or if there be a crack or a fissure on the 
external parts, and the germ-laden pus applied to it, will produce 
a sore or chancre, with a hardened base, from which focus, the 
point of induration, a germ-breeding colony, the germs will enter 
the blood, causing a disastrous destruction of the red corpuscles, 
the life of that fluid, and grow there with less or more vigor 
according to the degree of vital force. 

The immature germ is a microbe of low potency, and although 
capable of exciting violent inflammation in the urethra or vagina, 
and causing a non-infecting chancre, which, in conditions of filth 
and insanitary states, may assume a phagedenic state ; still, the 
germ never enters the blood, even if the individual has it a hun- 
dred times. The germ is so immature that it will not grow in an 
alkaline fluid like the human blood ; and if it is not interfered 
with, will die out in a few weeks ; whereas the mature germ, the 
microbe of syphilis, the perfectly developed germ, whether it 
finds access to the urethra, and there gives rise to a pock, or a 
crack, fissure or abrasion anywhere on the skin, invariably enters 
the blood. 

The growth of the true syphilitic germ in the blood depends 



BACTERICIDES. 



/3 



altogether on the degree of vital force he possesses ; if vital force 
is good, its fecundation and growth may be retarded — that is, it 
will remain latent ; but if vital force be slightly deteriorated, it 
will grow ; and if vigor be low, it will grow with rapidity. No- 
thing can be more disastrous than the contraction of the disease 
from an opposite and distinct race of men or w^omen. 

As the venereal disease has been described and spoken of 
under the terms primary, secondary and tertiary stages, these 
terms must now be discarded, for the discovery and elucidation 
of the disease, as being due to a living microbe, renders the use 
of such terms absurd and meaningless under the science of 
modern medicine. The living syphilitic germ can enter the body 
in many ways, as by towels, drinking vessels, breath, sweat, 
saliva, kissing, close contact, as in sleeping ; through air, water, 
milk, clothing, cushions, articles handled in ordinary use, from 
parent to child, neither primary nor secondary states existing. 

Just let the germ enter the blood in any way, so it reaches the 
true skin, and it will grow and multiply in weakened tissues or 
gland with a slowness or rapidity according to the status of 
vitality of the individual. 

GonorrJica. — This is essentially a specific form of inflammation 
of the mucus membrane of the urethra of the male, or vagina 





The Micrococcus of 
Gonorrhea, la hours 
after sexual congress 
with a woman afflicted 
with gonorrhea, magni- 
fied 750 diameters. 




Microscopical diagram of the 
gonococcus and the germ sy- 
philitic in the same patient. 
The cocci are the gonococcus 
of a soft chancre ; the rods in 
section, the embryonic 'germ 
about to split up in curved 
microbes, true cryplica syphi- 
litica. Taken from the dis- 
charge of an infected female. 
Magnified 750 diameters. 



The Micrococcus of 
simple Gonorrhea, due to 
the immature germ of a 
soft chancre, from 24 to 
48 hours after coition, 
magnified 750 diameters. 
Within may be seen seve- 
ral forms of fission cf their 
nuclei, and micrococci 
moving in the protoplasm, 
(magnified 600 diam.) 



of the female, caused by the gonococcus, or immature germ. It 
usually makes its appearance in from forty-eight to seventy-two 
hours, sooner or later, after a suspicious connection or exposure 
to the germ-laden virus. 

As men and women have numerous other discharges, the mi- 
croscope should be brought to bear upon all doubtful cases. 

The above beautiful microscopic diagrams of the gono- 
coccus in different stages of microbial existence are worthy of 



Ii;r6 DISEASE GERMS. 

serious attention. Interspersed through those germs we have 
the streptococcus pyogenes, pus germ, which has been completely 
isolated and removed. 

The gonococcus, cocci, singly, in pairs, groups. They are 
found in great abundance in the muco-purulent discharge from 
the urethra, in the pus of a soft chancre and buboes. The mi- 
crobe bears cultivation well in nutrient broth, and the patho- 
genic character of the cocci is established beyond all doubt by 
inoculation. 

Symptoms. — The presence of the gonococcus in a healthy 
urethra or vagina gives rise to the following : The first manifes- 
tation which attracts attention is a tickling, burning or smarting 
sensation at the orifice or at about three-quarters of an inch 
within, upon its under surface. On ex:amination, the meatus is 
found to be of a pinkish color, slightly swollen, and between its 
lips may be seen a drop or two of mucus, as the germs multiply 
rapidly. Pain and smarting in urinating become decided, dis- 
charges increase in quantity, become thicker, muco-purulent, 
change to milky hue, then yellowish or greenish, often streaked 
with blood. The pain in urinating increases, the meatus becomes 
highly inflamed, swollen, contracted in calibre, the glans penis, 
and the whole extremity of the organ becomes reddened and 
enlarged. The prepuce may become affected, swollen, puffed up 
by infiltration of the products of inflammation into its cellular 
tissue, that it may be impossible to cover the glans, or it may be 
swollen over the head and it may be impossible to retract it. 
Pain is experienced all along the urethra, sensitive to pressure. 
An increased desire to urinate is felt at all times, and the act is 
accompanied with difficulty and extreme suffering owing to the 
swelling of the urethra. The act of micturition is described as 
if molten lead was passing. P^xtremely likely to be attended 
Avith chordee, a bent or crooked condition of the penis during 
an erection ; painful erections along the urethral canal ; pain in 
the back, groin, perinaeum, fever, aching in the testicles. 

In four or five weeks, without treatment, there is a gradual 
subsidence of the acute symptoms. 

In order to constitute a gonorrhea, the characteristic microbe 
must be present and detected in or on the mucous membrane, in 
the discharge. In the male this is never difficult, but in woman 
there are numerous bacilli and cocci which are satellites of that 
micro-organism which render a diagnosis more obscure. 

There is, so to speak, a conglomeration of germs usually 
present in the female vagina when the gonococcus 'is present. 
Indeed, the female genital tube is a true, natural incubator, favor- 
able to the most luxuriant growth of germs. A bacterioscopic 



BACTERICIDES. 



II77 



-examination is imperative in both sexes, so as to detect the mi- 
crobe. Such a proceeding aids diagnosis, prognosis and treat- 
ment. 

Although the gonococcus is an immature germ, — never enters 
the blood, — still its presence either in the acute or chronic form 
operates disastrously upon the genitals of both sexes, giving rise 
to impotency and sterility. 

The formidable prevalence of the gonococcus demands the 
strictest surveillance over prostitution. 

Diagnosis of a gonorrhea in a woman, the gonococcus must 
be present, and there must be pelvic trouble, her general health 
suffering to an extent not explainable b}^ the slight changes ob- 
served in the sexual organs. She has a purulent discharge, not 
depending upon the presence of an existing erosion, sarcoma, or 
carcinoma ; or there may be a scanty glairy discharge from the 
bright red, eroded cervix. There is a catarrh of the ducts of the 
vulvo-vaginal glands. Small acuminated condylomata are seen 
around the vaginal outlet; there may be a ring of them just 
above the anal orifice. Granular vaginitis is present. Evidences 
of peri-salpingitis, or ovaritis, the latter being of the glandular 
variety. It is essentially important, that several or all of 
these symptoms should be combined ; a single one has no diag- 
nostic value whatever. * 

Of all forms of venereal disease, oricrinatina; in sexual inter- 
course, the above is the most common. 

In the other form of gonorrhea, the infecting form, that due 
to the microbe of syphilis, the mature genu, there are few of the 
above symptoms present, — usually a slight muco-purulent dis- 
charge in the morning. The entire uretha is not affected, simply 
a small area, in the lower aspect of the canal— an ulcer or 
chancre at the neck. In this form there are few complications, 
except chordee. The great trouble with this form is s}'philitic 
germ disease of the entire blood. 

Treatment of Gonorrhea. — Since the recent discover}' of the 
germ origin of gonorrhea, the treatment has been somewhat 
modified. If a case is seen early before the discharge has become 
muco-purulent, an effort should be made to abort the germ 
evolution in the urethra. For this purpose the patient should be 
instructed, after every urination, to inject the urethra with the 
ozonized distillation of the eucalyptus, in the proportion of one 
ounce to four of water. This might be repeated for twenty-four 
hours after every micturition, and at night before retiring, a solu- 
ble gelatinized. germicidal bougie, composed of either thallin, or 
three grains of ic)dol to each bougie inserted. If this is performed 
early enough, the gonococcus is killed; even if it is the true 
syphilitic germ it is likely to be sterilized. 



1 178 DISEASE GERMS. 

The aborting or stamping out of a gonorrhea may be effected as 
follows : It consists in irrigating the urethra with large quantities 
of a tepid solution of boroglyceride or creolin, and repeating the 
procedure three times a day. It is best effected by a fountain 
syringe ; patient seated upon the edge of a chair ; syringe elevated 
four feet above the pelvis, rubber tube same size as number six 
catheter, passed to the deep urethra, and let current flow, it 
passes out outside of the catheter, causes no irritation whatever. 
In nearly every case in which this is tried, the microscope has 
shown no micrococci to be present, but it is best to continue the 
irrigation, as the germ is often imbedded in the lymph spaces of 
the mucous membrane. 

In some cases it is worthy of a trial. 

If this abortive treatment is not successful, in arresting the 
entire germ colony in the urethra or vagina, then a regular sys- 
tematic course must be resorted to and persistently pursued. 

In beginning this treatment, the patient must be carefully in- 
structed to have his bowels opened every morning with some 
saline, such as the following mixture ; sulphate of magnesia, one 
ounce ; bitartrate potassa, two ounces ; nitrate potassa, one 
drachm ; water, six ounces. Mix. 

A tablespoonful or more added to a glass of water first in the 
morning. This will keep the urine alkaline, obviate the presence 
of an overloaded rectum, overcome the local congestion, lessen 
the pain in urinating. He should also be cautioned to avoid all 
active exercise, such as prolonged walking or riding on horse- 
back, dancing, etc., and as much as possible to sit or lie 
down. No doubt the best position is the bed, in the recumbent 
posture, as the erect posture favors congestion of the parts. This 
may be impossible, but a partial compliance may be effected. All 
sexual excitement while suffering from the disease must be 
avoided. The diet should consist of articles, that will not en-, 
gender acidity ; salads, hot dressing, mustard, pepper, asparagus, 
gross food like pork, together with all alcoholic and malt liquors, 
must be positively forbidden. 

Frequent ablutions, are an important part in the management. 

The patient should be directed to bath the parts morning and 
night, or more frequently, in hot water, and to immerse the penis 
and testicles in it for five or ten minutes at a time. If the parts 
are much swollen and painful, the patient should be instructed to 
wear a T bandage, and by means of that and a handkerchief keep 
the organs properly supported, so that they do not hang loosely. 

Various methods of treatment are resorted to and pushed with 
less or more activity, all having but one object .in view the de- 
struction of the germ. 



BACTERICIDES. 



179 



This being so, all remedies used, internal or local, should in the 
highest degree be of the most germicidal character, and the in- 
ternal ones of utility are those not used up in the process of diges- 
tion, such as kava kava, copaiba, oil of sandal wood, resorcin, 
petroleum ; these exert an antiseptic action on the mucous mem- 
brane of the urethra, in the urine in form of infinitesimal molecules 
come in contact with the germ, unite with it and destroy it. 

Formulae for killing the gonococcus in gonorrhea. 

Comp. syrup stillingia, four ounces ; tincture of kalmia, one 
ounce ; balsam capaiba, one ounce ; oil of sandal Avood, two 
drachms ; oil of peppermint, thirty drops. Mix. Shake well be- 
fore taking. Dose, one teaspoonful every four hours. 

Balsam copaiba ; sweet spirits of nitre, of each one ounce ; 
mucilage of acacia, two ounces; tincture of opium; tincture of 
iodine and tincture of lavender comp., of each two drachms. 
Mix. Dose as above. 

Mucilage acacia, four ounces ; oil of cubebs ; oil of sandal 
wood, of each one ounce. Mix. Dose as above. 

Comp. syr. of tolu, four ounces ; oil of sandal wood, one ounce ; 
spts. nit. ether dulc. Mix, Dose as above. 

Kava kava paste or pill. 

Comp. syr. tolu, fl. ext. kava, oil of sandal wood, equal parts. 
Mix. Dose as above. 

One of the above should be selected, the one which the physi- 
cian deems best suited to destroy the germ ; have the best healing 
and modifying action upon the irritated or ulcerated mucous mem- 
brane. The use of some such remedy in all stages of the disease 
is attended W'ith advantage. They are useful remedies, and should 
not be omitted. 

The use of the gelatinized urethral bougies, highly ozonized, 
is to be recommended in all cases. They are prepared from 
various ingredients all of a powerful antiseptic character, capable 
of killing the gonococcus and healing the abraded mucous mem- 
brane. They are prepared from hydrastis canadensis, iodol, 
resorcin, thallin, and numerous other agents, incorporated in a 
plant of glycerine and gelatine. When a bougie made of any of 
the above ingredients is inserted into a germ-laden urethra, it imme- 
diately commences to dissolve, and the medicating ingredient with 
ks peroxide of hydrogen causes the microbe to die, and heals the 
abraded surface. As time — from twenty minutes to three- 
quarters of an hour — is required for the complete solution of the 
bougie, a gradual prolonged and continuous action of the remedy 
is maintained, and during that time it does its work well. It 
causes no pain in its introduction, it separates and distends the 
walls of the urethra, penetrates into every sinus, every follicle or 



IlSo DISEASE GERMS. 

fold. As the germicidal properties of the bougie penetrate in 
all and every direction, killing the germs as fast as evolved, and 
healing. 

The advantages of these bougies, are, they are thorough in 
their action, prompt in their effect, affording a speedy cure in all 
cases. They prevent the formation of stricture, relieve chordee, 
and will effect a cure without any other treatment, in all stages of 
the disease. 

Gleet. — In this we have great debility of the mucous mem- 
brane of the urethra, either from long-continued inflammation or 
inherent weakness, with a glairy, weakening discharge, like the 
white^ of an ^^^, or it may be milky or watery, without any 
symptoms of inflammation. The discharge may be quite little, 
a drop or two, or even very profuse. 

It is most important in all cases of so-called gleet to be sure 
that there be no stricture, no prostatorrhcea. 

Then pursue a tonic course of treatment, either administer in- 
ternally compound tincture matricaria alternated with ozonized 
iodine, or iron and quinine alternated with salix nigra. 

Urethral bougies of iodol, hydrastis, have an excellent effect. 

Urethral Catan^li. — Patients will sometimes return after a sub- 
.sidence of all tne symptoms, when the are apparently well, com- 
plaining that the discharge has returned, probably owing to some 
indiscretion, as prematurely, having sexual congress, or causing 
their urine to become acid by the use of malt liquors, etc. 

On examination of these cases there is found a slight watery 
discharge, probably most in the morning, or merely a drop or 
two, once or twice a day ; no pain in urinating, simply due to de- 
bility, a sort of lack of tone in the capillaries of the mucous 
membrane of the urethra. 

General tonic and alterative course ; compound saxifraga and 
Phytolacca, compound tincture matricaria, avena sativa. 

Stricture. — When the case is permitted to run along for several 
weeks or months there is very apt to be deep-seated damage done 
by the inflammation or by the remedy administered ; lymph is 
often effused from localized patches of inflammation that may 
exist ; this lymph is generally effused on the inferior aspect of 
the urethra ; it is thrown out either in a flattened piece, or in 
membranous bands across the canal, and if not promptly re- 
moved will form an impediment to micturition, cause the stream 
of urine to be twisted like a cork-screw, or forked, or like a 
thread or in drops. This continued obstruction gives rise to a leak- 
age or discharge; if they are old, ulceration is liable to take 
place behind them ; they invariably produce congestion of the 
prostate and prostatorrhcea, with functional impotence, invariably 
some leakage. 



BACTERICIDES. Il3j 

The correct treatment — gradual dilatation and absorption. 

Chordee. — This is perhaps the most common comph'cation of 
a gonorrhea, when it is permitted to run its course ; the gono- 
coccus eats through the tissue, usually the inferior aspect. 
When the patient becomes warm at night in bed, owing to the 
existing inflammation, a great determination of blood takes 
place in the organ, powerful, painful erections; when these 
erections take place the penis becomes crooked or bent, in the 
form of a bow or arch. The complication gives rise to great 
suffering. 

The best remedy for the purpose of paralyzing the erectile 
fibres of the penis is the green root tincture of gelsemium in the 
following mixture : 

Camphor water, four ounces ; bromide of potassa, half an 
ounce ; nitrate potassa, two drachms ; green root tincture of gelse- 
mium, one ounce. Mix. 

This mixture should be given in the afternoon, after supper 
and before retiring, in teaspoonful-doses, added to a little water. 

The rectum should be washed out with ozone distillation of 
hamamelis, followed by a cocaine suppository. Sleep on hard 
mattress, in a cool room, avoiding all sexual thoughts. 

Chronic Gonorrhea. — As a rule, the gonoccocus dies in from 
.five to six weeks in an acute attack of gonorrhea without treat- 
ment ; with treatment, of a germicidal kind, a few days, or at least 
from a week to ten days, should be ample time to kill the germ 
and cure the patient. True, there are cases in which the germ 
may hold on, the discharge quite a good deal, re-aggravated by 
the slightest provocation. 

Even indigestion, the slightest sexual excess, or ungratified 
sexual desire, the use of alcohol, cold, wet, over-exertion, will re- 
surrect the gonoccocus, give rise to more or less pain in urinat- 
ing, with a rather profuse creamy discharge and other inflam- 
matory symptoms. 

The patient should be placed upon a general alterative and 
tonic course of remedies, embracing compound saxifraga and 
sandal wood, kava-kava paste. 

The most common lesions occurring in chronic gonorrhea are 
these: i. A catarrhal inflammation locahzed in deeper parts of 
the urethra. 2. Papillary granulations resulting from hyper- 
plasia of the mucous membrane. 3. Granular vegetations, or 
peculiar bloodless (or rather vesselless) protrusions, the degener- 
ation ending in atrophy of the tissues. Every one of the three 
forms is accompanied by a mucoid or muco-purulent discharge, 
and may lead in course of time to the formation of strictures of 
varying size. The stenoses of extreme degrees are usually recog- 



1 1 82 DISEASE GERMS. 

nized fairly easily. It is otherwise in cases of milder strictures, 
which frequently do not give rise to any marked symptoms 
beyond the so-called goiitte militaire — that is, a morning drop of 
discharge arising from inflammation caused by stagnation of the 
urine behind a narrowed spot. Without a careful examination, 
such slight strictures may be easily overlooked, and our treat- 
ment accordingly prove a failure, since such means as routinary 
injections are powerless to remove the lesions of this kind. In 
view of the facts, Dr. Hobensack recommends the examination of 
every patient suffering from urethral discharge by means of a large- 
sized catheter. If the latter failed to pass into the bladder, a 
stricture is present. If the instrument passes with some diffi- 
culty, one of the three lesions mentioned above must be sus- 
pected. The best means for establishing a differential diagnosis 
between the forms is undoubtedly afforded by an endoscopic ex- 
amination. The latter, however, requires a considerable skill and 
experience. In the absence of the conditions, the endoscope may 
be, to a certain extent, substituted by a bulbous catheter. In 
such cases, where the introduction of the instrument causes a 
strictly localized pain, and is followed by a few drops of blood, 
either the i form or the 2 must be thought of In the absence 
of the pain, and bleeding, the cause of the urethral discharge is 
constituted, probably, in granular vegetations (the form 3). The 
treatment varies according to the nature of the cases. In those 
mentioned under i and 2, excellent results may be obtained from 
injections of ozonized distillation of eucalyptus. In cases of 
granular vegetations, soluble bougies of papoid. Strictures are 
best treated by a systematic dilatation of the urethra with metallic 
bougies. 

Besides the two forms of gonorrhea, men are liable to have 
numerous other discharges, all due to micro-organisms ; sexual 
congress with females who suffer from intra-uterine catarrh, in 
which both the yeast plant amoeba and sarcinae are present, will 
contract a discharge in which these germs appear. 

Congress with ladies during their menstrual flow, or with 
those affected with ulceration, will be likely to give rise to a dis- 
charge in which the bacteria, the factors of the irritation, are 
present, so with cancer, the bacilli of tubercle, etc. 

Both forms of gonorrhea are liable to have a train of compli- 
cations or sequelae in their acute and chronic stages ; they ex- 
hibit features and characteristics of inflammation of mucous 
membrane, whatever germ be present. The germs travel back 
gradually, extending by continuity of surface, to the deep 
urethra, bladder, ureters, kidneys. 



BACTERICIDES. 



II83 



The venereal disease consists of 

The Venereal Bacillus, two distinct germs, one immature, 

{The Pathogeyiic Microbe the other a full-fledged microbe. 

of Syphilis}) The immature germ gives rise 

to a gonorrhea, and a soft, 

non-infecting chancre, but is too feeble to enter the blood and 

produce any havoc there. The immature germ gives rise to 

specific suppurative inflammation on both mucous membrane 

and skin ; on the latter a well defined pock or pustule, with 

scooped-out edges, and an abundant secretion, and when you 

take it between your finger and thumb, it is soft to the* feel. 

In the treatment of this form of sore, since the introduction of 
so many germicides, caustics are avoided, and instead, this class 
of sores are promptly destroyed and healed • by sprinkling on 
them iodol, or applying a wash of lime water and tincture of 
iodine, or any other good antiseptic, like the peroxide of 
hydrogen lotion. Whichever of these be used, they should be 
applied fresh every morning and night, until the sore is healed. 

When this immature germ is inoculated on the prepuce or 
glans of an individual of a tubercular diathesis, the sore in which 
the germs are breeding take on a serpiginous or horseshoe ap- 
pearance, owing to the tubercular bacilli and the venereal germ 
mingling, which gives us a true hybrid ; one which cannot pro- 
create, but is nevertheless most intractable to get rid of 

The iodine salts are the best remedies, painting the sore with 
a mixture of tincture of iodine and iodide of potass, in the pro- 
portion of half an ounce of the former to three drachms of the 
latter, about once a week ; keeping iodol applied in the interim. 
Keeping the patient upon the comp. saxifraga, internally. 

The non- infecting sores have a great tendency to suffer ad- 
ditional degradation if exposed to, or in close proximity to, 
insanitary states, such as overcrowding, filth, meagre, or un- 
healthy food, mercury, imperfect drainage, absence of sunlight, 
etc., the oiJium albicans, evidence of the human rot, mingles 
with the immature, and gives us phagedena, eating, sloughing 
condition. 

Such cases call for prompt attention : apartments should be 
disinfected by the fumes of burning sulphur, greater cleanliness 
observed, removal of all nuisances, germicidal applications, as 
lotions of peroxide of hydrogen, boroglyceride, sulphur-water, 
fresh air, nourishing food, thorough hygiene. 

The bacillus of syphilis consists of rods, very minute. Two 
or more ovoid points are visible in the course of the rod, which 
are spores. They are best observed from the secretion or dis- 
charge of the indurated chancre, or from the ulcers in the mouth. 



ii84 



DISEASE GERMS. 



When the blood is searched for them, they are, when present, 
found in the interior of the nucleated cells. The microbe is 
pathogenic of systemic syphilis. Bears culture well ; reproduces 
itself in all red-blooded animals when injected subcutaneously. 
The ptomaines excreted by the syphilitic germ are peculiarly 
toxical to skin, mucous membrane, bone, brain, lungs, etc. 
When the atmospheric electrical influences are low, germ breeds 
most actively. Thence the nocturnal pains in bones, etc. 




The bacillus in syphilis as seen in the blood ; the full-fledged microbe. 



The mature, full-fledged germ, the true syphilitic microbe^ 
wherever it reaches the true skin, a true secreting membrane, 
through a breach of mucous tissue, or cuticle, finds ingress to 
the human blood, its genuine pasture field, where it remains 
latent or breeds according to the degree of vital force present in 
the individual. There are numerous other channels of ingress 
into the blood for this germ, besides cracks, fissures, abrasions 
on the genital organs of either sex. It may come into our bodies 
from the germ-laden tissue of the affected by close contact, 
breath, kissing, clothes, bathing dresses ; through food, espe- 
cially milk and raw beef, and we might cite the case of profes- 
sional tattooers, who often contaminate thousands of persons by 
their saHva. 

In ordinary everyday life, the spread of this germ, either in 
the urethra, vagina, male genital organs, is generally through a 
scratch, or abrasion, or fissure of the cuticle or mucous mem- 



BACTERICIDES. 



I185 



brane ; in this crack, or fissure, the microbe breeds, forms a nest, 
or reservoir, from which the veins carry the germ to the nearest 
lymphatics, or blood-forming glands ; so fast, so energetically does 
the microbe breed, that the veins are unable to carry off the 
germs, so entire colonies remain at the point of inoculation, 
forming a ridge, or eminence, or induration of the sore. It is 
simply a mass of germs, an aggregation which feeds the blood. 
When those microbes enter the blood they are safe, their living 
particles find protection and nutrition there. 

If vital force be maintained at a high standard, it will resist or 
retard germ evolution, and the microbe can be held dormant, 
although the individual 
can at all times be trans- 
mitting the disease to 
others, especially to his 
offspring. Let vitality 
be low, depressed by any 
cause, then growth, ac- 
tive multiplication of the 
germ takes place ; the 
rate of germ growth and 
destructive metamor- 
phosis being in propor- 
tion to the deviation 
from the standard of 
health ; and if there be any localized weakness in any part of 
the body, the microbes will congregate there and grow, giving 
rise, through the germ-laden blood, and reflex irritation, to ob- 
scure chronic disease of vital organs, as the brain, heart, lungs, 
bones, mucous membrane, skin. 

From the moment that the germ enters the body, till its 
death or destruction in the body, for it must die there, systemic 
syphilis is a contagious and infectious disease, whether it be 
latent or active. Suppose, then, that vital force is depreciated 
and the germ merges into activity and growth. Simultaneously 
with the entrance of the germ into the body, if vital force is 
feeble, or six months later, if somewhat stronger, or even years, 
subsequently, an indescribable train of symptoms make their 
appearance in no definite order. There may be languor, lassi- 
tude, debility, even fever. If the skin is feeble, the germ may 
appear there in some form or grade corresponding to the con- 
dition of vital force ; if mucous membrane be feeble, colonies of 
germs will settle there, giving us various forms of ulceration, 
but it has now blended with it the oidium albicans of aphthae ; 
but on skin and mucous membrane it is easily recognizable in 

75 




Indurated chancre on the lip, the result of a kiss. 



II 86 DISEASE GERMS. 

the Caucasian by its copper-colored appearance and lack of sen- 
sibility ; if the bones are feeble, the germs will lodge there, giv- 
ing us periostitis with nodes ; ostitis with necrosis and caries ; 
they often find their way into the most delicate parts ; one even 
can estimate or approximate their growth and their destructive 
action on the blood, by the degree of nocturnal pain in the 
bones, the tenderness of the sternum and enlargement of the 
post-cervical glands of the neck ; they are never-failing cri- 
terions ; the matrix of hair suffers an invasion, and the hair drops 
out. Tuberculae are created, mucous tubercles or patches be- 
come common at points where skin and mucous membrane meet, 
lips, vulva, anus ; often iritis, if vital force is greatly shattered, 
with deafness, and brain affections ; in some cases, the onyx of 
nails are copper-colored, and often rot or crumble ; ulceration of 
tongue, hard and soft palate, perforating ulcers, larynx, trachea ; 
elevations and gummy deposits ; caries and necrosis of the 
cartilage and bones of the nose, and in a large per cent, of cases 
the germ invades various vital organs, as the brain, spinal cord, 
lungs, heart, liver, kidneys, never appearing on skin or mucous 
membrane at all. 

Treatment. — The first and most important consideration in the 
management of these cases is the care of the general health. The 
bathing of the entire body daily is a matter of great importance. 
Cold or tepid baths, either by sponging or immersion, followed 
by shampooing or massage, are of great utility. The clothing 
should be woolen, adapted to the season of the year, so as to 
give warmth. The diet should be generous, consisting of the 
most easily digested and nutritious articles possible. 

The mouth, gums, and teeth should be well cleansed before 
and after meals, with a solution of boroglyceride, or comp. tinc- 
ture cinchona, tincture of myrrh, or resorcin, added to water. To- 
bacco in all its forms must be rigidly forbidden, as it is decidedly 
injurious. The patient should sleep in a well-ventilated apart- 
ment, and alone, as his disease is pre-eminently contagious and 
capable of transmission to sound persons by close contact or by 
drinking vessels. Gentle exercise in the open air, selecting 
healthy locations, elevating amusements, the regular routine of 
business, unless it proves too exhausting, then change of scene. 
The mind should be kept cheerful, free from needless worry or 
anxiety, and all thoughts of their disease as much as possible 
avoided. 

Malt . and alcoholic drinks should be employed solely under 
the explicit directions of a physician. 

Infection. — The question of the possibility of several attacks 
of syphilis has long been settled. It admits of no discussion. An 



BACTERICIDES. 



iiSy 




Venereal Microbe in the breast, 
caused by nursing a syphilitic ch'ld. 



individual may have attack after attack ; his blood never becomes 
sterilized to the ingress of brood after brood ; there is no im- 
munity ; re-infection after re-infection is 
the rule. 

A man or woman may each have an 
indurated chancre ninety-nine times, 
and each time it is a fresh syphilitic re- 
infection. The germs are there until 
they are absolutely annihilated. 

Turning to the use of remedies em- 
ployed in systeniic syphilis, we may re- 
mark that there is no routine plan of 
treatment, no specific which can be 
advantageously used in every case. The remedies which are to 
be employed must be powerful germicides, and on the part of the 
physician, he must have experience, fine discrimination, good 
judgment, unusual professional skill to manage those cases. 

The success in curing venereal cases, that is, destroying the 
microbe in the blood, does not depend on the largest amount or 
varied assortment of drugs, but in the tact and skill in their ap- 
plication in combating a most most formidable disease. Prepa- 
rations of mercury, iodide of potass, nitric acid, iron, quinine, 
are the great remedial agents for the destruction of the syphilitic 

microbe ; these may be 
used to no purpose by 
one physician, whereas 
another, with greater tact, 
achieves the most bril- 
liant results with them. 

The vegetable prepara- 
tions, stillingia, saxifraga, 
Phytolacca, kalmia, dul- 
camara, iris versicolor, 



tt*.^ 




are slower 
effective 



as 



but 
the 



fully as 
mineral 



agents. 



But a microscopical 
inspection of the blood 
in syphilis is the best for 
diagnosis. This is posi- 
tive, and demonstrates 
clearly to us that the 
germ is there, and how 
numerous or how scanty they are. During a course of treatment 
under saxifraga, phytolacca, and other germicides, it emphatically 



The microbe of syphilis as seen in the inter-corpuscular 
spaces, from the blood of an affected individual, 1200 
diameters. 



1X88 DISEASE GERMS. 

tells us how fast the disappearance of the germ takes place. The 
preceding diagram exhibits the syphilitic germs in the bloody 
active with life, hurrying hither and whither with the ceaseless 
motions of protoplasmic life. They appear as copper-colored 
bacilli in the blood. 

Before proceeding to lay down a course of treatment for the 
destruction of the microbe syphilitica with remedies of acknowl- 
edged value, it must be borne in mind that no two cases are 
alike ; that there is the widest range between the most benignant 
forms of private practice to the most malignant type as seen in 
hospitals. 

Mercury as a germicide stands to-day unrivalled as a remedy 
for the destruction of the syphilitic germ. Administered with 
skill, in a properly graded dose, immense advantage is often 
gained by its use, provided the patient gains in health, strength, 
and vigor ; but if salivation, stomatitis, fetor of the breath, spongy 
state of the gums, with inappetence, gastro-intestinal disturbance, 
be produced, more harm than good may be produced. 

The least hurtful, and a form of great energy is the protochlo- 
ride in the following : 

Comp. saxifraga, four ounces . tincture of kalmia, one ounce ; 
iodide potass, two drachms ; bichloride of mercury, two grains. 
Mix. Dose, one teaspoonful every three hours. 

The hypodermic injection of mercury is very popular and effec- 
tive. The following is the formula in general use. 

Hydrarg. bichloride, eighteen grains ; chloride of ammonia,^ 
eighteen grains ; chloride of sodium, one drachm ; distilled water, 
four ounces. Dissolve and filter, and add the white of one 

Our professional brothers should test the action of the com- 
pound saxifraga or the compound phytolacca, ozonized, or either 
combined, or as follows : 

Compound saxifraga, ozonized, four ouiaces ; tincture of kal- 
mia, one ounce ; iodide potassium, three drachms ; resorcin, one- 
half ounce. Mix. Dose, a teaspoonful thrice daily. 

Watch the blood changes on the syphilitic germ, and later on 
the total disappearance of the germ from the blood, under this 
germicide. 

Since the discovery of the venereal bacillus, there has been 
inaugurated a change from the older methods of treatment to one 
essentially of a bactericide character ; the change has been gradual 
and progressive, and to-day it is as simple and sensible as 
formerly it was complicated and senseless. 

The very moment it is detected, treatment should be begun, 
and continued for some time after all symptoms have disappeared* 



BACTERICIDES. 



189 



In this way it can be cured. It is not necessary to have an ini- 
tial, as the microbe can enter the body in many ways without, as 
by close contact, breath, saliva, sweat. 

If there is a sore, or pock, excision is regarded with favor by a 
few syphilographers as capable of preventing general infection. 
Others regard the initial lesion as a sign of general infection. 
The former position is hard to establish, as it is open to two ob- 
jections : first, that it is impossible for the diagnosis of the initial 
lesion to be certain until later manifestations appear ; and second, 
that it is impossible to be sure that the disease may not manifest 
itself after the usual period of observation. This part of the treat- 
ment of syphilis cannot, therefore, be considered as yet accepted. 
Again, as to the proper time to begin treatment, we say at once, 
Treatment early diminishes the intensity of the disease. There 
must be no inaction where this germ exists, as we have abundant 
means for combating it. 



The bacillus of syphilis frequent- 
The Venereal Bacillus, ly localizes itself in the eye and 
{The Pathogenic Syphilitic on the lids. On the lids the mi- 
Microbe in the Eye.) crobe appears in three forms, pri- 
mary lesion from a towel, or a finger, 
with the virus, initial sclerosis, exanthem, and gumma. Ophthal- 
mia due to the mature germ is very rare. Still occasionally we 
meet with ulcers on the cornea, following corneal abscesses in 
which spores of the syphillic germ can be isolated. 

Iritis is undoubtedly the most common of all eye affections. 
In broken down states of the body associated with poor or meagre 
food and insanitary conditions. 

In such cases, general treatment must be energetically pushed, 
with stimulation to the nape of the neck, quinine internally, never 
neglecting atropia in the eye. 

The tendency to corneal ulceration often lies in a diminished 
vitality of the cornea, which debilitates it for the battle against 
the ever present pyogenic microbes. One essential portion of 
the treatment must, therefore, ever be the fortification of the gen- 
eral system and improvement of its condition. In many cases in 
which ulceration of the cornea is found to frequently recur, it will 
be found that there is a chronic condition of trachoma, or a neg- 
lected inflammation of the lachrymal sac, or obstruction of the 
duct, causing the cornea to be constantly bathed in stagnant tears. 
These collateral relations should ev^er be borne in mind, for no 
treatment can be successful which does not include a rational at- 
tention to the general physical, as well as the local health of the 
cornea and its adjoining tissues. 



1190 



DISEASE GERMS. 



Civilization with its varied im- 

The Venereal Bacillus, provements is unfavorable to brain 
{Phrenal Syphilis. longevity, much more so than the 

The Pathogenic Microbe in intellectual torpor of a semi-civilized 
the Brain^i condition. Modern thought with 

its neurasthenia of the cerebrum, 
renders the brain proper a favorite site for the location and evo- 
lution of the germ syphilitica. 

But over and above the well-recognized forms of nervous and 
mental disease, there are certain groups of symptoms which may 
fairly be regarded as indicative of specific infection, although the 
proof may not be greater than that to which the lawyers give the 
name of" prima facie ^' — /. e., proof amounting to a presumption, 
which may, however, be rebutted by adequate testimony to the 
contrary. These symptom-groups, if I may be allowed to formu- 
late from my own experience, are as follows : 

(i) Quasi-periodical cephalalgia of a peculiar kind. (Nocturnal.) 
(2) Hemiplegia under forty years of age, with or without preced- 
ing cephalalgia of the aforesaid type. (3) Cephalalgia followed by 
hemiplegia, which bear a singular relationship to one another in 
that the cephalalgia ceases immediately upon the supervention of 
the hemiplegia, and does not recur. (4) Convulsions in the adult, 
which have not been preceded by convulsions in infancy, and are 
not of traumatic or nephritic origin, or due to pregnancy, or in 
an individual subject to migraine. (5) Symptoms indicative of a 
lesion at the base of the brain. (6) A comatose condition ex- 
tending over days or weeks, not traumatic, meningitic, diabetic, 
nephritic, or from typhoid fever. (7) Tabes dorsalis. (8) Gen- 
eral paresis. (9) Spinal lesions in a subject who has had intra- 
cranial syphilis. 

I have very pronounced ideas with regard to treatment. I have 
no faith whatsoever in mercury. 

I am quite prepared to say, that unless the iodides with their 
proper adjuvants — of which I shall speak in a moment — can cure 
a case of nervous syphilis, it cannot be cured at all. But the 
dose of the iodides which is administered by the Germans and 
French will often be entirely inadequate. I give the iodides until 
the symptoms yield, or until iodism is produced. Should iodism 
ensue before the symptoms yield, I pursue one of two methods. 
I first increase the dose of the iodide by about one-third, and 
rapidly increase each succeeding day. Singular to say, in some 
cases this increased dosage will cause the iodism to disappear, 
and the larger doses will be borne very well. Should, however, 
these larger doses still more increase the iodism, I decrease to 
one-half of the dose at which the iodism had begun, and continue 



BACTERICIDES. 



91 



this decreased dose until the iodism diminishes or disappears, 
when I again rapidly increase the dose, and am usually able to 
go on without further trouble. In some few individuals, however, 
no amount of care will cause more than a certain amount of the 
iodide to be borne, and such cases, as I have said, are usually of 
unfavorable prognosis. In some cases, too — fortunately they are '^ 
rare — even small doses of the iodide will produce a cardiac dis- 
turbance that prohibits its administration. I am perfectly well 
aware that the medical chemist will object that these large doses 
of the iodide pass through the body and are quickly excreted by 
the urine ; but I am equally well aware, in the face of this fact, 
that these large doses of the iodide will cause symptoms to yield 
that cannot be made to yield by lesser doses. I have given as 
much as several hundred grains of the iodide of potash in the 
twenty-four hours, and have seen symptoms disappear with these 
enormous doses that would not yield to minor ones. I admin- 
ister the iodide after meals, and either in a full tumbler of ice- 





Cerebral softening. 
Small blood-ves- 
sel from a focus 
of yellow soften- 
ing in phrenal 
syphillis. 



o. 

Softening of the cerebral pulp in 

phrenal syphilis. 




Sclerosis of the brain. 
Cerebral sclerosis 
• in chronic intersti- 
tial inflammation 
from the presence 
cf the syphilitic 
germ. 



water, or in a glass of Vichy, or in a glass of Bohemian spring 
water, the Giesshiibler. 

But he who expects to cure his patients with the iodides alone, 
unless the case be so grave as to call for immediate relief, will be 
disappointed. The human organism must be put in the best 
possible condition. A generous diet should be employed. Free- 
dom from care and worry, where possible, should be enjoined, 
and all strenuous exertion of body or mind avoided. 

The germ syphilitica frequently localizes itself on the circum- 
ference and base of the brain, in the form of an exosmosis from 
the blood vessels, and appears in the form of thickenings, adhe- 
sions, contractions, puckerings, with a germ-eaten state of the 
blood vessels. 



1 192 



DISEASE GERMS. 



Microscopically throughout the effused lymph, there appears 
soft jelly like masses, irregular in form, blended intimately with 
brain structure, the pathogenic micrococci appear as spindle and 
stellated cells imbedded in an alveolar frame work. 

It is needless to emphasize the fact that cerebral syphilis is very 
common — true the brain resists with tenacity the localization of 
the germ — but epileptic seizures, paralysis, as hemiplegia, or eye 
neurotis, aphasia, etc., occurring in middle life, are most significant, 
especially if there are symptoms of nocturnal headaches, numb- 
ness, formication, heats and colds, etc. If those exist look for 
syphilis, because tumors, abscesses, organic lesion are rare at 
that time of life. 

By placing the patient on specific treatment for syphilis, when 
in doubt, is the safest. The repeated application of tv/o small 
fly blisters to the nape of the neck for six hours at a time, twice 
weekly, often diverts the germ to other pasture fields. It is safe, 
salutary. The internal administration of comp. saxifraga ozon- 
ized is a treatment calculated to be invariably beneficial ; its use 
for months is the only probable means of cure. The origination 
and use of this remedy is the outcome of a national necessity, an 
agent that never fails to give satisfactory results. 

Good authority says, the profession must depart from their 
usual course in the treatment of syphilis — the initial lesion affects 
the whole system — disseminates the germs through every tissue. 
Our people, more than any other nation, suffer from phrenal 
syphilis. 

Syphilitic growths, gummata, will, if formed on the brain, 
disappear as speedily as any other lesion ; and when their mi- 
crobial growth gives rise to pressure, the resulting damage to 
the nerve structure is recovered from in the most complete 
degree. 

When there is reason to suspect inflammation of the cranial 
nerves — syphilitic neuritis — the prognosis is chiefly influenced by 
the duration of the morbid process. If the inflammatory pro- 
ducts are in such a stage that they can be removed, the progno- 
sis is good if the damaged nerve fibres will recover conducting 
power. If, however, there is reason to suspect cicatricial trans- 
formation of the new formation into fibroid tissue, it is improbable 
that the degree of improvement will be sufficient to permit severe 
symptoms to pass away entirely. The same general prognosis is 
true also of infiltrating growths. In true acute inflammation that 
is treated early and arrested early, the prognosis is the same as 
in similar inflammations that are not specific. The recovery or 
persistence of the symptoms depends on the recover}^ or per- 
sistence of the changes in the nerve elenients which are pro- 
duced by an intense inflammation, and effusion of germs. 



BACTERICIDES. j Iq^ 

The clinical history of the neurotic form of syphilide has an 
individuality of its own. In the \'ery earl\' months of the di- 
athesis, either in the stationary period of an early syphilide or at 
its decline, generally preceded or accompanied by severe neural- 
gic symptoms involving the facial or cranial, intercostal, anterior 
•crural, or, in fact, in any cutaneous nerve, by severe cephalalgia, 
continuous or nocturnal ; by rheumatoid pains in muscles or 
joints, and by general malaise and debility, this eruption makes 
its appearance with more or less promptitude and dev^elops quite 
rapidly. In some instances the invasion is very acute, so that at 
the end of a week, we may find fully developed tumors an inch 
or two long, in others and in the majority of instances the de- 
velopment is slower and nearly two weeks elapse. Besides the 
general neuralgic symptoms, local pains on the site of the lesions 
or in the whole territory on which they are de\^eloped are ex- 
perienced. These may be continuous or intermittent, and in 
some cases are excruciating as in severe herpes zoster. 

There are two points in the treatment of syphilitic diseases of 
the nervous system on which I think a word of caution is ur- 
gently needed. The first is regarding the prolonged adminis- ' 
tration of anti-syphilitic drugs, especially of iodide of potassium. 
By " prolonged " I mean exceeding from six to ten weeks. I 
believe that full doses in this time will effect all it can achieve in 
the removal of the syphilitic process. Here, as I have just said, 
we want facts that are visible, numerous, and carefully observed, 
to guide us in our conclusion. I do not say that the symptoms 
will have disappeared. It cannot be too firmly remembered that 
symptoms are due to changes that are not syphilitic, changes in 
the nerve elements secondary to the syphilitic disease, but so far 
independent in course that they may persist long after the speci- 
fic lesion is at an end. Hence the fact that the symptoms have 
not yet ceased is no indication that the specific lesion is not en- 
tirely removed. If iodide be continued, as it often is, during 
many months (and much more, as it sometimes is, during years), 
there is a danger that the normal tissues of the patient may be- 
come so accustomed to its presence that the drug may no longer 
hold in check the syphilitic processes. Probably we may still 
influence the lesions by increasing the dose, but this process 
must have limits in practice, if not in theory. Such prolonged 
and augmented treatment may. do definite injury to the patient's 
health, and even then fail to effect the desired object. If the 
poison is in an organized virus we might a priori expect this re- 
sult. By long-continued, gradual alteration in the conditions, 
low organisms, as has been shown in remarkable experiments, 
•can be made to endure influences that would at first be fatal to 



11(^4 DISEASE GERMS. 

them. By slowly raising the temperature they will not only live 
but flourish at a degree of heat which, had it not been for their 
acclimatization, would have killed them in a few minutes. But 
the question is not one in which we can be guided by theory, 
far less by analogy, possibly 'remote. There is, moreover, a 
positive danger in this method. It is also great in the practice 
to which I referred, that of repeated courses of energetic treat- 
ment to remove residuary symptoms .that cannot be thus re- 
moved, because they do not depend on any residual specific 
process. 

A very eminent authority says : Inherent weakness of certain 
parts or structures of the brain permits of the deposit and locali- 
zation of the syphilitic germ if present in the blood. The mi- 
crobe is here found in the form of gummatous tumors, composed 
of small, round, oval and pyriform cells, with basement sub- 
stance. These masses may undergo a variety of changes and 
degenerations, and often migrate from bone to brain and vice 
versa. 

The history of the case, persistent localized nocturnal head- 
ache, impaired intellect, dull, stupid, apathetic ; impairment of 
the senses, often facial paralysis, and, if energetic treatment is not 
pursued, unconsciousness, stertorous breathing, dilated pupils 
and death. 

The diagnosis rests chiefly on the presence of the syphilitic 
germ in the blood. 

The treatment consists in the use of the most energetic 
remedies to kill the germ, with persistent repeated blisters to the 
nape of the neck to attract the germ away from this vital organ. 



The venereal disease, both con- 

The Venereal Bacillus, tagious and infectious, is to a great 

[Pathogenic Microbe extent a preventable disease, if 

Syp/iilitica) licensed and put under restraint by 

the State. 

The microbe, when once in the body, is generally carried to 

every nook and corner of the tissues. The ingress of the germ 

is silent — effected without a sore, coming in by the breath or 

contact, or through the translucent lymph of vaccine pustule. 

Of all forms of venereal infection, lung syphilis is the most 
potent and effective. The microbe is generally scattered through- 
out the entire body of the blood vessels and lymph canals. It 
is to be freely found in all the secretions and excretions — in the 
S}'novia, bone, periosteum, brain, skin, etc., but in no form 
is the infection so great and pungent as in pulmonary syphilis. 



BACTERICIDES. 



II95 



So, it is well in all cases, especially those with a cough and 
expectoration, to resort to rigid antiseptic precautions. 

The room in which a lung syphilitic 
affected individual sleeps or lives in should 
be disinfected at least every two weeks, 
thoroughly fumigated with burning sul- 
phur ; that his sputum, faeces, urine, 
should be destroyed ; that the individual 
should be isolated from his fellows. He 
should not be permitted to sleep with or 
come in contact with healthy persons. 

All workshops in which venereal pa- 
tients congregate should be frequently dis- 
infected. 

It must ever be remembered that both in tuberculosis and 
syphilis, that domestic animals play an important part in carry- 
ing these germs from one individual to another. 




Syphilitic germ in the kidney^ 
found forty-eight hours after 
death actively evolving 
spores ; ihey were detected 
in the urine several months 
before death took place. 



The Venereal Bacillus. 

(The Pathogenic Microbe of SypJiilis 

passing from Parents to 

their Offspring}) 



The microbe passing" 
either in the spermatozoa 
of the male or ovum of 
the female, or both, is a 
frequent cause of either 
blighting the foetus, caus- 
ing its death, or, if the uterus is healthy, it often repels the germ- 
smitten foetus, and miscarriage results. 

The child may be born with unmistakable signs of the disease, 
or may be born apparently healthy and in a few weeks the 
symptoms develop. Emaciation or great sleeplessness may sug- 
gest the taint. The symptoms resemble the secondaries in the 
adult, and appear about the same time as the acquired after 
inoculation. When markedly present the child has a peculiar 
" old man " look, a prematurely old appearance, is very ema- 
ciated, simply skin and bone, these children being frequently 
premature. The cry is shrill and hoarse, compared to the sound 
of a penny trumpet, and the child has a hard cough, often sick- 
ness and diarrhea, coryza, and snuffling due to inflammation and 
ulceration of the mucous membrane of the hose causing it to 
become blocked, the child therefore refusing the breast on 
account of it only being able to breathe properly by the mouth. 
The skin is hard, dry, dirty looking and wrinkled ; soon, acquires 
patches of a light brown color, and the nails are often cracked. 
The skin and mucous membranes are the first to show the symp- 
toms, gummata being met with later in the skin, mucous mem- 



1 196 



DISEASE GERMS. 



branes, periosteum, bone and lymphatic glands. The usual 
history helps in the diagnosis, as rash, throat, bones, miscar- 
riages, or children dying soon after birth, etc. The eyes seem 
weak, the eyelids sore. The parts about the mouth, nostrils, 
buttocks, anus, flexures of joints get copper-colored, fissured 
and excoriated. A dermatitis about the pelvic region is not 
always specific, and may be due to wet napkins, etc., although if 
reaching beyond the limits enclosed by the napkin, i. c, down 
the legs and up on the abdomen, it is syphilitic. A detachment 
of the epidermis from the palms and soles is an almost certain 
sign of the disease. In the various systems the following lesions 
are met with : 

Skin. — Dermatitis and detachment of the epidermis as stated. 
Deep red or copper-colored blotches on palms, soles and pelvic 
region (gluteal folds and genitals). Mucous tubercles about the 
anus and flexure of the groin, condylomata about scrotum, and 
on neck, thigh and arms. 

Mucous Membranes. — Condylomata and mucous tubercles about 
the mouth and anus, bucco-pharyngeal mucous membrane, and 
in larynx. A chronic inflammation and ulceration of the mucous 
membrane of nose causing " snufiles." At the angles of the 
mouth we get ulcers leaving cicatrices (specific stomatitis). 

Bones. — Periostitis leading to formation of nodes ; 

Diffuse ostitis, causing hypertrophy and sclerosis. 

Ulceration, causing caries and necrosis (in the case of the nose 
causing the bridge to fall in). 

Cranio-tabes from atrophy (often not specific as is rickets). 

Cranial bosses (often not specific as is rickets). 

Separation of the epiphyses. 

Stoppage of ossification. 

Eye. — Acute iritis, interstitial keratitis. 

Ear. — Otitis. The disease in question is the most common 
cause of double deafness in children. 

Voice. — Lary n giti s . 

Teeth. — Notched (the permanent ones). 

Visceral. — Congestion and fibroid enlargement of liver and 
spleen. Peri-hepatitis is one cause of infantile jaundice and 
ascites. 

Chronic inflammation of cerebral arteries. 

Meningitis, hydrocephalus, pulmonary affections, etc. 

With regard to infantile syphilis, this is either hereditar}' or 
acquired. If the former, it is transmitted from one or both 
parents, and the infected foetus may be expelled with a clean skin 
and the characteristic rash not displayed for six weeks after birth ; 
if the latter, the immediate contagion may be from the nipple of 
the nurse, or from kissintr, or from some article of dress. 



BACTERICIDES. 



I 197 



The presence of the syphilitic germ in an infant gives rise to a 
shrivelled or emaciated appearance. Some cutaneous manifesta- 
tion appears near the sixth week. Defective nutrition, in the 
form of emaciation or marasmus. Emaciation progresses 
rapidly ; the skin seems to stretch unnaturally over the facial 
bones ; the expression is one of distress ; the cry becomes a 
fretful moan ; the skin loses its natural hue, and acquires a 
sallow or muddy tint ; and very peculiar wrinkles or puckered 
lines radiate from the angles of the lips. The faces of those 
germ-eaten creatures have the appearance of age. 

In the recognition of the disease, the history of the case, the 
copper-colored appearance of the rash, together with syphilitic 
coryza, give a clew to the presence of the germ. The discharge 
from the nose, at first serous, later purulent, desiccating suffi- 
ciently to obstruct the nasal passage. 

Crusts form about the nose and angles of the mouth, giving 
rise to the snuffles, obstruct respiration. 

The mouth, larynx, vulva, anus are often the seat of mucous 
patches or condylomata. 



The liver in our country is 
The Venereal Bacillus. naturally weak, being exposed to 
(The Pathogenic Microbe of the malarial germ, the irritating 
Syphilis in the Liver. action of carbonaceous food and 
Syphilitic Hepatitis}) drink, and to this organ the bacil- 

lus often migrates. Let the germ 
enter the body- of a person with a weak or devitalized liver, the 
first thing we often observe is syphilitic hepatitis. As a rule, 









Fatty liver, interspersed with 
Microbe of syphilis in the liver, the syphilitic germ. 

the syphilitic germ does not manifest any special preference for 
the liver, like the skin or mucous membrane ; it does not seem 
to be a pleasant or congenial pasture field. When it takes that 
organ for its abode, it colonizes in three forms : (i) germs gen- 
erally diffused through interstitial structure ; (2) a large congre- 
gation of germs, colonies varying in size from a linseed to a bean ; 
(3) in large irregular patches. 



1 198 



DISEASE GERMS. 



Symptoms. — Sometimes there are all the indications of chronic 
inflammation of the liver ; in other cases, there are few, if any, 
symptoms present but jaundice, a coppered-colored appearance 
of mucous membrane, with other marks of syphilitic cachexia, 
enlargement of spleen and albuminuria. 

When the microbe migrates to the liver, there is usually all the 
symptoms of jaundice present ; nausea, vomiting, brown-coated 
tongue, yellow skin and conjunctiva, itching in the skin, cla}'-col- 





Syphilitic microbe in the liver. Another form of syphilitic 

microbe in the liver- 

ored stools. The usual treatment for the destruction of the 
syphilitic germ must be persevered with, to wit, saxifraga, Phyto- 
lacca, comp. dioxide of hydrogen, etc. 

In addition, local stimulants over the liver, as either the irri- 
tating plaster, or take iodoform, one ounce ; ether sulphuric, suf- 
ficient quantity to dissolve it. Mix. Paint freely over the region 
of the liver twice daily ; or ozonized iodine. Internally, such 
remedies as phosphate of soda, nitro-muriatic acid, fringe tree, 
with chloride of ammonia. 

These remedies exercise a most salutary action on the liver. 

In all cases, it is most important to attend to this germ migra- 
tion and at the same time take care of the mother germ and its 
brood of spores in the blood. 



All individuals who have the 

The Venereal Bacillus, pathogenic microbe in their blood, 

{TJic Microbe in the Liings}j if their lungs be weakened in any 

way or from any cause, are liable 
to have a migration of that bacillus to that weakened point, when 
it passes by the name of syphilitic phthisis. 

There can be no question, that in the majority of instances 
in which phthisis has been produced through acquired syphilis 
— and syphilitic phthisis is more prevalent than is generally be- 
lieved — the symptoms, physical signs, and course of the disease 
are peculiar and characteristic, and distinguish it somewhat from 
other forms of phthisis. There is no doubt, too, that many cases 
which are regarded as examples of ordinary phthisis possess a 



BACTERICIDES. ngg 

congenital element of syphilis, and that this disturbs the normal 
course of the disease. Just to what extent this factor is opera- 
tive we are not prepared to say, but it is very certain that some 
cases of ordinary phthisis are more readily influenced by micro- 
bicides than others. 

Although syphilitic phthisis is a well-reorganized disease, so 
far as its pathology goes, I am convinced that clinically it is not 
understood as well as it should be ; and in order to aid as much 
as I possibly can in determining it from other diseases, I shall 
endeavor to lay before you the salient points of the disease as 
they occur in its clinical course. 

The characteristic signs and symptoms which distinguish the 
syphilitic from the non-syphilitic form of the disease are chiefly 
an absence of well-defined physical features in its earlier stages, 
frequently the only evidence of the presence or the disease being 
a wavy respiration, or an impaired respiratory sound. However, 
when crepitation appears it commences suddenly, and is usually 






The sputum in syphilitic Micrococci in the sputum in Mould of bronchial twigs 

phthisis. syphilitic bronchitis. expectorated m a case 

of syphilitic bronchitis, 

■of a loud, moist character, and may diffuse itself very rapidly 
over the whole side of the chest. Haemoptysis is generally a 
prominent factor ; there are no persistent, well-defined fever and 
night-sweats ; the expectoration is frequently tough, white, 
stringy, and abundant ; the patient, as a rule, is anaemic, subject 
to diarrhea and vomiting ; the marked anorexia and wasting 
do not appear early ; and every change which occurs in the course 
of the disease, either toward recovery or death, is generally more 
marked and sudden than in the ordinary form. 

The absence of fever, or the tendency of the fever to assume 
an irregular or abnormal course, I regard as • one of the most 
valuable symptoms in differentiating this form of phthisis. When- 
ever I meet with a constant low temperature in such cases, my 
suspicion of infection is always aroused, in spite of the absence 
of other satisfactory evidence. The presence of fever is deter- 
mined, I think, in a great degree by the rapidity of the destruc- 
tive process. If this assumes a gangrenous form, as it does oc- 
casionally, the fever, as a rule, runs high. In addition, there 
may be aching pains in the sternal region, over the crest of the 
tibia, as well as in some of the articulations. 






The venereal bacillus in lung structure, found forty-e.ght hours after death in a case of syphilitic phthisk 



BACTERICIDES. 



201 



Also enlargement of the post-cervical glands, with nocturnal 
pains in the bones. 

There is a great difference between the behavior of microbe 
of syphilis and the tubercle bacilli in the lung, an interstitial as 
well as an anatomical difference. 

The anatomical changes in the lung chargeable to syphilis are 
cicatrices, connective-tissue growth, gummata, and chronic in- 
duration of the pulmonary tissue in the form of peri-bronchial 
growths, nodular formations, and diffuse lobular condensation, 
which generally start from the bronchus of the part (diffuse 
syphilitic infiltration). 

The diagnosis of these changes during life may be made with 
a certain degree of probability at times, but can never be made 
with certainty. The shortness of breath, cough, scanty and 
sometimes bloody expectoration, and other signs, rational as well 
as physical, are so wanting in characteristic peculiarities that the 
syphilitic nature of the affection cannot be made out from them. 
The diagnosis is to be based rather on the history of the case, 
the presence of well-known symptoms of general syphilitic infec- 
tion, and laryngoscopic examination, which will reveal in nearly 
all cases of pulmonary syphilis old lesions of the upper air-pas- 
sages. 

The tubercular and syphilitic bacilli may co-exist in the same 
lung, and both can be detected and isolated in the sputum. 








Syphilitic brrnch'tis with myriads of Transverse fertion of bronchial wall m" 

'perms at work forty e yht h urs after syphilitic bronchitis with the venereal 

death. Magiiilied 50 diameters. bacillus hard at work i'orty-eichi hours 

after death. 

The most common form in which the syphilitic germ appears 
in the lung is the gummata. These vary in size from a pea to 
an eg?, and are either single or in groups, appearing in the lun^s 
as well-defined rounded tumors, surrounded by a fibrous capsule 
and usually deep seated. The microbe in its eating operations on 
the lung has fibrous tissue thrown out with it. The presence of the 
gummata in the lung causes it to be more weighty, larger, more 
dense. White, dry specks are seen on a section of it. There is 
also thickening of the alveolar walls, and minute bronchi, thick- 
ening and obliteration of pulmonary areas. 

76 



1202 DISEASE GERMS. 

Any irritation in the lungs of a syphilitic patient may cause 
gummata to form, and abscesses are quite common. There may 
be masses, nests of the tubercle bacilli, right alongside of the 
gummata in the same lung. 

There is also in syphilitic cases a deposit of the germ on the 
bronchial mucous membrane, which gives rise to the syphililic 
asthma or bronchitis, or both. In some cases there is great 
ulceration, with copious expectoration, with the microbe in 
sputum. 

Lung and bronchial syphilis resemble in their symptoms tuber- 
cular affections of the same organs. 

Lung syphilis more generally follows inhalation of the germ 
by sleeping with an individual affected, or by berthing in a Pull- 
man with germ-saturated persons, or by kissing, or from the 
use of drinking vessels, than when the germ enters through a 
pock on the genital organs. Still, if the lungs are weak, we may 
have bronchial and lung syphilis before the germ appears in any 
other location. 

The weaker the aff^jcted individual or organ, the more virulent 
and active the germ. There are no sta^-es — microbial infection 
calls for none. There is no protection from one or a dozen 
attacks ; every time the germ enters, a fresh attack. 



At whatever point the syph- 

The Venereal Bacillus. ilitic microbe enters the body, 

( The Pathogenic Syphilitic whether it be by a hard chan- 

Microbe in the Lynipliatics— ere on the penis, or on the 

Syphilitic Bilbo) lip, or on the nipple, or 

through the endosmosis of a 
kiss, or contact by a drinking vessel or a towel, the lymphatics 
in the vicinity convey the microbe into the blood; in this process 
they themselves become contaminated by the deadly microbe, 
and suffer a partial death in the presence of the germ ; inflam- 
mation of the lymphatics takes place ; they become clogged up 
with germs and products of inflammation, and form what is 
termed buboes. The seat and virulence of the sore determines 
in a great measure the kind or quality of the bubo. 

All the muscles of the 

The Venereal Bacillus. body may become the seat 

(The Svphi/ific Germ of the syphilitic germ. The 

Enterino; Muscular Structure — muscle most frequently af- 

Myositis Syphilitica) fected is the sphincter ani. 

The localizing of the germ 
on this muscle gives rise to great pain, tenesmus before and after 



BACTERICIDES 



1203 



defecation, which often lasts for hours. The pain is aggravated 
by pressure from without. Women are more subject to it than 
men. The whole muscle is not affected ; sound bundles of fibres 
may be found among the diseased ones. 

Both the blood vessels of the perimysium and the nuclei of 
the sarcolemma are involved in the inflammatory process. As 
the affection of the sphincter may last long after the other symp- 
toms of syphilis have disappeared, we may have to treat the con- 
traction of the muscle and the consequent pain by sphincter- 
otomy. 



The Venereal Bacillus. 

( The Pathogenic Microb^of 

Syp] Litis in the Male Urethra; or the 

Female Vagina^ 



Hard, indurated in- 
fecting chancres are met 
with in both locations, 
and require tact and 
good judgment, with re- 
liable remedies, to effect 
their destruction. In the male, gelatinized bougies of iodol can 
be introduced, and the germ colony gradually killed off. In 
the female, the task is much easier, as the capacity of the vagina 
will admit of copious vaginal injections of either boroglyceride 
or resorcin, or creolin, or even packing the vagina with borogly- 
ceride, are usually successful in wiping out the sore, together 
with bactericides internally. 

Another form of location, but much less frequent, is the ap- 
pearance in the form of papillomata, or warts, or condylomata. 
In ihe male urethra .,-^.— ^.-^^t,-^— ^- - 

these are not mfre- 
quently mistaken for 
organic strictures, and 
very foolishly dilated, 
curetted, even burned 
out with electrolysis 
with no result what- fQ 
ever but a return of 
the affection. In the C^ 
vagina of the female, ^ 
they also appear as 
papilloma, warts, con- 
dylomata, and unless a very careful examination is made, the 
leucorrheal discharge is often mistaken for some other affection. 
In all cases of supposed stricture of the urethra, the endoscope 
should be used for the purpose of making a diagnosis. If warts 
are present they are readily seen in the form of gelatinous 




Vegetating condylomata of the vulva. 



1204 



DISEASE GERMS. 



growths of various sizes, studded over the canal. In the female 
the Fame procedure should be adopted, although here they can 
be readily felt. 

In the form of papilloma, either in the male urethra or the fe- 
male vagina, the introduction of the oil of thuja speedily steri- 
lizes the germs and causes them in all cases to peel off — effects 
a cure. 

Frequently around the corona glandis, on the penis, or on the 
vulva, orifice of the urethra, or on the internal labia, these papil- 
loma make their appearance, and are most annoying. 

It is well to bear in mind that cleansing off by a lotion of per- 
oxide of hydrogen, and subsequently applying oil of thuja sev- 
eral times, they readily disappear. 



Chancres in and around the 
The Venereal Bacillus, nose are rare. The slightest ab- 
{^TIlc Pathogenic Syphilitic rasion at the entrance of the nos- 
Microbe in the Nasal trils and the application of the 

Cavity') microbe by an infected towel, in- 

strument, etc., may be the exciting 
cause. Later on, especially if mercury or debilitating treatment 
be used, the region of the nasal fossa is often the abode of the 
germ. 

Symptoms vary according to the period of germ growth and 
number of spores and germs present ; ulcers surrounded by a bor- 
der of inflammatory tissue are seen on the anterior portion of the 
septum and inferior turbinated bone, while posteriorly they are 
localized behind the uvula and soft palate. The symptoms com- 
plained of by patients vary with the position of the lesions. Thus, 
if the latter be situated anteriorly there will be a sensation of 
heat and discomfort, with slight muco-purulent discharge ; if 
posteriorly, the disturbances will affect swallowing and hearing, 
and impart a nasal twang to the voice. Examination reveals the 
characteristic patches on the mucous membrane, with, later on, 
ulcerations. Along with these appearances there will be the 
usual constitutional manifestations in other parts of the body. 
Syphilitic condylomata occasionally make their appearance on 
the border between the skin and nasal mucous membrane. 

It is, however, in the later or tertiary stages that the ravages 
of nasal syphilis are most clearly manifest, The most wide- 
spread destruction of the nose, externally and internally, is by no 
means uncommon. Ulceration of the integuments may spread 
from without inwards, or from within outwards, destroying the 
tissues and forming ashy colored open sores, with the character- 



BACTERICIDES. 1 205 

istic indented edges and indurations. These ulcerations spread 
in depth and width and, unless arrested, permanently destroy the 
shape of the nose. Flattening and collapse of the bridge, and 
partial disappearance of the whole organ, are not unfrequently 
met with. The internal lesions are, however, the more common. 
The earliest symptom is a gummatous infiltration of the mucous 
membrane, which is at first apparently harmless, and may readi- 
ly be mistaken for chronic rhinitis. 

Obstruction of the nose, disturbances of smell, increased 
mucous discharge and a change in the timbre of the voice are at 
first the only diagnostic symptoms. Gradually, however, the 
discharge becomes thicker and more purulent, but not fetid. 
About this period examination will reveal ulcers on the septum 
and turbinated bones, The next stage is the presence of fetid 
discharge, sinking of the bridge of the nose, perforation of the 
septum, and caries and necrosis of the turbinated bones. The 
diseased bones can be seen as dark masses projecting into the 
nasal cavities and emitting a sickening stench (syphilitic ozaena). 
In these cases the discharge from the nose is generally abundant, 
and no amount of syringing with disinfectants can remove its 
foetor. If the vomer be attacked the bridge of the nose will fall 
in and become characteristically flattened ; on the contrary, if 
the cartilage of the septum only is destroyed the tip of the nose 
will collapse. 

The ravages of the disease do not, however, in the worst cases 
stop here, for they may extend to the lachrymal canal, or the 
ethmoid and sphenoid bones, and large pieces of these may be 
thrown off. Even the brain has been occasionally laid bare, 
and this has been followed by meningeal inflammation and death. 
The odor from syphilitic ozsena is peculiarly repulsive and dis- 
gusting, and cannot be removed by disinfectants. In its char- 
acter and obstinacy in this respect it differs very distinctly from 
true ozaena, and should not be confounded with it. 

The diagnosis of nasal syphilis during the early stage of gum- 
matous rhinitis, may be difficult ; later on the collateral symp- 
toms will be a good guide. 

The prognosis, provided bactericides are pursued with vigor, 
is good. 

General remedies. — Nose must be cleaned out with lotions of 
creolin, resorcin, permanganate potass, which are of a stimulating, 
detergent, deodorizing character. 

Stimulating, antiseptic inhalation of distillation of the pine, 
eucalyptus, jequirity, are of great value. 

Push general treatment, which will consist of iodide of potass 
in comp. saxifraga and phytolacca. 



I2o6 DISEASE GERMS. 

The venereal bacillus is 
The Venereal Bacilius. dualistic, consisting of two 

{The Pathogenic Microbe on the microbes, one immature, 
Skin — D em iqto- Syphilis.) the other full-fledged. The 

imniatnre gives rise to soft, 
non-infecting sores (soft chancres), and a gonorrhea, but the 
germ is too feeble to enter the blood, hence there are no blood 
or tissue lesions ; the mature germ, if inoculated on any part of 
the body, ogives us an indurated chancre, in which resides the 
true syphilitic germ, which enters the blood and produces the 
gravest form of blood changes. This, the true syphilitic germ, 
may appear in the urethra or vagina and give rise to some dis- 
charge. It is not at all necessary for this microbe to have an 
inoculation, a breeding place, a focus from which the blood can 
be saturated, hence the entire body, for it can be communicated 
from individual to individual by breath, by close contact, by 
kissing, drinking cups, towels, seats, cars, etc. 

This is the pathogenic germ of syphilis ; the immature germ 
of a soft chancre can do no more harm than excite local inflam- 
mation ; it has not advanced in the scale of microbial existence 
to enter the blood. 

The true microbe syphilitica, once in the blood, seeks the 
weakest part, and there either grows, or if vital force is moder- 
ately good, may remain latent. 

Suppose a depreciation has occurred and the cutaneous surface 
weakened, then the microbe will make his appearance in any or 
all of the numerous forms of skin affections. 

The diagnosis of these are important, that is, the difference 
between simple skin eruptions and those that contain the patho- 
genic microbe of syphilis. In making this, the history of the 
case is fallacious, as the germ can effect an entrance without a 
pock or primary sore ; the history of the case has no bearing in 
diagnosis, neither have such terms as primary, secondary or ter- 
tiary ; the germ will, if present, show itself microscopically and 
the appearance of the syphilitic eruption must be taken as it 
exists ; without a history of the case. 

The appearance of the complexion of a microbe-syphilitic 
patient is remarkable. More prevalent in a chronic case than in 
one which the microbe has recently effected an entrance ; also 
influenced by the number of germs present in the blood and the 
constitution of the individual. 

We must not, for example, expect to meet with it at the begin- 
ning of an outbreak of secondary specific roseola; but if the dis- 
ease has lasted for some months, we shall almost surely find that 
it has produced a peculiar change in complexion, which is best 



BACTERICIDES. 



I 20)^ 



described as a pale and dirty opaque appearance. This change in 
color is due to two causes. (1) The paleness is the result of 
general anaemia from an impoverished condition of the blood, 
which may often be demonstrated by placing a little blood under 




The venereal bacillus on the skin in the 
i'jxvn. of a lichenous msh, assiciaied 
\v;<h Hroiipsofihe niiur -coccu-; furfur. 
A splendi 1 photograph of a living 
case 




-.vf- 



'■\\ 



'^, 



7 



'^. 



V 



Micococcus furfur — with groups ot 
-spores — taken froir- the same 



the microscope, when many pale corpuscles will be seen. (2) The 
muddy, opaque or dirty look is due to an abnormal increase in 
the pigmentation of the skin. I know of no disease that, pro- 
duces an exactly similar 

appea-ance. It is scarcely .-^^t*^ 

necessary to add that it is 
general and quite inde- 
pendent of the " coppery 
hue" of syphilitic erup- 
tion.s. 

The bacillus of tubercle 
and the microbe of .syph- 
ilis united on the face, 
forming indolent, circular 
or crescentic losses of skin 
isubstance. covered with 
crusts. The floor of each 
is a granulating, pale red- 
dish surface, with a cop- 
per-colored ring around^ 
in which the syphilitic 
microbe is found ; the 
edg*:s are notched from 
the occurrence of succes- 
sive crops of the two bacil'i. Those microbes grow slowly, 
coa'e^ce, but isolate themselves in nutrient fluid. 

We note that the syphilitic eruptions develop ivith remarkabl 




The bacillus of tubercle and li 



.|2o8 DISEASE GERMS. 

slowness and m/i a protracted course as compared with the simple 
inflammatory diseases of the skin which they closely resemble. 
Thty also have an especial tendency to recur. This rule does 
not apply to syphilitic zz/crr^, which, compared with non-syphi'itic 
ones, often run a rapid course, but nevertheless, taj<ing a general 
view, the rule holds good, and is especially applicable in distin- 
guishing syphilitic eruptions resembling varicella or varioloid 
from those diseases, and syphilitic rose rashes from urticaria, 
erythema and measles. 

The color of syphilitic eruptions is often remarkable and highly 
characteristic; it is described as coppery. This peculiarity of 
color varies with the age of the eruption and other attendant 
circumstances. It is of the first importance to recollect that the 
typical color is rarely met with in recent syphilitic roseola, which 
follows closely on the primary sore ; on the contrary, this rose 
rash is at first quite bright, and of a clear 
red or pink, and without the slightest trace 
of anything syphilitic in its appearance ; 
when, however, it has lasted for some time, 
an irregular increase in the pigment of the 
skin occurs, and then we have the dirty 




Tenia Tonsurans in a syphilitic casc. In praclicc we mcct wlth various 

patient — the vegetable fiin- 
gu> greatly modified by the 
aciioM ( ' 
microbe. 



^^:Z:S^lX shades of color, from the pale dirty brown 
ac.ion of the pathogenic ^q ^hc typical coppcr-coIorcd blotch, and 
from this again to the deep purplish-brown, 
or almost black pigment stain, which is sometimes left after a 
syphilitic sore has healed. Indeed there is no other disease of 
the skin which leads to more remarkable changes in the rete 
Malpighii. 

Of all the characters which distinguish dermato-syphilis, per> 
haps polynioryhisni, or the appearance of sev^eral forms of erup- 
tion at the same time, is most important, because in no simple 
disease is this peculiarity developed to anything like the same 
extent or with equal frequency. It is, in fact, the exception to 
find a syphilitic eruption assuming a uniform appearance in dif- 
ferent parts of the body. For example, we may find maculae in 
one part, and mucous tubercles in another, or ulcers in one part, 
and nodes in another ; or we may even find four or five diffc;rent 
forms of eruption on one and the same individual. Hence the 
great importance of examining every part of the eruption in 
doubtful cases. A red patch on the chest may present none of 
the characters of syphilis, but if we find also a typical ulcer on 
the arm. there will be no difficulty in arriving at a diagnosis. 

Locality^ as a means of diagnosis, is sometimes of value. 



BACTERICIDES. £209 

Secondary eruptions which ' follow closely on the sore, are com- 
monly syinnicti'ical ; but remote eruptions are, on the contrary, 
generally nnsyini/ictrical, tJiongJi frequently both-sided. The rea- 
son of this diffjrence is, that recent eruptions occur while the 
microbe is still in the blood, while remote eruptions occur after the 
perm has migrated everywhere, when all the tissues of the body 
have probably undergone some obscure change, which is manifest 
by the development of syphilitic growths. Ulcers often appear en 
the arm, abdomen, without any apparent cause. Certain forms 
of alopeci I, seborrhcei, appear on the scalp, and sometimes on 
the pabis ; syphilitica roseo'a, maculae, pemphigus, on the palms 
of the hands and soles of the feet. In all forms there is a per- 
fect lack of sensibility and copper-colored appearance of the 
emotion. 

If the affjcted individual be tubercular, or acquire that condi- 
tion during the progress of syphilitic germ life, all forms of the 
eruptions will be either round, crescentic, or serpiginous, but 
copper-colored, with lack of sensibility. 

Irritation, pain, itching, are at a minimum in all syphiHtic 
eruptions. 

The microbe can be found in the crusts of the sores, hence 
thev are typical syphilitic. 

The fre4uent development of tubercles in the skin, in conjunc- 
tion with other changes, is extremely characteristic, as those are 
never found in any other skin affection. Gummata and tubercles 
never can be confounded with any other affection. 

The occurrence of ulcers of a round, serpiginou=;, crescentic, or 
horseshoe shape, with sharply cut edges, and of the character- 
istic copper-color, or ash-gray, is an important sign of the pres- 
ence of the microbe. 

The presence of white, flattish scars on different parts of the 
body is sometimes an aid to diagnosis. It will generally be 
possible to obtain a history of these scars, and if they have been 
produced by sores which occurred without any such apparent 
^cause as bu'-n=;, injuries, or bed-sores, there will be presumptive 
evidence of a former attack of syphilis, and this will be all the 
stronger if they are pretty numerous, and found on the trunk, 
thighs, arms, or scalp. We must be very careful, however, in 
drawing conclusions with regard to a single scar found on the 
face or shin. 

The chronic indurated enlargement of the lymphatic glands in 
different parts of the body, without any apparent local cause, is a 
dia'Tfnostic sign of syphilis of the first importance. 

The foregoing remarks apply more or less to dermato-syphilis 
generally. It will now be necessary to enumerate in detail the 



12IO 



DISEASE GERMS. 



principal forms assumed by syphilitic eruptions, and also to point 
out briefly the peculiarities that disting^uish each variety. 

The common recent secondary eruption are the following: (i) 
Roseola, or rose rash. (2) Maculae. (3) Papular eruptions 
(syphilitic lichen, so called). (4) Mucous tubercles and patches, 
\ve also meet with alopecia, pustules and ulcers, but of these the 





The venereal bacillus. Aiuist syphililic 
eczema ot the lace, l^a niebs, copper 
colored. 



The venen al bacillus Dry syphilitic ecaema. 
Devoid of p.iin, and copper colored. 



two latter are less common on the skin as recent secondary 
forms, and usually occur only in severe cases. There is no well- 
defined line of demarcation between the recent and the remote 
secondary eruptions, of which latter the following are the most 





The venereal bacillus. Syphilitic Lepra. 
Scattered sp.jrstly over the fore-arms. 
Painless, copper colored. 



The venereal bacillus. Lepra syphi- 
litica, with paral\sis of the extensor 
muscles of thu fingers. 



common: (5) Pu.stules, particularly ecthymatous and acne- 
form. (6) Seborrhoea and alopecia. (7) Squamous patches. 
(8) Tubercles. (9) Ulcers. (jo) Rupia. (n) Onychia. 
There are many other varieties of syphilitic eruptions, but they 
hardly require any special description. 

Congenital syphilides correspond very closely with secondary 
eruptions, but coppery blotches and mucous tubercles are the 
prevailing forms. Bullae, though rare, are more common in con- 
genital syphilis than in the acquired disease. 

Rose rash or roseola syphilitica, when it first appears, may be 
very easily mistaken for other red rashes if we trust alone to its 



BACTERICIDES. 



12 



appearance, which is often identical with simple erythema. It is 
in this form of the disease that the history of a primary sore and 
other symptoms are of the greatest value for the purposes of dif- 
ferential diagnosis. Syphilitic roseola always follows closely on 
the primary disease (inoculation) ; indeed it often develops be- 
fore that has disappeared. It is frequently accompanied by the 
characteristic sore-throat, and other well-known symptoms, and 
at the outset of the eruption, these .general symptoms are our 
chief means of diagnosis. A little later on, when pigmentation 
occurs, the dia:^nosis is easy. Syphilitic roseola may, in the 
first instance, be readily distinguished from measles and German 
measles, by the febrile and catarrhal symptoms of those mala- 
dies. Pigmented syphilitis rose-spots become more defined by 
exposure to cold ; the reverse is the case with the simple red 
rashes. Again, the subjective sen- 
sations are more marked in the 
latter than in the former. 

Syphilitic macules are among 
the commonest manifestations of 
the disease. They may be red, 
livid, copper-colored, dirty brown, 
purple, or almost black, the tint 
of color being produced by the 
varying combinations of local 
hyperaemia and abnormal pig- 
mentation. They may occur as 
recent or remote secondary erup- 
tions ; in the former, the hy- 
peraemia usually preponderates 
over the pigmentation, and therefore the red or bright copper- 
colored maculae ajre the most common. The yellowish syphilitic 
pigment spots, especially about the forehead, may be easily mis- 
taken for chloasma or freckles. The pigmentary syphilide which 
is sometimes met with on the back of the neck in women, is 
generally a remote secondary eruption. 

Papular dertnato- syphilis for the most part follows quickly on 
roseola ; mucous tubercles, and patches, are the most character- 
istic evidence of the germ. 

Pustular-dermato-syphilis may assume many forms. It may 
closely resemble acne, variola, ecthyma. 

Pustular-syphilitic rash on face, back and body, very common 
in broken-down subjects. Syphilitic alopecia very common. It 
takes the form of a thinning of the hair of the whole of the head, 
and is not at all confined to the parts usually affected with bald- 
ness. It commonly occurs as a secondary affection, and is often 




Syp^iilitic microTie attacking the tiiberoFities 
of vari m-; honis. The nodules if germs 
on ihe elbows and knees were thick y set. 



212 



DISEASE GERMS. 



associated with scboii^Jiosa. The head becomes covered with 
dirty yellow scales, and the hair harsh and brittle, so that it 
breaks off and also combs out easily. Sometimes alopecia is 
associated with a distinct active syphilitic inflammation of the 




Syphilitic papulae, with germ laden blood, 
'i he gemimi syphil lie inicr. I'C :ippcar. 
ing ill ilic turin of coppei-coloitil paj u se 
on the face. 'I'h' re vv.is no ori^;iiial p -ck 
— ihe sysiem was s:itiirattd wiih the 
niicrnbe ihioiijih vsashing the clothes of 
ail uifccted brother. 




: p- on IMS, cnverinjj 
;ht-st all haci-c I tie dead 
vtiieieai bacillus could lie 
isolated Imni the scales; 
spore could bear culiivuiiou. 



scalp resembling eczema, and producing a discharge which forms 
dirty unhealthy-looking crusts ; as these are removed the hairs 
come out. It may be distinguished from simple eczema by the 
absence of itching and irritation, by the character of the crusts, 

the rapid loss of hair, 
and by the peculiar 
and very disagreeable 
smell and the presence 
of specific symptoms 
in other parts of the 
body. 

Squamous sypJiilidcs 
are either diffuse or 
circumscribed. The 
former are usually a 
later stage of some papular, mascular or rose ash, and as such 
are not difficult to recognize; the scales are thin, there is on 
itching, and the skin is more or less abnormally pigmented, 
which gives it the peculiar dirty look to which I have so often 
referred. In short, scaly affections of this kind are little more 
than a chronic desquamative stage of previous eruptions. 




Syphilitic Rupiaand Ichthyosis. 



BACTERICIDES 



1213 



The circumscribed forms of scaly dermato-syphilis are more 
important, and may be easily confounded with dry eczema or 
psoriasis vulgaris, particularly the latter, which often leaves be- 
hind brown pigment-spots. The syphilitic scaly eruptions, how- 
ever, do not especially 
attack the point of the 
elbow and the skin 
below the knee-pan, 
though they may oc- 
casionally appear there 
as elsewhere. The 
scales are thinner and 
dirtier than those of 
psoriasis and more diffi- 
cult to remove, and the 
corium does not blend 
readily on their re- 
moval, as is the case in 
psoriasis ; pigmenta- 
tion is usually well 
maik:d and of typical 
color. Itching is rarely 
present. Moreover the 
scalp is often affected, 
and this is invariably 
attended with loss of 
hair, whereas simple 
psoriasis, when it attacks the scalp, has but little effect on the 
hair. Listly.^the complexion of those who suffer from the latter 
disease is clear and fresh, and contrasts remarkably with that of 
the constitutionally syphilitic patient. 

Psoriasis palmaris and plantaris, as it is miscalled, is always 
either of syphiliiic origin or a dry eczema of the palm. It differs 
in apparance and nature from true psoriasis, which, moreover, 
never occurs as simply a palmar eruption. It usually shows 
itself as a small copper-colored spot; this gradually becomes 
scaly, with a desquamation of epithelium, leaving a somewhat 
thickened, raised, or di ty ragged edge. The tendency of these 
patches is '^o spread at the circumference. Scfmetimcs the cuticle 
becomes thickened, brittle, and fissured. The affection is very 
chronic, and often very inveterate. It may be confounded with 
dry cracked abortive eczema of the palm, but the appearance is 
different, the itching and pain are much less, the history of the 
commencement is also different, and lastly, eczema rarely occurs 
on the palm without being, or having been also 'present else- 
where. 




Syphilitic g*'in papii'a; (Ik hen), has the diHgnostic character- 
isiics — «.oppir-coiore(l, lack of sensibility. 



214 



DISEASE GERMS. 



Syphilitic squamous patches are not uncommon about the peri- 
naeum, scrotum, and penis. They usually present a rounded, 
well-defined border, and from their situation are apt to become 
red, inflamed, and very chronic. They may be easily mistaken 
for old patches of psoriasis or eczema ; the latter disease, how- 
ever, especially in this region, is attended with intolerable itching, 
and although this form of syphilis is also often irritable, yet the 





Syphi itic lupia a'most 
Covering ihe eniire 
body. 



Mollusaim cpiihelia, associated with inherited 
syphilis, showing ihe copper-colored eruption 
on neck. 



itching is far less than in simple eczema. The previous general 
history is here a valuable guide, but it must be admitted that the 
diagnosis is sometimes difficult. 

SypJiilitic tubercles. — I have already referred to tubercles, and 
therefore will only add that the remote ones are "^f two kinds, 
gummy tubercles and tubercles of the connective tissue. 

Rupia is a rare eruption, typical of syphilis. It consists of pe- 
culiar hard, conical, laminated crusts of a limpet-shell shape. 
The removal of the crust exposes a specific sore. 

Onychia maligna is also frequently met with, which give rise 
to a brittle or rotten condition of the nails. 

The syphilitic germ modifies all cutaneous diseases, by the 
microbe altering the nutrition of the tissues; the normal re 
sisting power is weakened, so that the change in the tissues usu- 
ally produced by syphilis is impressed upon it; it is altered by 
being made more chronic, there is greater pigmentary deposit, 
less scaling, more crusting, and more infiltration, especially at 
the margin of the lesion. 

In the treatment of all forms of cutaneous syphilis, there 
should be no deviation from the general line of remedies. Anni- 



BACTERICIDES. 



1215 



hilate the microbe and build up the vital forces of the patient. 
Saxifraga and phytolacca are the remedies. If mercury is 
deemed advisable, let it be the proto-iodide, in pill form, with 
one grain of opium. If this is administered, it is a good plan not 
to exceed one twelfth of a grain, and to follow it up with larger 
doses of iodide of potass than what is contained in the saxifraga 
syrup. 

The special indications for the administration of this salt in 
dermato-syphilis are (i) the existence of periosteal affections ; (2) 
a l6w constitutional condition ; (3) the co-existence of albuminu- 
ria, other than that due to syphilis, in which case mercury is gener- 
ally contra-indicated. The most important point in connection with 





Syphilitic microbe in pustules 
(rupia). 



The venereal bacillus. The germ syphili- 
tica in pustule s oi> the hand, with moist 
gangrene of the fingers. 



the use of iodide of potassium is the fact that it soon loses its 
effect unless the dose be from time to time steadily increased. 
This should be done about once a week, otherwise the result of 
the treatment will be often disappointing. In those cases in 
which the constitutional condition is low, iodide of potassium 
should be given in combination with carbonate of ammonia and 
cinchona, and the dose gradually increased from five grains up 
to half a drachm (or more if required) three times a day. Under 
these circumstances, if there is no indication to the contrary, a 



I2l6 



DISEASE GERMS. 



dose of opium every night is of the greatest possible value. 

When there is much aniemia or albuminuiia, tlie iodide of po- 
tassium should be combined with iron, 
or with the citrate of iron and quinine. 
The great use of opium in the treat- 
ment of all syphilitic sores is too much 
forgotten. 1 have seen cases in which 

'^ >^ J **/ y^.- 'i^^ ^^1 remedies seemed to irritate, and had 

little or no effect until the nervous sys- 
tem was soothed by the action of opium. 
The use of sulphur, iodine, and ozone 
baths is attended with ^ood results in 
the severest forms of syphilitic eruption. 
They are especially useful to aid the 
action of internal remedies, and used 
about twice a week. 

Local treatment of syphilitic eruption 
is not of much utility, but they should 

be covered with ozone ointment, or sprinkled with iodol or iodide 

of starch, or the anti-microbe powder. 

Sozoiodol is the best remedy for indolent ulcers ; the ulcers 

should , first be washed with a solution of boroglyceiiJe, then 




Syphilitic Ichthyosis 




Dry pangtene. rne r f ihefflTectsof the A'cnereal 
b;<ciihis. This !-tiiie is iistially u-litr- ri in 
wiih iiuense nocturnal j a n in ihe 1 ali of ihe 
gr<-at tne. After thi^ lasK a few weeks the 
Uiherosiiy beiomes r f a bluish color, uradu- 
fllly Hack, dry, cold, and spreads up the 
foot. 




Dry c^rg'f ne of thf foes, the venrreal 
I acillii^ fiiM aii.-iikiij: ihc niairix of 
tlir nail-, ni'il t-ia. n:<l y t aiiijij up iLe 
pans. This abo abctn^-s. 



dried and the sozoiodol sprinkled or painted on, once a day. The 
ulcer covered with a piece of dried lint. 

The sozoiodol can be either used full strength ordiluted, or put 
into ozone ointment. Being devoid of all odor, it is an elegant 
dressing. 

Localized patches of syphilitic papulre. tubercle, serpiginous 
eruptions, should either be dusted with the anti-microbe powder, 
or dressed with ozone ointment, and covered with lint. 

Spyhilitic maculae and scaly eruptions, covering a considerable 
extent of surface, are best treated with a lotion containing iodide 
of potassium and chloride of gold. This should be applied two 
or three times a day, and allowed to dry on. Syphilitic scaly 



KACTERICIDES. 



121 



eruptions of the palm are well treated in this way when it is in- 
convenient to apply ointments. Syphilitic sores and fissures 
about the mucous membrane of the tongue and mouth should be 
painted with sozoiodol. 



The Venereal Bacillus. 

(The Pathogenic Microbe of 
Syphilis in the Trachea^ 



The in ic robe of syphilis 
sometimes localizes itself on 
the trachea ; true, it is a rare 
form, but it exists, both in the 
hereditary and acquired form. 
In the earlier stage of syphilis we meet chiefly with tracheitis, 
condylomata and mucous plaques. These affections give rise to 
no grave symptoms, and yield' soon to treatment. The lesions 
which are found associated with the later stages of syphilis, are, 
however, much more serious, and often lead to death. These 
lesions are either gummous tumors or, much more commonly, 

syphilitic ulcers with surrounding in- 
filtration, which by their cicatrization 
lead to stenosis of the trachea; or, by 
an extension of the ulceration, there 
may be perichondritis, necrosis of the 
cartilage rings of the trachea, with con- 
\ ■ s \jy I I p traction and displacement of the trachea 

v''*"' 1 ^If^^ i ^^ perforation of the tracheal wall, with 

\^ !fg^ ,^ l\ abscess formation in the mediastinum; 

or again, especially if the ulcer is situa- 
ted in or near the bifurcation and in- 
volves also the large bronchi, there may 
be rupture into the pulmonary artery 
or into the arch of aorta. In most 
cases, however, death has resulted, 
suddenly after the symptoms of tracheo-stenosis had existed for- 
some time. 

The symptoms produced by syphilitic disease of the trachea 
vary with the situation and extent of the ulcerations, and with 
the presence of syphilitic disease in other portions of the respi- 
ratory tract, especially in the larynx. In an analysis by Vierling 
there was an affection of the larynx in thirty out of forty-six cases 
reported ; in sixteen, the trachea, with or without the bronchi, 
was found affected ; while in five the bronchial mucous mem-- 
brane was the only part attacked. 

The diagnosis of tracheal syphilis presents no dif^culty when 
the larynx is also affected, and when there are other syphilitic 




-^v^^^^^sAa 



Dififerent forms of microbes, or 
baccer a — micrococci of various 
forms — found in the mouth of all 
syphilitic patients on awakening 
in the morning. Magnified 750 
diameters. 



symptoms. 
77 



If, however, the trachea, alone, or the trachea 



I2i8 DISEASE GERMS. 

and the bronchi, are affected, the symptoms are those ot 
stenosis, and the differential diagnosis, between syphilis of the 
trachea and some mechanical compression of the trachea, either 
from an enlarged gland, a small intra-thoracic tumor, or an aneur- 
ism of the arch of the aorta, is not always easy. 

The most prominent symptoms of tracheal stenosis are : 
Dyspncea, most marked during inspiration, and especially 
so on any exertion of the patient. This, though a most promi- 
nent symptom, may occasionally be absent, though the obstruc- 
tion to the entrance of air into the lungs may be very great, as in 
a case reported by Beger, where there was most marked nar- 
rowing of the bifurcation and of the bronchi by a gummous 
tumor. 

A hoarse, weak, or croupy voice, even if the larynx be free 
from disease due to the weak air-cut-rent. 

Swelling of the jugulars with every expiration, due to the 
abnormally increased pressure in the large veins within the 
thorax during expiration. 

Slight downward movement of the larynx with every inspira- 
tion. This movement is much more considerable in stenosis of 
the larynx. 

The patient breathes easier with his chin depressed, as this 
causes relaxation and dilatation of the trachea. In laryngeal 
stenosis, on the other hand, the head is thrown back to facilitate 
the breathing. 

Retraction of the lower part of chest with every inspiration. 
Loud inspiratory stridor heard best over the sternum, occasion- 
ally accompanied by a thrill to be distinctly felt over the place of 
constriction. Auscultation of the lungs reveals weak breathing 
and loud rhonchi, unless there be some lung complication. It 
often happens that the stricture is at the bifurcation of the trachea, 
and extends to one bronchus rather than to both. In such cases 
we have the characteristic symptoms of stricture of a bronchus 
(diminished fremitas, diminished breathing, and more marked in- 
spiratory retraction of the ribs) on that side. 

The laryngoscopic examination may enable us to see the 
affected part, especially if stricture is high up in the trachea or if 
the ulceration is tensive; and the introduction of a sound through 
the larynx, recommended first by Demme, may in doubtful cases 
assist us in our diagnosis. In spite of these definite symptoms, 
the diagnosis between syphilitic stricture of and pressure on the 
trachea is sornetimes a matter of great difficulty. 

The most energetic treatment should be carried out, saxifraga, 
Phytolacca, manaca, iodide potass internally ; inhaling creosote, 
chlorinated soda ; nriphthaline. pinol ; locally to nape of neck, re- 
peated blisters, until two small sores are established. 



BACTERICIDES. I219 

Tne syphilitica bacillus 
The Venereal Bacillus. may find ingress into the 

{The Pathogenic Microbe Syphilitica blood through the mu- 
on the Tong7u\) cous membrane of the 

mouth, with or without 
a primary sore, or the germ may migrate to the mouth from the 
blood, giving rise to every variety of ulcer, from the simple 
round, scooped-out ulcer, to that of phagedena, with the charac- 
teristic copper-colored mucous membrane, and lack of sensibility 
which we see in the gravest form of syphilitic skin affections. 

The most common form which the microbe assumes is a sort 
of glossitis, with cracks and fissures. Deep cracks running far 
into the tongue are very characteristic. These tongues do well, 
once they are pickled down in an eight- volume solution of per- 
oxide of hydrogen. This solution should be held in the mouth 
for ten minutes at a time, and repeated twice or thrice daily. 
Under this remedy the ulcers will heal, and cicatrization take place. 

Ichthyosis LingucE Syphilitica. — Scrapingr — The syphilitic af- 
fection of the tongue and mouth known as keratosis or ichthy- 
osis linguae, or as leukoplakia specifica, which is due to unequal 
development of epithelium over different papillae, and which is 
by no means a very easy affection to treat successfully, caustic, 
astringent and disinfecting' applications having but very little 
effect upon it, is, according to Dr. Horovitz, best managed by 
mechanical scraping. He uses a sharp spoon, with which he re- 
moves the thickened epithelium ; in order to accomplish this, 
several sittings may be required. He scrapes away the indur- 
ated tissue until the surface presents the appearance of a multi- 
tude of minute bleeding points, showing that the vascular loops 
in the papillae of the dermis have been reached. lodo-glycerine, 
glycerine of borax, or a ten-per-cent. solution of sulphate of 
copper is applied to the raw surface. The pain is usually not 
severe, but in the case of sensitive persons, cocaine can be used. 

Resorcin, or thymol jelly, either make an elegant agent when 
the germ syphilitica has imbedded itself in the follicles of the 
tongue. A piece of this jelly frequently introduced into the 
mouth has a most marked effect in annihilating microbial growth, 
simply allowing it to dissolve in the mouth, and the days of the 
microbe are ended. 

or giddiness, is that peculiar sensation wherein we 
Vertigo, seem to be standing quite still, and objects running 

round us. This commonly causes loss of balance, 
and the individual may fall down. In a good many cases he is 
able to recover himself without falling, especially if he can lay 



X220 DISEASE GERMS. 

hold of anything to steady himself with for a moment. In most 
cases, giddiness depends on an insufficient or improper supply 
of blood to the brain. Thus, in giddiness after a severe illness, 
in attempting to stand upright, we have imperfect blood supply. 
In other instances the blood supply is impure from containing 
too much alcohol, or the products of imperfect food-metamor- 
phosis. In old people, when the vessels become hardened and 
unyielding, as well as incapable of due resilience, we often find 
giddiness a permanent symptom. 

Thus it is seen that vertigo is rather a symptom than a malady,, 
and a symptom, too, of very varying significance, for sometimes 
apparently over-fulness of the vessels gives rise to a kind of 
giddiness. If, for instance, the face is flushed and the head hot, 
it may be desirable to give some purgative medicine, whereas,, 
the kind referred to first of all as occurring in convalescence, is 
best remedied by a glass of wine. The subsequent manage- 
ment depends on the same principle. Where there is weakness,, 
good food and exercise are the best remedies : in the other, 
saline purgatives, with some diuretic. 

Not infrequently vertigo depends on brain disease, and such 
brain disease may be very intractable in character. Headache is 
commonly associated with such vertigo. Thus the symptom of 
giddiness, taken by itself, may teach us nothing beyond direct- 
ing attention to the case which, if carefully studied, will gradu- 
ally reveal itself to the skilful practitioner. 

When vertigo is due either to anaemic states of the brain, car- 
diac insufficiency, or obstructed kidneys, nitro-glycerine is the 
remedy. Its effects are immediate. 

If due to congestion, free secretions and the use of small doses 
of strophanthus affords speedy relief 

Essential vertigo, an impairment of equilibrium, accompanied! 
by strange sensations of varying kinds and degrees, is met with, 
as a symptom, not only of cerebral, but of a great many other 
diseases, especially those of an exhausting and debilitating char- 
acter. In fact, there is scarcely an adult but has not, at one or 
the other period of his life, experienced vertigo of some kind. 
Whereas, then, vertiginous sensations may be said to fall within 
the boundary lines of health, they may constitute a well-marked 
disease. 

Etiology. — Essential vertigo is pre-eminently a disease of the 
middle period of life ; it generally occurs between thirty- five and 
fifty, i. e., that period in which most of the nervous affections are 
developed. The remote and most important cause of vertigo is 
a neurotic disposition, and a general defective nutrition of the 
brain. In short, the victims of vertigo are recruited from among: 



BACTERICIDES. I 22 I 

that ever-increasing class of neurasthenics who have been so 
graphically depicted by the master hand of Geo. M. Beard, in 
his classical treatise on " Nervous Exhaustion." 

Among the immediate causes, exhausting diseases and excesses 
of all kinds, exposure to the rays of the sun, overheated, and 
badly ventilated rooms, indigestion, mental emotions, and malaria 
may be mentioned. The latter is, at least in our section of the 
country, responsible for the often observed recurrence of vertigo 
in predisposed individuals, and occasionally an attack of inter- 
mittent fever may be ushered in or substituted by a spell of 
vertigo. Next to hereditary predisposition, there is no more 
fertile soil for the neuroses to grow and develop upon, than ma- 
larial cachexia. 

Vertigo, a swimming in the head ; miiscce volitantes, specks or 
spots before the eyes ; and tinnitus aurinm, noises or ringing in 
the ears, are respectively due to exhaustion of the cerebral pulp 
associated either with congestion or ansemia. Vertigo, a transi- 
tory state of giddiness, a whirling or falling, surrounding objects 
appearing to be in motion, is often followed by headache, nausea. 
It is a symptom of a devitalized state of the brain, weakness or 
general disease of the blood, or it may be due to a poison, as 
opium or tobacco, or alcohol; or of some auditory, cardiac, 
gastric, intestinal or hepatic affection. Any want of equilibrium 
will give rise to it. It is often a precursor of apoplexy and 
paralysis. In aged persons it is often due to disease of the cere- 
bral arteries. Vertigo is the most common of all morbid states of 
the brain, and its great frequency must be accounted for irrespec- 
tive of disease or poison. 

It has long been known that the nervo-vital fluid within the 
skull forms a bed-plate upon which the brain rests ; that this 
watery fluid within the ventricles finds entry and exit from 
the brain into the spinal column, so that it comes and goes 
from spine to brain according as the pressure of blood is less 
or more. 

The mechanism by which the human frame is adapted to go 
upright is unnecessary to discuss. It will not do to say that it 
was the size of his brain and ambition that gave him this nervous 
energy to brace up or take the trouble to be upright. True, the 
increased size of man's brain and its peculiar richness in gray 
matter necessitates an increased supply of rich blood. The erect 
posture placed the brain aloft, so that blood supply is difficult, 
but this is guarded against and regulated by the cerebral-spinal 
fluid. Three ounces of fluid is a small quantity ; still, the circu- 
lation of blood in the cranium is subject to small changes. In 
extravasation in apoplexy the amount of blood seldom exceeds 



1222 DISEASE GERMS. 

three ounces ; there is no room for more, for that corresponds 
with the amount of cerebro-spinal fluid. 

In the recumbent posture, the entire spinal fluid is within the 
skull, which slows the heart ten to fourteen beats per minute. 
When the body is raised and the venous blood flows away 
readily from the brain, the cerebro-spinal fluid may outstrip the 
arterial blood in the race to supply its place, and thus the ventri- 
cles of the brain may fill up with water more quickly than its 
substance with blood, and so the brain blanches and the person 
feels giddy. In the anaemia of exhaustion the ventricles have an 
increased capacity, and many persons, with feeble circulation, ex- 
perience giddiness, a sense of insecurity. Besides these there are 
numerous other conditions that render vertigo more comrnon 
than the other two symptoms. 

The immense size of the human brain, and its extreme richness 
in gray matter (weighing from forty-five to sixty-five ounces.) 
necessitates a great demand for phosphates, which, if not very 
abundant in human food, gives rise to a condition of starved brain, 
of which vertigo is the only symptom. This is common in brain- 
workers who neglect a phosphatic diet. 

Stomach derangements operate reflexly and give rise to vertigo. 

Avditory Vertigo. — A condition of giddiness dependent on dis- 
ease of the ear. There is associated with it, vomiting and physi- 
cal debility; a pale, haggard expression of the features, and it 
comes on in fits, or paroxysms. 

The ear, in some way or other, is at fault, and the centres 
suffer ; usually a lowering of health, which is the great factor in 
causing the disease ; when neither stomach nor liver is at fault. 
True, stomach vertigo is very common. Auditory vertigo 
is present in ear diseases, and is liable to attack persons, 
already deaf, in a variety of forms. The pneumogastric nerve 
sends a branch to the membrana tympani, so as to enable 
us to hear the dinner-bell ; and irritation from the ear can 
be carried back so as to cause the gastric symptoms. The 
fifth nerve is also carried to the membrana tympani. 

The vast majority of cases in which vertigo of definite and 
uniform character is apparently excited by gastric disturbance, 
an auditory defect, will be discovered on careful examination. 



Very common among locomotive engi- 

Vesico-Urethral neers, who all suffer with irritability of the 

Erethism. urethra, with loss of power in the bladder. 

It is, so to speak, a special disease among 

this class of mechanics. 

The erethism, with impaired power about the bladder referred 
to, is occasioned by the series of vibrations, imparted by the 



BACTERICIDES. 122^ 

action of the engine in motion, intensified b}' the character of the 
seat used by the engineers. Ordinarily the engineer sits astride 
of a narrow seat, which presses solely on the perinaeum. Such a 
seat gives rise most promptly to the symptoms complained of, as 
it transmits directly to the perineal portion of the urethra, as well 
as to the neck of the bladder, a constant series of sudden shocks 
or successions, soon establishing an erethistic state of the sphinc- 
ter, vesicle accelerator and ejaculator urinae muscles, resulting in 
a frequent desire to micturate. In many cases' this symptom is 
so very urgent and persistent that a painful incontinence of urine 
ensues. 

Many of the symptoms presented by this class of cases are 
similar to those of organic stricture, except tliat there is seldom 
a sensitiveness induced by instrumental measures, for purposes 
of diagnosis, as it is the case in the latter condition. A spas- 
modic resistance to the introduction of a sound is sometimes ob- 
served, but when this symptom is present, a stricture of large 
calibre in the penile urethra may be expected as a complication ; 
and located without doubt, if a careful investigation is made with 
bulbous sounds. It is difficult to estabhsh a correct diagnosis in 
these cases, except by the method of- exclusion, because urethral 
erethism without central lesion is a constant symptom of organic 
stricture, which sometimes co-exists with the type of urethral ir- 
ritability under consideration. 

It is important to differentiate between these conditions of ure- 
thral irritability, because the treatment would be necessarily dif- 
ferent. When stricture is present, dilatation often relieves the 
irritation, in a measure, while it is not an advisable procedure in 
the uncomplicated type of urethral erethism which we have been 
describing, and seldom proves advantageous in the form which is 
due to central lesion. When due to the latter cause, complete 
mental and physical rest should be enjoined, but in the engineer's 
form of erethismus, relief can be obtained without necessarily 
causing the patients to cease work, provided attention be given to 
diminishing the vibratory shocks sustained by the perineo-ure- 
thral cushion. As the cause is mechanical, this can be effected 
by providing a seat with a soft, elastic cushion, supported by easy 
springs, arranged so that the w^eight of the body will be mainly 
supported by the gluteal muscles, the seat itself thus being made 
to yield to the jarring and vibration of the iron horse. 

Most decided benefit is derived from the nightly use of the co- 
caine suppository ; the internal administration of the ozonized 
uric acid solvent, alternated with glycerite of kephaline, four 
ounces ; sulphate quinine,two drachms ; nuxvomica, fluid extract, 
one and one-half drachms. Mix. Dose, thirty drops every 
three hours, added to a little water. 



1224 



DISEASE GERMS. 



The warm sitz bath, medicated with kreuznack salt, effectual u\ 
some cases. The bath particularly lessens irritability about the 
pelvic viscera, and when used adds undoubted tone to the urinary 
organs. 

Strictures of large calibre, I find, are frequent complications, 
and unless these receive due attention the symptoms are decidedly 
aggravated. 

Enlarged prostate is sometimes a complication, and I am in- 
clined to believe, is not infrequently occasioned by the continual 
irritation set up in the urethra and bladder by causes which have 
been already mentioned. 

When this condition is present the warm sitz bath will prove 
a valuable resource, and the patient should, at least once daily, 
void his urine while in the bath. Internally, benefit will follow 
the use of pichi, belladonna, and strychnia. 



Shrinking of the vulva is a peculiar form 
Vulva, Shrinking, of atrophy of the muco-cutaneous cover- 
ing of the female pudendum. The affec- 
tion is due to a pathogenic microbe. 

We reproduce the article from the treatise Diseases of IVomen : 
" The nymphse are the subject to a peculiar degenerative and 
atrophic change, which occurs only at or after the climacteric 
period. It is a very distressing complaint, and one of the most 
intractable with which we ever have to deal. It is very often, but 
by no means always, associated with vascular caruncle of the 
urethra, of which I shall speak further on. This affection has 
been alluded to by various other authors, but no description 
which I have seen includes all the facts that may be observed in 
connection v/ith it. It is always confined, in my experience, to 
the mucous membrane of the inner surfaces of the nymphae, and 
it is never met with m the labia majora, or in the vagina higher 
than the vestibule. It is a very frequent cause of the total sus- 
pension of marital intercourse, and is the real disease existing in 
a large number of cases of so-called vaginismus, a term which is 
widely used as a cloak to cover ignorance and carelessness. A 
patient suffering from this disease will nearly always be found to 
be over forty years of age, and she will state that she has a slight 
yellow discharge, a good deal of scalding when she passes water, 
and that she suffers excruciating agony on any attempt at inter- 
course. This latter is always the first symptom in date; and 
when a case comes under the notice of the gynecologist it will 
generally be found that intercourse has been discontinued for 
many months, if not for several years. The misery is very great, 
a great deal of the climacteric drunkenness, too common among 



BACTERICIDES. 



1225 



women, is due to this disease. When the labia are separated and an 
inspection made, one or two spots of redness on the mucous sur- 
face of the nymphse will be observed, varying in color from a 
palish black-red to a bright purple ; and if these be touched they 
will be found to be exquisitely tender. 

The disease is a progressive atrophy of the mucous membrane, 
the last textures affected being the blood-vessels and nerves ; for, 
when the process has been completed, the pain ceases, the red- 
ness disappears, and nothing remains but a vestibulum vaginae, 
so narrow that incredulity may be excused when the patient 
states that she has borne children. Great relief is obtained, 
though only temporary, by the application of strong lactic acid 
to the red spots. The acid is a powerful local anesthetic, and it 
never fails to mitigate the tenderness for a time. Following this 
vaginal injection of boroglyceride daily, packing vagina with the 
solid paste over night has a marked effect in wiping out the 
germ. 



or, as they are scientifically termed, verrucae. arc 

Warts, papillary tumors, the varieties of which depend 
upon their locality. The most common are those 
situated about the hands or fingers, or sometimes on the face, and 
more rarely on other parts of the body ; they chiefly affect young 
persons, and their structure is hypertrophied papillae, closely ad- 
herent to each other, and covered with thick cuticle. A some- 
what scarce variety occurs upon the scalp occasionally, and 
almost invariably in women after adult age, although it has been 
met with in males, and from its presence and form gives great 
pain and inconvenience in brushing the hair. A third variety is 
occasionally met with beneath or at the side of the finger or toe 
nails. These originate beneath the skin and protrude beyond 
the free margin of the nail. They are generally very painful and 
troublesome. Warts of a peculiar nature, arising from venereal 
causes, are met with under the foreskin and between the labia, 
and are liable to rapid propagation from their close contact with 
neighboring parts. All warts are undoubtedly contagious. 

Bacterium porri. — The microbe of all wdiXXs.contagmm viviim, a 
minute germ. 

Bears culture well in any warm nutrient liquid (is patho- 
genic), injected into any animal it invariably causes an abundant 
crop of warts to appear over the entire body. 

The isolation of the microbe of warts, whether they be on the 
hands, on the labia, vagina, urethra, opens up an immense field 
of scientific investigation. (See Papilloma.) 



1226 



DISEASE GERMS 



Microbe is at first sterilized, subsequently annihilated, in the 
presence of thuja occidentalis. Washing them over with salt 
water twice daily, and then sprinkling them with calomel. The 
reaction of the residual sodium chloride and calomel produces 
mercuric chloride, which speedily annihilates the microbe with- 
out the slightest pain. Lactic or acetic acid efficacious. 

Warts are cutaneous excrescences ; sessile or pedunculated ; 
pointed or flat ; smooth, rugous, or having a cauliflower appear- 
ance ; pigmented in various shades, or of the natural color of the 

skin ; congenital or developing after birth. 
They may be single or multiple, and 
occur upon the hands, feet, face, scalp, 
neck, genitals, and other parts of the 
body. They may develop slowly or rap- 
idly, and persist for years, or disappear 
without apparent cause. They may be 
soft, dense, or even corneous to the touch. 
The several names given to the various 
forms of warts have no clinical import 
whatever, as it matters little whether they 
are the size of a pin's head or bean ; 
whether they are hard or soft. Each 
one is due to irritation, with microbic 
evolution, which is pathogenic; bears 
cultivation well in any warm nutrient 
fluid. The cultures injected into any 
mammal is invariably attended with a 
copious crop of warts. 
Their removal by ligature, excision, or caustic is barbarous, 
for each species of microbe is more or less sensitive to the action 
of a special therapeutic agent, one that will either sterilize or de- 
stroy it. Either internally or locally, or both, use the oil of thuja 
occidentalis, which promptly kills the bacterium porri, the minute 
germ, the contagiuin viviun of all warts. 

The oil of thuja occidentalis. This is decidedly our best 
remedy. 

The following are esteemed by some as local germicides. 
Salicylic acid, thirty grains ; solid extract cannabis indica, five 
grains ; collodion, one-half ounce. Mix. Paint it over the wart 
every morning and night with camel's-hair brush, or 

Arsenious acid, pulv., six grains ; hydrargyrum bichloride, five 
grains; solid extract belladonna, thirty grains. Mix. Apply. 
Acetic or lactic acid, or chromic acid, are all good. 
The internal administration of thuja completely sterilizes and 
annihilates the bacterium porri in the blood ; the drug has a 
special affinity for the germ. 




Vertical section of a wart, show- 
ing the nest or cavity in which 
the bactermm porri evplves 
its spores. 



BACTERICIDES. 



1227 



Wasting, either a symptom of micro- 
Wasting Disease, bial evolution, or parasite growth. 

In children, wasting indicates the 
evolution and growth of microbes. It may arise from insufficient 
nourishment, or from unsuitable food, or from diarrhea. The 
bacillus tuberculosis, as a rule, is the great factor of nearly all 
wasting diseases ; closely allied to it is the microbe syphilitica. 
Wasting in the adult may be due to the same and numerous 
other causes, as degeneration of all kinds. A portion of the body 
may waste for want of use. 



This very rare form of skin disease seems to 

Xeroderma, .attack males and females with equal frequency. 
It has a tendency to set in in the spring and 
summer, and develops itself into four sets of lesions. 

The first is characterized by the development of little pigment 
spots, identical in appearance with, and sure to be mistaken for, 
ordinary freckles, all the 
more as they are found 
upon the uncovered parts, 
namely: face, neck, hands, 
arms and legs, although the 
trunk of the body occasion- 
ally suffers later on. In 
some cases the pigment- 
spots are preceded for a few 
days by the development of 
little congested spots, some- 
what like those of measles, 
although this is the excep- 
tion. By degrees the pig- 
ment-spots tend to become 
much darker in color, and 
sometimes by aggregation, 
they may become irregular in shape, and attain the diameter of 
an inch or more. 

Soofier or later, it may not be for months or even for years, the 
second stage is reached, which consists of the formation of little 
congeries of dilated capillary vessels (telangiectases) between the 
pigment-spots, and about the same size as they, though they are 
not nearly so plentiful; occasionally they are slightly elevated. 

In the third stage, many of these telangiectases are replaced 
by an atrophic condition of the skin, although some hold that the 
telangiectases succeed, and are consequent upon, obliteration of 




Xeroderma pigmentosa x 250; tumor from beneath 
outer canthus. A, "cell nest," highly magnified. 
B, fibrous stroma. 



1228 



DISEASE GERMS. 




vessels in the atrophic areas. The latter are, for the most part, 
from the size of pin-heads to lentils; but they may assume vari- 
ous shapes and sizes, and the skin of these parts is very white, 
A A A and either smooth and 

cicatricial in appearance, 
or thin, dry and wrinkled. 
In the last stage, which 
may not appear for a good 
many years (in one case, 
not for thirty), at some 
parts, especially on the 
right side of the face, the 
vascular or pigment-spots 
become warty and ulcer- 
ate ; and fungoid growths 
develop, which, sooner or 
later, terminate the life of 
the patient. Some hold 
that these are papilloma- 
tous, while others con- 
sider them to be ephith- 
eliomatous in character, 
as they certainly are in 
my case. Probably, they 
are sometimes the one 
and sometimes the other. It is only in this last stage that the 
general health suffers. The ultimate prognosis is therefore grave, 
although, in some instances recorded, the last stage was not 
reached when they were reported. 

The best plan in all such cases is to place the patient upon a 
tonic and alterative course, precisely the same as for cancer; 
locally lotion of bichloride of mercury, alternated with the boro- 
glyceride, is the most efficient treatment. 

More recently, the introduction of dermato-bactericides into 
gelatine-glycerine compounds, has been attended with brilliant 
success in xeroderma. 

Simply brushing them over the affected parts. 

In these compounds, a large number of them can be introduced. 



Xeroderma pigmentosa x 35 ; tumor from beneath 
outer canthus A A, cell nests — peripheral, irregular, 
epithelial cells with large nuclei. Central cells— corni- 
fied and arranged round centre in a laminated fashion. 
B, B. fibrous stroma — here and there between epithelial 
masses in stroma collections of round cells. C, C, cell- 
nests, from which central cornified masses have fallen 
out. D, D, epithelial masses ol large size, central cells 
of which have become, to a certain extent, cornified. 
the nuclei being indistinct Peripheral zone of irregu- 
lar, epithelial cells with large, deeply stained nuclei. 



BACTERICIDES. 



Jequirity seeds or beans. Infusion of seeds 
Abrus produces a shedding or peeling off lymph infil- 

Precatorius. trations on the conjunctiva and cornea. In 
effecting this exfoliation of morbid tissue, an 
artificial purulent ophthalmia is produced, which speedily sub- 
sides, leaving a healthy eye; free from opacities and granulations. 

Freshly powdered seeds, three parts ; cold water, 500 parts ; 
with hot water 500 afterwards added, filtered. When cold^ 
dropped into the eye three times in one day ; and repeat the 
next day if exfoliation has not taken place. 

Ozonized distillation of the jequirity bean annihilates the mi- 
crobe of diphtheria, and causes it to shrivel up and exfoliate from 
the mucous membrane ; it can be brushed over the microbial 
patch in full strength or diluted, or used in a hot steam atomizer. 
Paint thrice daily, if by atomizer every one or two hours. 

Uterine wafers from powdered jequirity bean specially prepared 
by both positive and negative ozone. This powder, ten to thirty 
grains blown through a speculum on a diseased or ulcerated, or 
gangrenous os uteri or neck, or better still, one or two capsules 
inserted against the diseased parts on retiring will cause a most 
complete desiccation, shedding or peeling off of morbid tissue, 
leaving the recently diseased parts in a most healthy state. This 
it effects if perfectly applied or inserted in eight hours. 

The method supersedes all caustic applications and old proce- 
dures. Boroglyceride and slippery- elm injections complete the 
cure. 

The distillation of the jequirity bean is the best local remedy 
for diphtheria. Invariable success attends its use, by painting it 
on over the germinal mass, with a camel's hair brush, followed 
by a spray of the pure distillation, and then continuing at longer 
intervals. In the case of very young children its strength should 
be reduced considerably ; just sufficient not to irritate the 
mucous membrane. Under the use of this distillation, even 
sparingly applied, the diphtheric membrane speedily undergoes 
a change ; temperature diminishes, and a general improvement 
takes place. If the false membrane has developed rapidly, and 

(1229) 



I 230 DISEASE GERMS. 

the case even seems hopeless, apply the remedy, and the germinal 
mass will soon detach itself. 

/. B. Klcckner, M. D., Lynchburg, Ohio, the most eminent 
bacteriologist in that State, thus speaks of the bacillus of the 
jequirity : 

"The bacillus occurs in the toxic juice infusions of the 
beans of abrus precatorins or jequirity. Infusions containing the 
bacilli, dropped into the eye, cause a complete exfoliation of the 
mucous membrane ; in doing this, if either granulations or opaci- 
ties are present, they are removed completely when this peeling 
process sets in. 

The beans reduced to an impalpable powder, and submitted 
to the action of ozone, fprm what is known as the ozonized ute- 
rine wafers. Either the application of this powder to the uterine 
OS or neck ; or the same powder contained in a capsule or wafer, 
causes a complete exfoliation of the mucous membrane where it 
is applied, with all the indurations, ulcers, excrescences, leaving 
a perfectly healthy tissue beneath. 

Boiling or distillation does not destroy the spores of the 
bacillus, but it kills the ferment, and when peroxide of hydrogen 
is added, we have in the ozonized distillation of the beans the 
most powerful remedial agent known to kill the microbe of 
diphtheria. This it will accomplish either by gargle, swallowing 
or atomized spray. 

The clinical results of the Massachusetts Ophthalmic Hos- 
pital, last year, gave 197 cases in all of granular conjunctivitis; 
various forms of opacity of the cornea ; and a dozen cases of 
lenticular cataract, cured by the repeated application of an infu- 
sion of the beans. 

Eminent gynecologists throughout the country report cases of 
uterine polypus, induration of the neck, various forms of ulcera- 
tion of the OS uteri, etc., in which the jequirity capsules were 
used with marvellous success," in every case causing a complete 
exfoliation or peeling off of the diseased tissues, leaving in all 
cases the parts in a normal condition. The use of these wafers 
is producing a complete revolution in gynecological procedure. 

The most powerful action of the drug is obtained from the 
distillation of the jequirity in the gravest forms of diphtheria. 
Used either as a gargle, or by painting or swabbing the parts, or 
better still by inhalation, which is adapted to the youngest 
child. 

Introduce the. remedy pure into the boiler of the atomizer, and 
as soon as the vapor or spray forms, permit the patient to breathe 
it. The instant the spray strikes the germ-laden mucins mem- 
brane, the microbial mass withers, shrivels up and dies ; it can 



BACTERICIDES. 



12^1 



be repeated several times daily, as often as the bacilli exosmose 
from the blood — the glycerite of sulphur ozonized being admin- 
istered internally to annihilate the germ in the blood and sterilize 
that fluid. 

This treatment entirely obviates all surgical procedure, which 
is a mockery of science. It cuts off the possibility of the forma- 
tion of ptomaines, which are so toxical to the blood in causing 
embolism and heart-rupture — to the nerve cell, in the production 
of paralysis. 



The gum Acacia is procured from various species 

Acacia, of the Acacia tribe, growing in the desert parts of 
Africa, where it is sometimes used as food. In this 
country the gums commonly employed for domestic, commercial 
and other purposes, are called gum Acacia, but, in reality, are the 
product of many other trees ; cherry gum 
being largely used. 

An excellent demulcent, useful for sus- 
pending balsams or oils. It blends, di- 
lutes or covers their acrimony. Incor- 
porated in water it is of gi:eat utility in 
inflammation of the stomach and bowels ; 
also in irritated or inflamed bronchial, 
urinary, mucous membranes. We have 
found the following most efficacious in old 
bronchial affections : 

Mucilage gum arable : syrup simplex, 
of each, 4 ounces ; chloride' potassa, 
pulverized alum, of each, 3 ounces ; 
tincture sanguinaria canad., i ounce. 

Mix. One teaspoonful every three hours. 




Gum Arabic. 



may be prepared in various wa}'s, but that 
Acetic Acid commonly used is obtained from the distilla- 
tion of wood in appropriate retorts, whence it 
is also called pyroligneous acid. It is used in medicine in two 
forms, the strong or glacial, and the dilute. The glacial acetic 
acid, so called from being normally solid or in the condition of 
ice, is chiefly used for external applications, the most frequent 
being the destruction of the microbe of warts. The skin round 
the wart must be protected by a layer of grease or oil, and the 
acid applied to the body to be removed by a bit of stick or camel's 
hair pencil. 



232 



DISEASE GERMS. 



Achillea. 




Yarrow, 



A most valuable remedy. In tincture form it is 
both an aromatic, haemastatic, astringent and anti- 
septic, and is of great efficacy in promoting the 
healing wounds by first intention. The aromatic 
and germicidal properties are strongest in the 
flowers, while the leaves are most astringent. 
An oil may be obtained by distillation with 
water and an alkaloid extracted in this usual 
manner. Take it all in all, it is a most invaluable 
remedy, and too little used. For the suppression 
of hemorrhages and profuse mucous dischagres 
an infusion of one ounce to the pint, made 
without boiling; wine-glassful doses; or the 
tincture of volatile oil in thirty-drop doses. 

Yarrow is used by the Swedes instead of hops 
in the manufacturing of beer, so as to render it 
more intoxicating. 



Aconitine. 



This alkaloid is obtained from both roots and 
leaves of the aconite napellus, the roots yield- 
ing it in great abundance. 

This crystallized aconitine differs widely 
from what is offered by different manufactu- 
rers, being one hundred times stronger. Prepa- 
rations much inferior to this, and termed 
aconitin, should be banished from all stores 
as they are liable to deceive. This alkaloid is 
best administered in ywwo, wo, tto ^^^ TW ^^ 
a grain in the form of a tablet. 

Its administration at once promotes dia- 
phoresis and diuresis, increasing the secretion 
from serous, mucous and synovial mem- 
branes. 

It is a powerful sedative to the nervous and 
vascular systems ; very valuable in all fevers 
and inflammation. 

It makes excellent liniment, thus : Tinc- 
ture of aconite, belladonna and chloroform. 

The tincture of leaves is the best form of administration. 

It should be given highly diluted in water, m small doses, fre- 
quently repeated, until it produces a soothing sedative action, 
which is usually manifest in diminished temperature and in mois- 
ture on the skin. 




Aconite. 



BACTERICIDES. 



1^33 



Receives various names, as cimicifuga race- 
Acta mosa, macrotys, black cohosh, black snake-root. 

Racemosa. Medicinal properties resides chiefly in the root. 

In decoction, tincture, fluid extract, it is an 

unexcelled bactericide, makes an excellent gargle ; in sewer-o-as 

sore throat, putrid, tubercular, or syphilitic ulceration of mouth 

and throat. 

An ointment prepared from the fresh dug root is useful in 
parasite skin affections. 

it is a valuable microbicide, effectually sterilizing and destroy- 
ing the bacilhts ainylob'acta and that of hooping-coucrh. 

It has strong acro-narcotic properties, allays nervous excita- 
bility ; passive congestion of the brain and cord ; active cerebral 
stimulant in variola, in which it drives the micrococci into the 
papulae. A fluid extract by re-percolation 
is the best form for general use. 

1. Cimicifuga has a positive sedative 
eflect upon the parturient woman, quiet- 
ing reflex irritability, nausea, pruritis, and 
insomnia, so common in the last six weeks 
of pregnancy; it always renders them less 
distressing, and they often disappear under 
its administration. 

2. Cimicifuga has a positive antispas- 
modic effect upon the parturient woman. 
The neuralgic cramps and irregular pains 
of the first stage of labor are ameliorated, 
and often altogether abolished. In fact 
during the first indiscriminate use of the 
drug in all cases, I had the mortification 
with a few women of terminating the labor 
so precipitately, and without prodromic symptoms, as to be un- 
able to reach the bedside before birth. 

3. Cimicifuga relaxes uterine muscular fibre, and the soft parts 
of the parturient canal, by controlling muscular irritability, thus 
facilitating labor and diminishing risks of laceration. 

4. Cimicifuga increases the energy and rhythm of the pains'^in 
the second stage of labor. 

5. It is my behef that cimicifuga, like ergot, maintains a better 
contraction of the uterus after delivery. 

6. The special physiological action of the black cohosh is a 
powerful cerebral and spinal stimulant, and vitaliser. 

It owes much of germicide properties to that action. 
7% 




Black Cohosh. 



1234 



DISEASE GERMS. 



A bactericide of the highest order. Unlike 
Adahatoda all other germicides, it is death to all the lower 
Vasica. organisms, and the lower we descend in the 
scale of microscopic life, even to spores and pto- 
maines, the more active this remedy becomes ; whereas, it is en- 
tirely innocuous and without any toxic effect on high-graded 
living tissue, such as man, and animals near to him in the scale 
of existence. All germicides of recent origin which would kill 
the bacteria of any given malady, except this, are liable in large 
doses to affect normal tissue deleteriously. 

Besides, it is of some value in ordinary doses in bronchitis ; 
and smoking the leaves is of utility in asthma. A decoction of 
the leaves rapidly destroys animalculae and insects, but upon 
higher grades of existence has no effect whatever. 



This glucoside is extracted from the adonis 
Adonidin. vernalis. It appears as a yellow powder, having 
an intensely bitter taste ; slightly soluble in ether 
and water, but much more soluble in 
alcohol. It is largely used by all pro- 
gressive physicians as a substitute for digi- 
talin. Its properties are identical with that 
drug, but lack the cumulative effect. It 
is an excellent cardiac tonic, diminishing the 
frequency while increasing the force of the 
heart. It is a diuretic, unlocks the ab- 
sorbents, but never causes diarrhea or 
vomiting. The ordinary dose of one-third 
of a grain several times a day. 

In heart affections, where digitalis and 
strophanthus fail. This drug often proves 
efficacious. 




Adonis Flower. 



Agaric Acid — 
For Night Sweating. 



Some years ago a substance derived 
from the well-known Agaricus atbus 
was introduced as a sweat-checking 
agent in phthisis. It was looked upon 
as an alkaloid body, and received the name of agaricine. This, 
however, has now been found to be an impure substance ; we 
have recently extracted from it a triatomic dibasic acid, to which 
the name of agaric acid has been applied. This is a white silky 
crystalline substance, scarcely soluble 4n cold, but readily so in 
boiling water. We have recently investigated its physiological 



BACTERICIDES. 



1235 



effects, and shown that its action is upon the centres in the me- 
dulla, especially the vagus and vasomotor. It possesses no 
mydriatic action : on the contrary, instillation of the sodium salt 
of the acid produces slight narrowing of the pupils, probably 
from mechanical irritation. The influence of the substance 
on the secretion of sweat is not a central one ; but the 
result of an action ; on the secretory structures. We have 
tried it in very many cases of profuse sweating. The dose 
given was usually ^ grain in pill, administered in the evening 
about six o'clock. If the action was insufficient, as many as 
five pills were given. In most cases the result was very satis- 
factory, even in. those cases where atropine failed, and it was 
unaccompanied by any unpleasant symptoms. 

The efficacy of this substance in relieving the sweat of con- 
-sumptives has been demonstrated by Prof. James A. Davis, M. D. 
It is given in doses of I-I2th to i-6th grain in pills, to which 
some Dover's Powder is usually added, as agaricin often pro- 
duces diarrhea, sometimes accompanied by violent abdominal 
pains. 

Agaricini, 8 grains ; pulverized ipecac, and opium, 120 grains ; 
althaeae pulverized, mucilag. acacise, of each, 60 grains. 

To be made into one hundred pills ; one or two pills to be 
taken at night. 

Considerable quantities of agaricin have been used in all city 
hospitals for relieving night sweats of consumptives and other 
patients with uniform success. It is usually given in combina- 
tion with atropin and aromatic sulphuric acid : 

Agaricini (Merck), 10 grains ; atropinae sulphatis, i grain; 
acidi sulph. arom., 1200 drops. 

Dissolve and filter. Dose: 10 minims, containing i-ioth grain 
of agaricin, i-i20th grain of atropine sulphate, and 10 minims of 
aromatic sulphuric acid. To be administered in syrup or simple 
elixir. 



(Eupatorium cannabinum), a 

Agrimony, bactericide of the highest order, 

a sudorific, very beneficial in 

catarrh and influenza. In large doses, emetic and 

purgative, and in small doses tonic and diuretic. 

The whole plant is a bitter tonic of the most 
active kind, and has a most energetic action 
upon the liver, very valliable in jaundice. Agrimony. 




'^36 



DlS'Ei^SE' GERMS. 



This entirely supersedes both 

- Aleteris Farinosa. the farinosa cordial and wi-B^e; 

' ipistillation of the Aleteris^ being at' least twenty times 

■'V' •; :;--'V'- more active; being a powerful 

uterine tonic and restorative, composed of aleteris farinosa, black 

haw, mitchella repens, helonias, elecampane, spikenard, hydrangea, 




Aleleris Farinosa. 



caulophyllum, etc. This perfect and elegant compound is indi- 
cated in the cure of all female disorders, as amenorrhoea, dys- 
menorrhoea, menorrhagia, leucorrhoea, subinvolution, puerperal 
convulsions, relaxed condition of uterus and appendages, and 



BACTERICIDES. 



237 



threatened abortion; directing its action in a most remarkable 
manner to the entire uterine system as a general tonic and' anti- 
spasmodic, and in cases of impaired vitality ; complete restoration 
follows its use. 

This remarkable preparation is used with great success in all 
eases of female weakness. It has no equal as a tonic and anti- 
spasmodic, sedative, prevents abortion and puerperal convulsions, 
imparts tone and vigor to the female reproductive organs, cap- 
able of facilitating fecundation and rendering partiirition easy. 

It is one of our very best remedies to tide a patient comfortably 
over the change of life, relieve her aches, burnings and reflex 
sensations. 

In the words of the eminent Prof. Rutledge, of St. Louis, Mo., 
it is unrivalled as a uterine tonic in irregular, painful, suppressed, 
and excessive menstruation. It restores normal action to the 
uterus, and imparts vigor to the entire uterine system. 



The cortical portion of the root of this plant con- 
Alkanet. tains a coloring principle, of a beautiful deep-red, 
which is very generally employed for coloring 
tinctures, wines, oils, ointments, plasters, which 
are beautifully reddened and rendered antiseptic 
by it. The best method to introduce it into 
those bodies, is to suspend a piece of it in them 
while being melted or otherwise prepared. This 
coloring principle is soluble in alcohol, ether, 
and the oils, to which it imparts a deep red, but 
is insoluble in water. 



An active bactericide and 

Alnus Nigra, efficient alterative ; decoction, 

(Alder.) fluid extract, and comp. 

syrup, operate well in syphilis, 

cancer, rheumatism, dropsy. 

A cerate prepared from the bark 
and leaves, kills all vegetable and 
animal parasite skin affections. 

It is still more efficient by the 
addition of rue. 

A succus or expressed juice of 
the green plant arrests the secre- 
tion of milk in the female breast. 

Alder. 





Alkanet. 
{Anchusa officinalis) 



1238 



DISEASE GERMS. 



The virtues of this plant are those of a de- 
Althsea. mulcent to all mucous membranes. The de- 

(Marsh-malloiv^ coction of the root is much used in all irrita- 
tions and inflammations of that tissue. Its 
great therapeutic value is, it is not 
only extremely soothing, aromatic, but 
it readily holds five volumes of the 
peroxide of hydrogen, without causing 
decomposition. 

Thus saturated with this very pow- 
erful germicide it becomes a most in- 
valuable remedy in nasal and bron- 
chial catarrh, and in all catarrhal affec- 
tions of the stomach and bowels. 

To obtain its antiseptic properties, 
the green root should be sliced up and 
digested in four times its weight of 
olive oil, at a temperature of about 
300° F., for several days, until they 
become dry or crisp. As soon as the process is complete, the oil 
is drained off, and is completely charged with the entire germi- 
cidal properties of the plant. 




Marsh-Mallow {Altheea officinalis). 



A genus of succulent plants or trees, which vary 

Aloe, considerably in size from six to ten feet. The medici- 
nal property of the tree is the 
hardened juice, which runs spontaneously 
from the leaves when wounded. 

The best extract is from the aloe soco- 
trir^a, which abounds and gives a character 
to the small island of Socotra, at the 
mouth of the Red Sea. 

If needed, to overcome constipation, use 
it prepared as follows : 

Aloes, two ounces ; soda bicarb., two 
ounces ; number six, two ounces ; hot 
water q. s. to make six ounces; dose, 
twenty to thirty minims in water night 
and morning. By care, the dose can be 
determined that will produce one evacua- 
tion daily, and not irritate the rectum. We 
regard aloes a true tonic to the rectum 
and colon, in appropriate doses. As a 
local application, use a salve made of vase- 
line, boric acid and belladonna. 

Aloes. 




BACTERICIDES. 



1239 



is a compound ciystalline body having as its es- 
Alum sentials alumina and sulphuric acid with potass or 
ammonia. It is an astringent substance, and is used 
to lessen discharges of many kinds, and as a gargle in sore throat. 
When heated, it melts and becomes powdery ; this, which is 
called burnt alum, is often used for ulcers when they become 
flabby. Two or three grains along with an ounce of decoction 
of oak bark, constitute a safe local application for ordinary dis- 
charges. 

Alum with all its compounds is an excellent bactericide. 



An antiseptic of great value, and the 

Aluminum. remedy occupies a prominent position in 

[Aceto-Tartratc.) the cure of ozeena. A weak solution for 

syringing the nose. Its action is rapid and 

safe. "^©' laryngeal phthisis it may be used by a vaporizer with 

great success. Dose : Local ; a teaspoonful of a fifty per cent. 

solution to teacupful of water once and repeat. 



A three-per-cent. solution of acetate 
Solution of Acetate of alumina is a powerful germicide and 
of Aluminum. disinfectant. It is greatly to be pre- 

ferred to any other agent in surgical 
practice as it is efficient and free from all objections. It is in- 
odorous, and it should be diluted with from two to five times its 
volume of water when used as an injection or by irrigation. It 
promptly destroys all disease germs on foul or gangrenous sores, 
and is orfe of the best of all antiseptic injections in puerperal 
septicaemia. Useful in some skin affections. Local use ; applied 
daily or more frequently. 



A miserable caustic, much inferior, more 
Alvelos Milk, irritating than nitric acid, used by a number 
of medical impostors as a barbarous counter- 
irritant for cancers, ulcers, chancres, tumors. It is applied b\' 
painting on and repeating. 

The drug has no redeeming property whatever, and should 
be excluded from the materia medica of all! nations. 



I240 



DISEASE GERMS. 



All parts of this plant but especially the 
Amaranthus. leaves yield a glucoside, amarantha, which is 
highly astringent and antiseptic. It is of es- 
pecial \'alue in uterine hemorrhage, 

more efficient than erigeron or 

ergot. It resembles matico, or 

alum, and if the remedy is fresh 

seldom fails in its action. It is also 

of great utility in gastric and rectal 

hemorrhages. 

The tincture forms an admirable. 

dressing to bleeding wounds. 




is used both by it- 
Ammonia, self and combined 

with other chemical 
agents for a variety of purposes. 
It is nowadays got from gas-house 
refuse, but used to be obtained by 
burning hartshorn, whence it got 
the same name. Pure ammonia, 
or, as it is called by chemists, 
caustic ammonia, is rarely used. 
When ammonia is given internally Amaranthus 

for its stimulant virtues, its carbonate is used — sal-volatile, or 
smelling salts. It is used as aromatic spirit of ammonia in doses 
of from a few drops on sugar to a teaspoonful or more (five drops 
to one drachm), to relieve flatulence, to remove the feeling of 
sinking, and to get rid of acidity and heartburn. It is also use- 
ful in some forms of headache, and in the chronic bronchitis of 
old people, when their winter cough is complicated with copious 
tenacious expectoration. Liquid ammonia has been of late used 
with much success as a remedy for snake bite. It has been given 
internall)' in considerable quantity along with brandy or whisky. 
In Australia it has been repeatedly injected into veins for snake 
bite, and the treatment has proved there quite successful, but has 
failed in India. The old remedy hartshorn and oil {^frcsJily pre- 
pared) will be found very useful for the stings of bees and wasps, 
the bites of mosquitoes, gnats, and such like. 

Acetate of Aimnonia. This substance has been a good deal 
used in practice as liquor of acetate of ammonia, commonly 
called Mindererus' Spirit. Its dose is from tvv^o to six teaspoon- 
fuls (two'^to six drachms,) and it has commonly been given to 
relieve feverishness, destroy germs, as in ordinary fevers, colds, 
etc. It is suppo.sed to cool the skin by promoting prespiration, 



BACTERICIDES. I^^i 

neutralizing ptomaines. It may be given along with sweet spirits 
of nitre, and a few drops (two or three) of antimonial wine, when 
the skin is hot and dry, and the pulse quick, or with salicylic acid. 

HydrocJilorate of Aniiiiojiia, also kno\\-n as chloride of ammo- 
nium, more commonly as sal ammoniac, is used in certain forms 
of headache. It often succeeds when everything else has failed. 
Five to twenty grains should be taken for a dose. It is also use- 
ful in certain female complaints, especially when the periods have 
been irregular or have prematurely ceased. 

Its germicide action is substantiated in nearly all microbial 
diseases. For example : a lotion of chloride of ammonia is in- 
valuable as a local application to destroy the micro-organisms 
of wasps, mosquitoes, ivy, sumach, erysipelas, when embedded 
in the skin ; the same preparation, in five-grain doses every two 
hours in syrup, destroys the conferva of bronchitis ; the same 
preparation in hepatic abscess destroys in a most mysterious 
manner the microbe of pus, with its ptomaine ; either the chloride 
or carbonate, alternated with copious draughts of infusion of 
skullcap, has a marked action in sterilizing the bacillus of rabies ; 
the liquor ammonia acetatis sterilizes the pneumococcus of lung 
congestion ; and the acetate of ammonia, combined with salicylic 
acid, completely annihilates the amylobacta oi' rlienniatisni. 



Tertiary amyl alcohol, or, as it is 
Amylene Hydrate, often called, amylene hydrate, recom- 
mended as a hypnotic, and it has lately 
been introduced into practice. It is said to be intermediate be- 
tween chloral and paraldehyde, safer than either, and not likely 
to disturb the digestion. When we consider that the next nurn- 
ber of the series above amyl, namely, hexyl, may yield thirty 
eight alcohols, and that thirteen of those are actually known, we 
can readily see what a possible field there is for the introduction 
■bf new hypnotics. 

A most remarkable 

Anagallis Arvensis. bactericide. A satu- 

{Piinpernel.) rated tincture has an 

acid and bitter taste ; 

when administered in any microbial disease it has 

the faculty of sterilizing the germ, besides it is 

an excellent local application to germ-laden 

ulcers. 

It has succeeded in hydrophobia, tubercle, in 
epilepsy, causes great activity of the hepatic se- Pimpemei. 

cretion. and thus becomes of value in hemorrhoids. 




1242 



DISEASE GERMS. 



Andromeda Polyfolia 

or 

Sorrel Tree. 



leaves 




This beautiful tree is indigenous 
in all the mountainous regions of our 
country, and its leaves afford a most 
grateful and refreshing drink to all 
fever patients. An infusion of the 
is refrigerant and highly antiseptic, 
sufficiently so to destroy the germs of a 
large percentage of our fevers ; its liberal 
use as a drink lowers heat, pulse, respira- 
tions. 

It also makes an excellent wash or lotion 
to gangrenous sores and chronic ulcers, 
erysipelatous inflammation. It speedily 
destroys the germs of the disease and aids 
nature in repairing the local lesion. 

It has been prepared in the form of a fluid 
extract, but it loses its best properties in that 
form. An infusion seems so far to be the 
only reliable preparation. 



Andromeda Polyfolia. 

A species of pulsatilla which grows 
Anemone Nemorosa. abundantly in the Western States, 

and contains the glucoside anemonic, 
which is a bactericide of most extraordinary power, being capable 
of destroying the bacillus of syphilis, leprosy, and phagedena. 

If the herb is used, it should be fresh, carefully preserved, not 
older than one year, and collected after the flowers mature. 

From an herb in that state either a decoction or fluid extract 
can be prepared possessing all the germicidal properties of the 
plant, which can be administered internally or locally in all mi- 
crobial diseases. Makes an excellent cerate with ozone ointment* 
for parasite skin affections. 



The root is produced by the plant known as 

Angelica. Gaudea Angelica, th^ Angelica Archangelica of the 

botanist. It contains a pleasant volatile oil, and 

is used as a stimulant and carminktive in medicine. Occasionally 

used as an emetic and purgative. 

The whole plant belongs to the class of aromatics, which possess- 
such decided germicidal powers. 

It has quite a reputation in some parts of the country as a 
complete antidote to .snake-bite. 



BACTERICIDES. 



1243 



For this purpose the fluid 
extract is generally used, ad- 
ministered internally and ap- 
plied locally. 

Some, for this purpose, 
combine it with the Scutellaria, 
equal parts of each, freely ad- 
ministered. 




Angelica. 



Antifebrine 

Antifebrine is a name se- 
lected for an 
antipyretic which affords most 
salutary results. It is identi- 
cal with phenylacetanide or 
acetanilide, prepared by the 
action of aniline upon acety- 
chloride or anhydrous acetic 
acid. It occurs in the form of 
pure white odorless crystals 
or rhombic plates, producing a 
slight burning sensation on 
the tongue. It is insoluble in 
cold water, but more soluble in hot water, and freely soluble in 
alcohol, and alcoholic liquids, such as wines, etc. It possesses 
neither basic nor acid properties, and is not readily attacked by 
most reagents. 

Extensive clinical experience clearly demonstrates that in all 
fevers due to the presence of a disease germ, four to fifteen grains 
enclosed in a wafer or dissolved in wine or suspended in water, 
administered not oftener than once in the twenty-four hours, will 
promptly reduce hekt, respirations and pulse. 

It has another recommendation, which is its comparative 
cheapness, which is offset however by the fact that, under certain 
circumstances, it dyes the whole body of the patient an intense 
blue, which, although said to have no serious consequences, and 
to last but a short time, must be extremely disagreeable to the 
patient. The blue color is said to be caused by its conversion 
into aniline in the system. 

It is a matter of theoretical interest as well as practical import, 
that, while others of the recent antipyretics are either phenols 
(such as carbolic acid, hydroquinone, resorcin, and salicylic acid),, 
or bases of the quinoline group (including quinoline, kairine, 
antipyrine, and thalline), in acetanilide we have a body of quite 
different chemical constitution, which exerts a similar effect. 



1244 



DISEASE GERMS. 



This is prepared by the action of ozone 

Anti- Microbe gas on boracic acid, forming a rose red 

Powder. powder of extraordinary germicidal power. 

It was specially prepared for surgical practice 

for dusting on wounds, obtaining in all cases in which it was 

applied union by first intention. 

Later on it has acquired quite a reputation in hospital and pri- 
vate practice, as a local germicide. It is especially adapted for 
the requirements of the nursery, as a dusting powder, and as a 
substitute for the villainous powders palmed off on mothers ; 
here it has been used with signal success. As a toilet powder 
for ladies' use, it possesses great advantages over the poisonous 
cosmetic powders of zinc and bismuth so much in use, prepara- 
tions which are very incautiously 
resorted to, and which cannot be 
too strongly condemned. 

In the management of cases of 
incontinence of urine, and in all 
urinary complaints, as a dusting 
powder it has proved invaluable; 
by its use the urine is deodorized 
and the skin protected against 
bacteria with soreness and ex- 
coriation. 

In chafing, in which bacteria 
are always evolved, its action is 
instantaneous, affording prompt 
relief 

In erythema, roseola, urticaria, 
in which the bacteria are on the 
skin in search of free oxygen, 
its application is instantaneous, 
in the removal of the burning, 
tingling in the skin. In bed sores in which the oidium albicans 
are present, this powder instantly kills the entire colony, and 
cicatrization takes place. 

These microbes are completely destroyed and the mouth kept 
aseptic by dissolving half a teaspoonful of the anti-microbe 
powder in four ounces of water, and used thrice daily as a 
mouth wash. This proceeding removes tartar, preserves and 
beautifies the teeth. 

It annihilates disease germs wherever they exist and can be 
reached. As a snuff, it will destroy the amoeba of nasal catarrh ; 
as a dentifrice or tooth or mouth application, all germs in the 
oral cavity will disappear if applied there ; it is inimical to all 




A cono;lomeration of microbes often found in 
the Human mouth — such as the microbe of 
dental caries ; the oidium albicans ; the 
bacillus amylobacta, etc. 



BACTERICIDES. 1 245 

forms of tinea, it will kill the cryptogamic growth of sycosis, if 
dusted on after the face is washed and dried. 

Microbe powder differs from any and every pulverulent sub- 
stance hitherto introduced for the skin. It contains no rice 
powder, starch, oxide of zinc, bismuth, fuller's earth, or violet 
powder, and is a most beautiful palpable substance, light, soft 
and of lovely flocculence (not lumpy), and is free from the slight- 
est trace of grittiness. It does not exert the least irritating ac- 
tion, but is, on the other hand, the blandest and most grateful of 
powders. 

It is perfectly neutral in reaction, and is freely soluble in water, 
so that it does not occlude the pores of the skin, or cake and 
form crusts thereon, to cause endless irritation, and aggravate 
instead of ameliorate unhealthy conditions. Microbe powder 
will adhere to the skin by gently dusting it on the face, as .after 
shaving. The most delicate, transparent, snowy film may be 
thrown over the skin to protect it from wind, sun, dust, and irri- 
tating gases. It is antiseptic, quite innocuous, and may be used 
on weeping surfaces, on parts which chafe, and on the axillae, 
feet, and hands. As a face powder, and for the nursery, it is all 
that could be desired. 

It is suitable for a mouth wash, for vaginal injections, and will 
be found most convenient to replace during the day. It is in 
itself a sure cure for all skin affections. 



Antipyrine is a quinoline derivative. It is a 
Antipyretics, white, crystalline powder, readily soluble in 
{Antipyrmc}) water, and of wealc, easily disguised taste. 
According to close observers, it promptly 
lowers the temperature, in doses of fifteen grains, with an hour's 
interval between. The temperature falls gradually, usually with- 
out sweating, and reaches its limit in three or four hours. It 
remains low for seven or eight hours, as a rule, but twenty hours 
may elapse before the original temperature is reached again. 
The rise is not accompanied by shivering. The pulse is retarded, 
but not proportionately to the temperature. No unpleasant 
symptoms occur, except vomiting in some cases after large 
doses. The urine is always free from albumen, and is not dark- 
ened. Half the above dose (seven and one-quarter grains) is 
enough for children, in sugar and peppermint. 
The use of antipyrine : 

1. In all cases of cardiac weakness. 

2. In diphtherial affections, in which there is evidence of myo- 
carditic lesion. 



1246 



DISEASE GERMS. 



3. After exhaustive hemorrhages. 

4. During menstruation and dysmenorrhoea. 

5. In catarrhal pneumonia generally, and lobar pneumonia 
when there is oedema of the lungs — heart failure. 

6. In the later stages of tuberculosis. 

7. In all cases of great debility and exhaustion, and in the 
latter stages of long-continued fevers. 

It is believed that the foregoing contra-indications with regard 
to the administration of antipyrine and similar medicaments, will 
receive the approval of physicians generally. 

According to the testimony of Wilde}"- Q. Brooks^ M. D., of 
Jacksonport, Wis., who has made a most careful study of this 
drug, exalgine, and antifebrine. He says, and he is authority on 
the subject, that antipyrine and exalgine are chemically and thera- 
peutically identical ; that the one is stronger than the other. 

Antipyrine. Antifebrine. 

Lowers temperature in a half hour. In an hour or more. 
Eftect lasts two hours. Effect last six hours. 

More diaphoretic. More diuretic. 

Depressing after-effects. No after-effects. 

Cerebral sedative. Cerebral vaso -motor and mus- 

cular (?) stimulant. 
Dose, 15 to 30 grains. Dose, 5 to 15 grains. 

Tolerance from continued use. Tolerance from continued use. 

This table, he says, will suggest the selective use of the two 
drugs. From the patient's point of view (which is really coinci- 
dent with the physician's), antifebrine is much to be preferred in 
continued fevers, because the dose is one small capsule instead 
of three ; the effect lasting so long requires one-third the number 
of doses ; the tonic stimulation excels the depression and after 
malaise; and the cost is one-fourth that of antipyrine. The anti- 
pyretic effect of antefebrine is as strong or stronger than that of 
antipyrine, and its only objection is its slowness of action. In in- 
solation and other cases where a quickly acting antipyretic is 
necessary, and when it has a specific action on the pathology of 
a disease, as is claimed in rheumatism, antipyrine is to be pre- 
ferred. Whenever one can wait an hour for the antipyretic 
action to begin, he greatly prefers antifebrine, and so he believes 
will the patient also. He regards its stimulant or tonic effect as 
very valuable in weak patients. 



BACTERICIDES. 



1247 



The effects to be derived from the apocynum 

Apocynum. are very variable, depending greatly upon the 
dose. It is an excel- 
lent drug in that debilitated, relaxed 
condition of the blood vessels which per- 
mits of effusion. In alternation with 
strophanthus or infusion of digitalis, it 
seldom fails in getting rid of dropsical 
effusions. 

It is a germicide of no mean power, 
arresting the lactic and butyric changes 
in rheumatism, thus controlling that 
morbid condition. 

It has a marked action in annihi- 
lating the crypta syphilitica. 

Its true sphere of action is in all 
forms of dropsy ; our most trust- 
ivorthy agent in hydrothorax. 

Apocynum. 

Rouses up the lum- 
bar plexus of nerves ; 
salutary in damaged 
kidneys ; of efficacy in 
Dose, five grains every 





Apiol. 

[From Parsley. 



amenorrhoaa. 
three hours. 

A distillation ozonized acts most en- 
ergetically, and exhibits all the charac- 
teristics of ergot and quinine. 

This ozonized distillation acts as a 
diuretic, emmenagogue, and bactericide. 
A poultice made of the green herb with 
vinegar neutralizes the bites of venomous 
reptiles. 

It exerts a powerful action on the 
uterine secretions. 



Arnica Montana as it grows in 
Switzerland. 

ity, and in paralysis. 



A perennial herb grow- 
Arnica. ing freely on the Alps and 
other parts of Central Eu- 
rope. Its roots, stem, and leaves are 
powerfully acrid and antiseptic. 

It is quite extensively prescribed in 

low fevers, conditions of extreme debil- 

Externally, it is much used in the form of 



2:48 



DISEASE. GERMS. 



tincture, applied to wounds, bruises, sprains. Some use it in full 
strength ; others dilute. Its peculiar bactericide properties reside 
chiefly in a resinous substance called arnicine, and to a volatile oil. 
The latter makes an excellent cerate. 



Arnotto. 



A tincture of the seeds of the fruit are equal, if 
not superior, to dioscorea, in colic. An extract 
prepared from the pulp surrounding the seeds is 
used for coloring butter and 
cheese. It is used to dye 
silks and cotton-cloth yellow, 
but the color it imparts to 
those are fugitive. 

Bixin, a crystallizable color- 
ing, is extracted from it. 

It has excellent microbicide 
properties, and its use as a 
coloring matter in dietetic 
articles is in no way injurious, 
but rather beneficial. 




Arsenic 



Bud of a branch with leaves and flowers. 
Capsule. 



is the common 
term for what is 
m o r e strictly 
called arseniou§ acid, or white 
arsenic. It is both a danger- 



Arnotto 

ous poison and a powerful 
remedy. It is best gi\en in the form of liquor arsenicalis or 
Fowler's solution, of which three, four or five drops may begiv^en 
in water immediately after a meal. Notwithstanding the dis- 
astrous consequences of large doses, given in the small ones 
described it is very valuable in certain complaints. A prepara- 
tion of arsenic was longr used in Eno-land as. a remedy for acrue, 
under the name of the Tasteless Ague Drops. Even in tropical 
fevers of the same class in which quinine has been given and 
failed, arsenic will sometimes succeed. 

There are some kinds of headache, especially one called brow- 
ague, in which arsenic does good, as it also does in others m.ore 
distinctly neuralgic in character. It has also been given for some 
forms of nervous disorder. Of all remedies arsenic seems to be that 
which is of most use in skin diseases, especially those of a scaly 
or scurfy kind; where much purulent matter is produced it seldom 
does much good. Small doses should be given very regular!}- 
in the way indicated above, and if any smarting of the eyes comes 



BACTERICIDES. 



1249 



on, it should be discontinued for a time and again resumed in 
smaller quantity. _______ 

Dragon root is an invaluable remedy, 

Arum Triphyllum. being antiseptic and antispasmodic, of 
great efficac}' in asthma and hooping- 
cough. A tincture or fluid extract is 
the best form for administration. 

For asthma the following formula 
is used with decided advantage : 

Fluid extract of dragon root and 
euphorbia pilulifera, of each, one 
ounce. Mix. Five to ten drops in 
hot water ; repeated at intervals until 
spasm of the bronchi yield. 

For Hooping- Cough : Compo u n d 
syrup of tolu, three ounces ; fluid 
extract dragon root and euphorbia 
pilulifera, of each, half an ounce. 

Dose, from thirty to sixty drops, 
repeated as indicated. 




Dragon Roct^ 



Pleurisy root is alter- 
Asclepias. ative, antispasmodic, 
diuretic, expectorant,- 
laxative, tonic and antiseptic. 

It has a special vitalizing action upon 
all the serous membranes of the body, 
which aids greatly in promoting a re- 
newal of life in catarrh, peritonitis, 
rheumatism, diarrhea and pre-eminent- 
ly in pleurisy. It makes an excellent 
formula, as follows : 

Opium and ipecac, thirty grains ; ni- 
trate potash, two drachms; pulverized 
asclepias, half ounce. 
Mix. Make ten powders ; give one every three hours, or more 
frequently ; at the same time apply the great ozone generator, 
turpentine, over the damaged part. 

There is another class of sulpho-compounds, the 
Aseptol. sulphonic compounds, in which the atom of sul- 
phur, instead of being united by means of oxygen 
to the aromatic nucleus, is attached directly to one of the carbon 
atoms of that nucleus. One such compound, ortho-phenol- 

79 




Pleurisy Root. 



1250 



DISEASE GERMS. 



sulphonic acid, sozolic acid, or aseptol, as it has been christened, 
has been introduced both as a local antiseptic and as an intestinal 
disinfectant. The commercial aseptol is a solution containing one 
part in three, and it is administered internally, in the same dose 
as salicylic acid, in cases both of gastric and intestinal catarrh, 
and apparently with good results. 



An infusion of the tops of this plant is a most 
Asparagus, efficacious remedy in states or conditions in 
which the kidneys are blocked up v/ith disease 
germs and cellular dropsy as a result. To open the flood-gates, 
so that the remedy will have a fair exhibit, its use should be pre- 
ceded either with digitalis 
or strophanthus, or one-per- 
cent, solution of nitro- 
glycerine. Either of these 
remedies act well, probably 
the nitro-glycerine is the 
best. Indeed the two reme- 
dies act like a charm. 

Nitro-glycerine is a stim- 
ulant, it acts promptly in all 
cases of interstitial nephritis, 
and being tasteless, color- 
less and odorless, and act- 
ing at once, deserves more 
attention than is accorded 
to it, in all kidney affec- 
tions, and to check the ten- 
dency of the blood to hsem- 
atolysis. As for the aspar- 
agus, it is a most efficient, 
never-failing diuretic ; its action upon the kidneys is of the 
highest vitalizing character ; succeeds often when all other reme- 
dies fail, in washing out the kidneys. The tops when in season are 
the best, at other seasons the bark of the root answers equally. 
The sprouts contain a peculiar crystalline substance, asparagin, 
which has a specific action on the entire urinary apparatus. A 
persistent use of this remedy will disintegrate phosphatic calculi. 




Conoveril CoU ssal Asparagus. The tops are more 
efficacious than the roots. 



Aspidospermine. 



(From Quebracho.) Valuable for 
the relief of difficult breathing attend- 
ing asthma, bronchitis, emphysema, 
phthisis, and in deficient arterialization and oxygenation of the 
blood. 

Dose : One-quarter of a grain every three hours. 



BACTERICIDES. 



I251 



The Wine of the 
American Ash. 



The new uterine tonic and restorative 
exerts its power principally over the 
kidneys, bladder, ureters, urethra, uterus 
and vagina, and stimulates the organs of 
assimilation. Indicated in amenorrhoea, dysmenorrhoea, menor- 
rhagia, leucorrhoea, pre- 
mature cessation or de- 
lay of the menses, pro- 
lapsus uteri. 

The wine of the Amer- 
ican ash has acquired a 
reputation as a uterine 
tonic in the treatment of 
irregular, painful and 
excessive menstruation ; 
as it restores normal ac- 
tion to the uterus, and 
imparts tone and energy 
to the entire utero-geni- 
tal system. 

It has also proved of Ash American. 

much efficacy in all atonic conditions of the uterus, passive 
hemorrhage, vaginitis, urethretis, hysteria, and to relieve tendency 
to repeated and successive miscarriages, and it should be con- 
tinuously administered during the entire gestation in those cases 
where abortion is feared. 

The dose is one drachm diluted three or four times a day. 




Balsam of Copaiba. 




Balsam of Copaiba Tree. 



A valuable germicide, consisting of 
a resin, and volatile oil. It flows 
from incision made into the stems of 
the trees. It has a rather disagree- 
able odor, acrid taste, but is a 
valuable stimulating diuretic. It 
has been used from time imme- 
morial as a remedy to destroy the 
gonococcus. The remedy is not 
destroyed or impaired by diges- 
tion, enters the blood, destroys the 
glucose fungus and is eliminated 
by the kidneys, in a fine state of 
molecular division. These mole- 
cules coming in contact with the 
gonococcus in the urethra, kill 



them, but it is a slow, barbarous method, as a fresh colony of 



1252 



DISEASE GERMS. 



germs start into existence before the next call for micturition. 
When used, the following formula is most efficacious : Of high- 
graded comp. syrup stillingia, four ounces ; balsam copaiba, one 
ounce ; fluid extract of kalmia, half an ounce ; tinctnre of iodine, 
two drachms. Flavor by adding a few drops of either oil of 
wintergreen or peppermint. 



Balsam of Peru. 



A valuable bactericide, excellent to 
apply to wounds and ulcers, and inter- 
nally in the chronic bronchitis of the 
aged. 







The microbe of epidemic in- 
fluenza fully developed with 
perfect adult forms of the 
pneumococcus. Magnified 
2000 diameters. 



Also a germicide 
Balsam of Tolu. of rare value. The 
compound syrup ad- 
ministered in tea-spoonful doses every 
three or four hours, completely annihilates 
the microbes of hooping-cough ; the sar- 
cinae ventriculi ; the microbe of green 
diarrhea, and malarial germ. It has also 
been used quite extensively in a recent 
epidemic of influenza with most brilliant 
success, completely annihilating the mi- 
crobe every time it was administered. 



herb of 



A perennial 
Balm Melissa the mint family. 

Officinalis. This well-known plant is 

teeming with ozoniferous 

properties, and almost any preparation of 

it, from a simple infusion to a fluid extract, 

is germicidal, aromatic, diaphoretic. 

A simple infusion, or the fluid extract 
added to hot water, sweetened, makes an 
excellent drink in fevers. It sterilizes 
germs, even destructive to the bacteria of 
mal-assimilation. 

A simple remedy too much neglected! 
by the profession. e 

A few drops of the fluid extract, added 
to warm water, and sweetened, make an 
excellent drink in fevers. An ointment 
also is of utility. 




Balm. 



BACTERICIDES. 



1253 



is, without a doubt, one of the most valuable 

Bayberry, remedies in the materia medica, being a tonic, 

astringent, and germicide, yielding its properties 

either to alcohol or water. 

Combined with an equal quantity 
by weight of either boroglyceride or 
anti-microbe powder, and added to 
boiling water, and permitted to cool, 
it forms an efficient agent to kill the 
entire brood of amoeba and other 
germs present in nasal catarrh. 

It is equally efficacious as a gargle 
in ulcerated sore mouth and throat, 
whatever germ be present. 

In catarrh of the stomach and 
bowels, it so astringes the mucous 
coat, the habitat of the sarcinae 
ventriculi, as to actually starve that 
microbe out. 

It is also excellent in catarrh and 
ulceration of the bowels, but the 
Virginia stone crop has entirely su- 
perseded it, being more efficient in both 
tion of the intestines. 

It destroys the bacteria of ulcers, and thus promotes their 
rapid cicatrization. An alcoholic extract (solid) inappropriately 
named myricin, is comparatively inert. 




Bayberry. 

catarrh and ulcera- 



or gum benjamin, is a resinous exudation from a 

Benzoin, plant growing in the Eastern Archipelago. Com- 
bined with aloes, storax, and balsam of tolu dis- 
solved in spirit, it used to have a great reputation as a vulnerary 
or application to cut surfaces. This compound was known as 
Friar's Balsam. It is rarely given internally. 

It is a bactericide of no mean power, equal to tolu, thymol. 

Benzoin. — Indications. — (Usually given in the form of benzoic 
acid). A strong, pungent, offensive odor of the urine, stiff joints, 
gouty pains, which are worse while at rest in bed, are the indica- 
tions for benzoic acid. In the form of an ointment, this drug is 
very valuable in sore nipples, and should be applied after the 
child nurses. 

It is also valuable for chapped skin, and chafing. It is also a 
very good protection to cuts and lacerated wounds. In enuresis 
of children, where the urine is strong, benzoic acid is a good 
remedy. 



1254 



DISEASE GERMS. 



Benzoic Acid. — Indicated in the uric acid diathesis, or graveL 
It combines with nitrogen, derived from nitrogenous substances 
contained in the blood, which would otherwise go to form uric 
acid, and is itself converted into hippuric acid, which is rich in 
oxygen. Dose: ten grains in syrup, thrice daily. 

Benzoate of Sodium. — Indicated as an antiseptic in erysipelas. 
Drachm doses in Seltzer water, every three hours. 

Benzoated chloroform is made by dissolving three drachms of 
pure benzoic acid in twelve ounces of chloroform, and filtering if 
necessary. This is a germicide of considerable value in the 
treatment of fetid wounds. The best method of applying this in 
cases of gangrenous ulcers of the limbs, is to apply a compress 
to bandage the parts carefully, and then pour about a drachm 
over the ulcer ; the action is effective in the destruction of all mi- 
crobes on its surface. It is not quite as efficient as the boro- 
glyceride in those troublesome cases of fetid exhalations of the 
feet. It is equal to a solution of resorcin, for the purpose of dis- 
infecting the hands after a post-mortem examination. 



It is an extremely useful remedy in 
Berberis Vulgaris, jaundice, in any form, decoction, fluid 
(^Barberry.) extract, or otherwise. As it is an ever- 

active cholagogue, causing the bile to 
flow freely, it relieves constipation, 
has a tonic and germicidal action, 
hence it is tonic to the digestive 
organs, and cures all forms of rec- 
tal congestion, such as piles. 

The berries (containing quite a 
percentage of various vegetable 
acids) are astringent ; neverthe- 
less, an infusion of them make an 
excellent drink in all bilious affec- 
tions. 

A combination of barberry and 
phosphate of soda forms an ele- 
gant preparation in all states of 
torpid liver, with biliary calculi. 

Several interesting cases have 
been recently noticed of amyloid 
and fatty livers, in which it was 
administered with great success 
prolonging life many years. It is 
certainly worthy of more general 
use. Dose: thirty to sixty drops of a fluid extract. 




Barberry. 



BACTERICIDES. 



255 



In doses of ten to fifteen drops, the berberis vulgaris is almost 
a specific for albuminuria, chyluria, nephritis, gravel of the blad- 
der; while the gravel is small. It may be combined with uva 
ursi and liatris spicata in hyperaesthesia of the bladder. In 
chronic cystitis and nephritis, it is a very active remedy. In 
gravel it may be given in a strong decoction of sarsaparilla. In 
kidney colic (sand or gravel in the kidney), berberis vulgaris is 
our best remedy, in doses of five drops every five or ten minutes 
until relieved. 



An invaluable drug to sterilize all germs 

Belladonna, and render them latent. 

Its wonderful action upon the nerves of the 
mouth and throat, renders it an exceedingly efficacious remedy 
in diphtheria and scarlet fever, 
and in all inflammatory condi- 
tions. 

It paralyzes the nerves of the 
mammary gland, and thus arrests 
secretion of milk. 

In incontinence of urine, rigid- 
ity of the OS uteri, nervous dys- 
menorrhoea, retention of urine, 
this remedy is of great efficacy. 

It paralyzes the nerves that 
supply sphincter muscles, hence 
its value in rectal fissure. 

It is especially valuable in 
nearly all forms of neuralgia. 

Combined with a definite quan- 
tity of nux vomica, it is of great utility in constipation, due to in- 
ertia of the bowels. 

It forms one of the constituents of that celebrated neuralgia 
liniment: Aconite, belladonna, and chloroform, equal parts. 
Mix. Apply over painful nerve. 

In colic, alternated with the wild yam, is most efficacious ; best 
in the form of hypodermic injections of atropia. 

Invaluable in embolism, combined with alkalies. 




Bella onna 
and flowers 



a, part of a branch with leaves 
d, fruit, with persistent calyx. 



A failure of the menses from cold, nerv- 

Betin. ous shock or in constitutional disease, as 

{The Glucgside .\_t\\hQYc\x\os\s, cancer, chlorosis, is a bad 

, '. omeri,and their re-establishment in all cases 

is conducive in restoring the patient to health. 

Emmenagogue remedies have been used empirically and erro- 



1256 



DISEASE GERMS. 



neously, and in some cases 
disastrously. More rigid 
legal enactments are re- 
quired — nay, imperatively 
demanded in the sale of 
santonine, permanganate 
potassae, tansy, gunpowder, 
cotton- root and the like. 

The annexed wood-cut 
by Crap gives an illustra- 
tion of the American red 
beet, from which a peculiar 
resinoid, betin, is obtained. 
This is extracted from the 
tuber or root, after it has 
been thoroughly crushed 
and macerated in alcohol 
for a month. 

The active principle, be- 
tin, is very volatile and must 
be either made into pills 
and sugar-coated, or else 
into capsules, so as to pre- 
serve its active medicinal 
properties. 

It is therefore chiefly used 
in pill or capsule form. 

The compound betin pill, 
according to the Dispen- 
satory of Great Britain and 
North America, is com- 
posed of betin, the active 
principle of the red beet, the 
tsa tsin (rhynchosia exca- 
vata) the great Chinese em- 
menagogue and caulophyl- 
lin. This is reliable. We would caution the profession in pre- 
scribing powderjed betin, as it is entirely worthless. 
The compound betin pill is our best form. 

is used in medicine in two forms, the sub-nitrate 
Bismuth and carbonate. The former is the more commonly 

employed. It is exceedingly useful in certain 
kinds of irritation of the stomach ; dose, five to twenty grains. 
As it is quite insoluble, it must be given in something which will 




American Red Beet. 



BACTERICIDES. 



125/ 



Bistort. 

{Polygonum Bis tor ta) 




Bistort. 



suspend it ; gruel will do. Gum arable is commonly used for 
the purpose. A useful liquid form of the remedy is known as 
liquor of bismuth. Some people prefer the carbonate to the 
nitrate ; its effects are similar. 

The salicylate of bismuth is destined to supersede all other 
preparations of this metal, being a tonic and bactericide. 

The sub-iodide of bismuth has been employed successfully in 

gastric ulcer. 

Yields excellent germicidal and as- 
tringent properties to either alcohol or 
water. The whole plant 
contains an abundance 
of polygonic acid ; the leaves part with a crystal- 
lizable coloring principle, identical with the glu- 
coside ^* rutin '' from rue ; bistort bears a close re- 
lationship to smart-weed or water-pepper. Its 
very active bactericide properties render it of great 
value in annihilating the microbe of green diar- 
rhea and dysentery, and like rue valuable in 
amenorrhea. A tincture is the best form for ad- 
ministration ; small doses frequently repeated suc- 

<ceed best. 

An invaluable alterative, antiseptic and dia- 
phoretic, especially useful in cutaneous affec- 
tions. The dried twigs as found in the shops 
of various lengths but about the 
thickness of a goose quill, are the 
best part for use. Boiling water 
extracts all its virtues, and these 
depend upon an alkaloid called 
solanine. Two fluid ounces of the 
infusion can be taken with advan- 
tage three times a day. 

Dose: Thirty to sixty drops. 
This is the remedy for catarrhal 
diarrhea, mucous stools, bloody 
slimy stools, catarrh of the nose, 
throat, chest, or bowels. It is the 
remedy in lepra, moist tetter, asthma 
from repelled eruptions or hives in 
children, for neuralgia from cold or 
from the suppression of eruptions. 
It is also a valuable remedy for 
erotomania. Alternated with lappa 
major (the seed) it is valuable in 
eczema. 



Bittersweet, 




Bittersweet 



1258 



DISEASE GERMS. 



Bladder ^V^ack. 



Sea-weed or fucus vesiculosus. The thal- 
lus dried, reduced to a No. 40 powder, 
prepared in the form of a fluid extract, is 
an invaluable remedy to rid the body of any superabundance of 
fat. 

It is the safest and most efficient anti-fat remedy in the Materia 
Medica. 

The dose is very variable, depending in a great measure upon 
the effect desired. It is also a good alterative and germicide. 

" Worthless as a weed " does not evidently 
apply to sea-weeds. A hundred tons of air- 
dried sea-weed will yield, besides its salts, 
seventy tons of algin and fifteen tons of cel- 
lulose. The algin is a glutinous substance, 
with fourteen times the viscosity of starch, 
and thirty-seven times that of gum arabic. 
It is used for sizing, as a mordant in dyeing, 
in cookery, and the making of confectionery, 
the manufacture of paper, to prevent the in- 
crustation in steam boilers, and many other 
uses. 

Besides the large amount of iodine it con- 
tains fucus vesiculosus. 

Whenever there is an excess of the non- 
vital element, adipose tissue, this remedy is- 
indicated. It strips the human body of the 
non-yital element, fat, without restriction of 
diet. It is the only anti-fat remedy known. 
Its chemical constituents being chiefly 
iodine and ozone from nature's laboratory — the one from the sea ; 
the other from the atmosphere. The vitalizing properties of each, 
render it a remedy of inestimable value as an alterative. 

Dose, from ten to thirty drops added to a little water every 
three hours. 




Fucus vesiculosus ; show- 
ing the receptacles of the 
fructification a, a, at the 
ends of the branching 
frond ; d, b, b, large air- 
cells which help to float 
the plant. 



Sanguinaria canadensis. The root is the part 
Bloodroot. used, and is emetic, sedative, germicide, tonic,. 

expectorant, emmenagogue, laxative. 
The action of this remedy depends upon the dose given. 
Small doses stimulate digestion and assimilation, and increase 
the tone of the heart; larger doses are sedative. It is an invalu- 
able remedy in croup, as it destroys the false membrane as soon 
as formed. The following is the formula for the acetic tincture 
of bloodroot. 



BACTERICIDES. 



1259 



Bloodroot, in fine powder ; lobelia, in 
fine powder ; skunk cabbage, in fine 
powder, of each, two ounces ; distilled 
vinegar, two pints. Mix. 

The dose will depend on the age and 
the effect desired. The same formula, 
made into a syrup by the addition of 
sugar, forms an invaluable remedy for 
all forms of bronchial irritation. In dys- 
pepsia it is best given in small doses 
highly triturated. 



Blue Cohosh. 




Bloodroot. 



The root of this 
plant is emmena- 
gogue, parturient, al- 
terative, tonic, and a stimulant to the 
uterine motor nerves. 

As a parturient it cannot be too 
highly prized ; it allays cramps, false 

pains, and hastens delivery in cases 
of debility, fatigue, or uterine inertia. 
Very beneficial in nervous dysmenor- 
rhoea and after-pains. An infusion is 
the most active of all the preparations. 
Distillation isolates the emmena- 
gogue properties. A formula in very 
general use is the following : 

Fluid extract of blue cohosh, three 
ounces ; fluid extract ergot, one ounce ; 
fluid extract water-pepper, one and 
one-half ounces; oil of sabina, ninety 
drops ; alcohol, two ounces. Mix. 
Shake well. Dose, thirty drops every 
three hours. 




Blue Cohosh. 

Fluid extract and glucoside ; an invigorator and 
Boldo. appetizer. 

Its exhibition insures prolonged natural sleep, and 
is a germicide to microbes on the mucous membrane. 

As a bactericide it is especially destructive to the bacteria of 
dyspepsia, the micrococcus of cystitis, gonorrhea, and bacillus 
of rheumatism. 

The dose of the fluid extract is from five to twenty drops. 



I260 DISEASE GERMS. 

The glucoside boldine. — A powerful hypnotic ; of special bene- 
fit in the sleeplessness of the insane, in whom it produces sound, 
refreshing sleep. There is an entire absence of anaesthesia in its 
use ; less carbonic acid is exhaled than when awake ; the brain 
is less full of blood than during waking hours, and in certain 
forms of insanity this is an invaluable drug. 

Dose, two, four, six to eight grains every three hours. 

The physiological action of the new boldo glucoside has been 
investigated by Dr. Miller, Sugar Branch, Ind., who finds that 
either when administered internally, or introduced into the sys- 
tem by hypodermic injection, it produces at once and rapidly a 
tranquil sleep, lasting a longer or shorter time, according to the 
individual experimented upon. This sleep is of a healthy char- 
acter, awaking from it without any appreciable change, with their 
usual health, habits, and appetite. In his more elaborate experi- 
ments, he found that this new substance stimulated and increased 
the secretory functions, especially the biliary secretion, the saliva, 
and urine. It would, therefore, appear to be peculiarly suited to 
cases of torpid action of the liver, accompanied with restlessness 
and sleeplessness, as is not infrequently the case. 



Ozone ; Boric Acid ; C. P. Glycerine. 

Boroglyceride A chemical compound, powerful germi- 

Ozonized. cide, hemastatic, prevents and arrests fermen- 

tative and putrefactive changes. 

Its 7ise is indicated internally and locally in nearly all micro- 
bial diseases. 

When the cutaneous surface becomes invaded with the micro- 
organisms of erysipelas ; burns, eczema, lichen, prurigo and 
there is intense burning, tingling, itching, the greatest possible 
relief is immediately experienced, and the microbe killed, by the 
application of a lotion of two ounces of boroglyceride to the 
pint of tepid water, kept constantly moist, covered over with 
oiled silk ; so with parasite skin affections. Applied to wounds, 
if the ordinary indications are observed, union by first intention 
is promoted. 

Ulcers, which resist the ordinary remedies are speedily cured 
by the application of a fifty per cent, solution. 

It sterilizes the microbe syphilitica, hence in its pure state it is 
an invaluable application to chancres (superior to iodol); makes 
a splendid germicidal injection in female gonorrhea, radically 
rooting out the gonococcus ; besides it is of great efficacy in 
metria, in washing out the uterine cavity, and rendering it 
aseptic ; of utility in metritis, endometritis, vaginitis, catarrhal 



BACTERICIDES. 



I261 



states of the neck, and undoubtedly our best remedy in all forms 
of leucorrhoea. To an indurated or hypertrophied uterine neck, 
packing the vagina, embedding the indurated parts into the 
boroglyceride paste for twelve hours at a times, effects a marked 
revolution in the parts. 

As a mouth wash or gargle, it destroys all germs in the oral 
cavity ; hence it is of value in all throat affections, in tonsillitis ; 
laryngitis ; in variable strengths it is very efficacious in nasal 
catarrh. 

Its vitalizing action on the 
skin of the face is superb ; 
here the boroglyceride oil, 
applied on retiring, rernoves 
all tan, freckles, rendering the 
skin soft, velvety. 

In ocular affections, the 
boroglyceride excels all 
known germicides in the 
various forms of ophthalmia. 
Kills the microbes of the 
common, acute, the purulent, 
the gonorrheal, and to the 
granular form it makes an 
excellent application. To 
this latter it is used thus : 
the lids being thoroughly 

averted, the boroglyceride heated into an oily consistency, is 
spread all over the conjunctival surface with a camel's hair 
brush. It is generously applied, readily gains access to the 
cracks, crevices, and into the granulations themselves. 

The immediate effect is to increase lachrymation, with a pain- 
ful gritty sensation, which passes off in ten minutes, followed by 
an amelioration of all the symptoms, the granulations look pale, 
less prominent, and if applied three times a week for six weeks 
become imperceptible. This remedy is destined to supersede all 
caustic or astringent lotions in eye affections. Boroglyceride 
has a large range of action, as an internal remedy, useful in 
indigestion, and numerous other complaints, but of special utility 
in inflammation of the bladder. Its administration in all cases 
of cystitis is indicated, as it prevents the evolution of the micro- 
coccus urincE, a most important point. This micro-organism is 
the result of the decomposition of the urine, w^hich increases 
the vesical irritation ; augments the secretion of muco-purulent 
matter, and affords a better field for germ growth. The internal 
administration of boroglyceride has a most remarkable action in 




Boric Acid Crystals. 



1262 DISEASE GERMS. 

all cases of irritable bladder, as it arrests decomposition and 
microbe growth. Acute cases that usually required several 
weeks to recover from, get well under this remedy in two or 
three days, with no germs whatever in the urine. 

In its use, it should be given in small doses, five, ten or more 
grains every hour dissolved in water, until the crystals of boric 
acid appear persistently in the urine, when it should be admin- 
istered at less frequent intervals. 

Owing to insanitary states, want of shelter, deleterious or swill 
feeding and other causes which devitalize, nearly all our domes- 
tic animals are suffering from actinomyces, anthrax, tuberculosis, 
the embryonic germs of scarlet fever and variola ; cows are the 
especial victims, and their. lactiferous fluid is germ-laden. 

That seventy-five per cent, af all cases of splenic fever, tuber- 
culosis, scarlet fever, variola, cholera infantum in city children, 
is caused by the use of this microbial milk. 

Those animal germs are of a giant form, neither boiling nor 
freezing causes their annihilation, certain temperatures may in- 
crease or retard their growth, but they are there, living, breed- 
ing, excreting their ptomaines, that poisonous alkaloid which is 
the cause of so much latent death among children. 

We claim from most extensive experience that a small amount 
of boroglyceride introduced into milk will keep it fresh, its mole- 
cules unchanged in the hottest weather for from fourteen to 
twenty-one days, without the use of ice, and also that it will 
completely sterilize and annihilate every germ in that fluid. 

In anthrax and after the incision of furuncles it acts well when 
applied directly to the parts. Forming furuncles should be 
painted several times daily with the following : Boroglyceride 
and water, of each equal parts. 

In burns, when the flesh is exposed, it is necessary to be care- 
ful with poisonous antiseptics. Boracic acid possesses the ad- 
vantage of being non-poisonous. Covering the burnt surfaces 
with a boracic vaseline ointment in the proportion of one to five : 
Boroglyceride, twenty parts ; glycerine, fifteen parts ; mix and 
add ozone ointment, eighty-five parts ; apply twice daily. 

In severe burns, with fever, the author combated the fever by 
the internal administration of the following : Borogloceride, four 
parts ; glycerine, ten parts ; water, one hundred parts ; syrup of 
poppies, twenty-five parts. A teaspoonful every two hours. 

In skin diseases, such as pemphigus, eczema, rhagades, rupia, 
and scabies, the results obtained with boracic acid have been 
most favorable. The formula used was : boroglyceride, ten 
parts ; glycerine, twenty parts ; lanoline, thirty parts. 

The treatment of scabies consists in first taking a warm bath 



BACTERICIDES. 



1263 



and then rubbing the affected parts with boracic-vaseHne salve 
(first one to two ; later equal parts). The duration of this treat- 
ment averaged six days. In a case of granular conjunctivitis a 
cure was effected within forty-five days; a like result was ob- 
tained in some cases of pannus. Chronic scrofulous otitis is im- 
proved by lukewarm injections of concentrated boracic acid 
solutions ; the application of boracic acid glycerine (one to ten) 
to stomatitis, aphthae, or tonsillitis is followed by a curative effect. 

For coryza : boroglyceride, powdered coffee, equal parts. Use 
as a snuff. 

In some cases of chronic endometritis with leucorrhoea and 
sterility, the uterus wass filled with powdered boracic acid, and 
then a boracic acid tampon applied. After removing the tampon, 
the cavity was irrigated with a boracic acid solution. A cure 
was generally effected after a three or four month's treatment, in 
some cases conception following. 

In cystitis the bladder was washed out (in acute cases) with a 
three-per-cent. boroglyceride solution, and in chronic cases this 
treatment was foUow^ed by the internal administration of from 
forty-five to ninety grains of boroglyceride. 

The white and black varieties have germicidal 
Bryonia, properties in common. 

The white variety is of great efficacy as a stimu- 
lant to the eighth pair of nerves that supply the liver, and is 
destructive to the micro- 
organisms of cholera infan- 
tum. Its use speedily 
clears the intestinal tract of 
the green germ-laden stools 
in that very fatal affection. 
The black variety is a stim- 
ulant to all the white fibrous 
tissues of the body, as the 
synovial membrane of joints, 
the pleura, pericardium, 
peritoneum, periosteum, 
membranes of the brain, 
sclerotic coat of the eye, 
hence its value in rheuma- 
tism. It must ever be borne 
in mind that it has no 
true curative action in rheumatism, such as the glycerite of 
wintergreen, or salicylate soda. It simply raises the standard of 
vitality of a class of membranes for which the lactic, butyric, and 
germ of rheumatism have an affinity. 




Bryonia. 



1264 



DISEASE GERMS. 



Burdock. 

(Arctium Tappa) 




A tincture jDrepared in the ordinary man- 
ner from the seeds exerts a tonic action in' 
atonic dyspepsia, in doses of a tabiespoon- 
ful after meals. It is also used with great 
success in all obstinate skin affections. 
More recently it has been found of great 
utility in epileptic seizui'es, used in alter- 
nation with ozonized sumbul. 

It makes a valuable compound with 
Scutellaria in other nervous affections. 



Burdock. 



Bursa Pastoris. 

[Shepherds Purse). 



An ozonized- 
tincture of bursa 
pastoris is one of 
the most excel- 
lent .styptics and germicides in the Materia Medica. 

The tincture must be made from the fresh plant, and ad- 
ministered in thirty-drop doses, every two or three hours, and 
then, without a doubt, it is the most reliable styptic in the 
Materia Medica. 



Dose : From one-half to five grains to ounce 

Cadmium, of water; locally, every three hours. Whenever 

(Sulphate?) lymph has been effused, and we are desirous of 

absorbing it, as in opacities of the cornea, 

chronic ulcers, indurated glands, stiff joints; not so efficacious 

as the clay. 

Tincture or fluid extract possesses remark- 
Calabar Bean, able germicidal properties. 

It sterilizes the microbe of tetanus, and 
other disease germs, the factors of nervous disease. 

Its alkaloid, Eserine sulphate, is a useful remedy in chorea, 
given in the form of an hypodermic injection, one-fourteenth of 
a grain being injected twice daily. In a number of cases a cure 
was effected in five or six days, but it was less successful with 
adults. It was also found beneficial in tetanus, paralysis agitans. 
spinal sclerosis, and in a case of hysteria in the male, accom- 
panied by great excitability and a remarkable increase in reflex 
movements. 



is an oil of a beautiful bluish green tint, ob- 

Cajeput Oil tained by distilling the leaves of a tree growing 

in the Moluccas. It is powerfully stimulant, 

bactericide in character, and is used both externally and inter- 



BACTERICIDES. 1 265 

nally. Externally, when mixed with olive oil, it may be used in 
certain forms of chronic rheumatism. Internally, a drop or two 
given on a lump of sugar acts as a powerfully stimulant germi- 
cide and antispasmodic. A drop on cotton wool applied to a 
carious tooth will often suffice to relieve toothache. 



in all its varied forms, is an invaluable germi- 

Calcium, cide. 

Carbonate of lime, 10 to 20 grains in milk, is 
very efficacious in tuberculosis, diarrhea, vomiting and teething 
of children. 

Lime water added to milk prevents the casein of the milk 
from coagulating, and tends to neutralize the acidity of the sys- 
tem, antidotes the tyrotoxicon. 

Sulphide of lime, in small doses, frequently repeated, annihi- 
lates all disease germs, even the most malignant, and its admin- 
istration so sterilizes the blood that no microbe could live in the 
body. 

Phosphate of lime, valuable in neurasthenia and all broken down 
conditions of the nervous system. Better still are the comp. 
hypophosphites. 

Olive oil and lime ivater good in burns. 

A most excellent form for spray is the following solution, pre- 
pared as follows : 

Take, of lime, one part ; sulphur, two parts ; water, tw^enty 
parts. Slake the lime with some of the water, then add the 
remainder and the sulphur ; boil to twelve parts and filter. 

Under this the diphtheric membrane is immediatel}- de- 
stroyed. 

Chlorine and chlorinated lijne may best be considered together, 
seeing that the latter is but a convenient form "whereby the other is 
rendered portable. Chlorinated lime, commonly called chloride 
of lime, is prepared by pouring gaseous chlorine over quick 
lime, which absorbs the gas and acquires certain of its properties. 
It is mostly used as a disinfecting agent. It acts by virtue of 
the chlorine, which it slowly evolves when exposed to the atmo- 
sphere, or gives it more speedily when spread in a saucer or other 
flat vessel (non-metallic), and a little acid, such as hydrochloric, 
is added. For ordinary purposes, such as cleansing close rooms, 
there is nothing more effectual than chlorine generated from 
chlorinated lime. But as it attacks many things, being a power- 
ful bleaching agent, readily destroys colors and affects metal- 
work, including gilding, it is somewhat at a discount ; but in 
privies, workhouses, ships, etc., it is of much value. To keep 
80 



266 



DISEASE GERMS. 



down ordinary smells, the powder need only be exposed in a 
flat dish, and renewed from time to time. For the purposes of 
active disinfection, it is better to add to the lime some acid, and 
shut up the doors, windows and chimneys for a time, taking care 
that the place has been well ventilated before re-entering. 
Chlorine is also used as a gargle, especially when there is much 
fetor from the throat, as scarlet fever, diphtheria, and the like. 
Here it is exceedingly useful. 



Camphor Gum 



is a stimulant, diaphoretic, antispasmodic 
germicide ; its action upon the brain and 
spine is direct, very soothing, at the same 
time exhilarating. When the nerve centres are irritated by the 
presence of alcohol, or damaged from sexual abuse or excess, 

camphor has a most tran- 
quillizing effect. It is of 
some utility in chordee 
and spermatorrhoea, com- 
bined with gelsemium, by 
allaying the irritability of 
the cord. 

In combination with 
numerous drugs it modi- 
fies their action ; for ex- 
ample, in combination 
with strychnine, it pre- 
vents twitching ; incor- 
porated into Dover's 
powder it greatly in- 
creases its diaphoretic 
and sedative action, etc. 
So with kaki in typhoid 
fever, it renders that drug 
still more efficient ; com- 
bined with tincture ferri 
and nitrate potass, of great 
efficacy in dropsy. 
Camphor can be freely dissolved in ozone ointment by heat ; 
then it is of the greatest possible value in arresting the secretion 
of milk in the female breast, smearing cloths with it and apply- 
ing ; the same ointment applied on the face, in variola, prevents 
pitting; stimulates indolent ulcers. 

It is a true bactericide ; it is thus of value in either sterilizing, 
or annihilatinor prerms ; three or four grains in the form of 




The Camphor Tree. 



BACTERICIDES. 



1267 



emulsion have a most remarkable action on the comma-bacillus 
of cholera. 

It has a strong affinity for ozone, and will take up pound for 
pound of the peroxide of hydrogen, and in this form constitutes 
" concentrated ozone." In this combination it instantly relieves 
the headache due to sewer gas ; the toothache, due to a microbe, 
the excruciating pain of neuralgia ; the prostrating effects of the 
cholera germ. 

It is this same preparation which renders labor painless ; 
promptly relieves the heart-pang of angina. 

The mono-bromide of camphor is a most efficacious remedy, 
being both a sedative and stimulant, used with excellent results 
in insomnia, chronic alcoholism, chorea, dipsomania, sexual 
erethism, spermatorrhoea. 

Camphor oil is a valuable parasiticide, destroys a large pro- 
portion of insect life, as moths ; suitable for painting the interior 
of trunks and wardrobes, to ward off insects ; a good application 
to bite of mosquitoes, wasps, etc., and, added to mucilage of 
gum arable, makes quite an efficient remedy to kill the gono- 
coccus of gonorrhea. 

Camphor acid is a powerful bactericide, valuable in cystitis 
and gonorrhea. 



An efficient germicide and antiseptic. 
Campho-Phenique. A decided local anesthetic, non-poison- 
ous ; mixes readily with chloroform and 
glycerine ; does not stain or discolor ; mixes well with petrolina. 
It has a most energetic action in destroying the microbe of dental 
caries, allays the sensitiveness of dentine, and, when mixed with 
arsenious acid, makes an excellent nerve-killing paste. 



Of utility in insomnia, low form of mania, inco- 

Cannabis herence of ideas, where the mind is lost in forget- 

Sativa. fulness, or where it has magnified ideas of things, 

mental deception, depraved appetite. It is very 

valuable in neuralgia, where there is severe pain in the crown of 

the head. 

Its germicidal action is best exhibited upon the genito-urinary 
organs of both sexes, it acts very promptly in sterilizing the 
gonococcus and destroying it. 

In menorrhagia, membranous dysmenorrhea, it acts well upon 
the bacteria, and promptly arrests the flow, after other remedies 
fail. 



1268 DISEASE GERMS. 

The dose is somewhat variable, from eight to ten drops of the 
fluid extract, repeated according to indications. 

The eminent S. B. Bell, M. Z>., 
of Esom Hill, Ga., says that it 
grows extensively in the Southern 
States, and is collected while flow- 
ering. 

A germicide of some power^ 
especially in sterilizing the urethra, 
and killing the gonoccocus ; acts as 
a sedative to the urinary passages. 

Besides its utility in insomnia, it 
is of great service in nervous affec- 
tions. 

The mode of administration 
Hemp(c«««a^z>ja//z'a): a, male inflor- should bc Small doscs frequently 
escence; b, female inflorescence. repeated in watcr, Until the systcm. 

is thoroughly brought under its influence. 




The common names are, waxweed, flax 
Cuphea weed, red pennyroyal. This medicament is 

Viscasissima. claimed by bacteriologists, to be a very valu- 
able germicide in the treatment of cholera 
infantum. A tincture of fresh plant is used, in doses of five 
to ten drops according to age, every hour until relieved, then so 
often as need be. There are two classes of cases in which 
cuphea is specific. First, those arising from acidity of milk or 
food ; vomiting of undigested food, or curdling milk, with fre- 
quent green, watery and acid stools, varying in number from five 
to thirty per day ; child fretful and feverish ; can retain nothing 
on stomach ; food seems to pass right through the child. Second 
class, the stools are decidedly dysenteric, small, frequent, bloody,, 
with tenesmus and great pain ; high fever, restlessness and sleep- 
lessness. In both the comma-bacillus is completely sterilized. 



is in our opinion the purest stimulant in the 
Capsicum Materia Medica. It possesses the properties of 
ergot and nux vomica combined. It is a pure 
stimulant to the ganglionic system of nerves, and acts on un- 
striped muscular tissue. It increases arterial tension by stimulat- 
ing the vasomotor centre. It is at the same time a sedative and 
a stimulant to the stomach and intestines, one action is on the 
mucous membrane, the other on the unstriped muscular tissue,, 
and the third on the glands of these organs. 



BACTERICIDES. 



1269 



Its action is both direct and reflex. Capsicum increases peri- 
staltic action by stimulating the filaments of the sympathetic and 
the unstriped muscular fibres of the intestines. In this way it 
cures chronic constipation. We have cured many severe cases 
of this trouble, the atonic, with infusion of capsicum. We know 
of no medicament that can be any more relied on in atonic dys- 
pepsia caused by catarrh of the stomach and duodenum, than 
infusion of capsicum. Its action is sure on the catarrhed 
mucous membrane and glands, on the nerve endings of the 
mucous membrane, acting on them as a tonic stimulant and thus 
controlling the secretion of the glands of the organ ; it contracts 
the arterioles of the mucous membrane 
in virtue of its action on unstriped mus- 
cular tissue. In all probability it acts 
on the local vasomotor mechanism of 
the parts, stimulates them to a greater 
functional activity in virtue of which the 
nutrition of the tissue is enhanced. 

In some cases of adynamic fever and 
inflammation, capsicum is the remedy 
to wake up the latent energies of the 
ganglionic nervous system and keep the 
forces of organic life jogging on until 
the crisis is passed. It slows the heart 
and firms the pulse and strengthens the 
respiratory centres, a failure of which 
is often a slow, yet certain decline to 
the grave. In delirium tremens, we 
have seen a very strong tea of cap- 
sicum steady the shattered nervous system, stop the delirium 
and restore the appetite. 

In all cholera and cholera morbus for- 
mulae, capsicum holds a conspicuous place. 
These are the words of one of the most 
brilliant savans in medicine, Prof Jos. Adol- 
phus, M. D., of Atlanta, Ga.: " It is an excel- 
lent drug in uterine hemorrhage." 




Capsicum. 




Cardamom 
Seed. 



The seeds of the arnomum 
rej^ens or cdLtddimom. are highly 
germicidal, and a grateful 
aromatic, less heating and 
stimulating than others of the same class but 
more highly germicidal ; it is a most useful 
adjuvant or corrective to all cordials, tonics and griping pur- 



Amomum 



1270 DISEASE GERMS. 

gatives. The use of all this class of aromatics increases the 
bactericide properties of every remedy into which they are in- 
corporated. 



Carbolic Acid 

or 
Phenic Acid. 



Is obtained by careful distillation from coal- 
tar. It is met with in two forms, either in 
liquid or crystal. Very sparingly soluble in 
water, but it parts when mixed with water, 
just sufficient to be of value. 
It is a powerful bactericide, and as such is extensively used to 
prevent and destroy microbes in wounds and disease-germs in 
the alimentary canal. Carbolic acid, twenty grains ; syrup of tolu, 
four ounces. Mix. From a half to one teaspoonful every three 
hours. Locally for burns or compound fractures, six ounces of 
olive oil to one of carbolic acid. Mix and apply. 

Locally. A ten-per-cent. solution or injection in the centre of 
a hemorrhoidal tumor or pile immediately causes it to wither 
and disappear. The following formula is esteemed excellent, 
and is used in the same manner : Glycerine, two and a half 
drachms ; phenic acid, twenty drops ; morphia, five grains. Mix. 
A few drops injected into any pile causes it to painlessly dis- 
appear. 



This is quite extensively cultivated for its seeds, 
Caraway, which contain on an average about four per cent, 
of a volatile oil, which when fresh is of a limpid 
brown color, becoming darker by age; 
it has the odor and chemical proper- 
ties of thyme — thymol. Without dis- 
tillation the seeds yield their oil to 
alcohol, more slowly and less sparingly 
to water. The seeds distilled with 
alcohol at forty-five gives us what is 
known as kemmel, a very favorite bev- 
erage of some European nations. 

In all its forms, seeds, oil or essence, 
it is an invaluable germicide, killing 
bacteria and the oidium albicans. Its 
more general use should be encour- 
aged, especially in food and medi- 
cine, among people denizens of over- 
crowded cities. 




Caraway. 



BACTERICIDES. I 271 

In small quantities has a germicidal 
Carbonic Acid Gas action, sterilizing bacteria, on the 
stomach, causing the arrest of vomiting. 
Carbonic acid is always present in the atmosphere in a small 
quantity, and it is partly an accumulation of this gas which makes 
a small, badly-ventilated room smell close and stuffy ; languor 
and headache then come on, and unless fresh air is admitted in- 
jurious consequences may supervene. From this cause over- 
crowding is injurious, and those who work together in a room, 
as dressmakers, etc., are often liable to headache, anaemia, and 
general debility. Fresh air is of course the simple remedy for 
this condition of things, while in serious cases of poisoning by 
the gas, and when the patient is found insensible, removal of the 
individual into the open air is the first thing to be done, and 
then artificial modes of respiration must be resorted to. Carbon- 
ic acid is a gas, and in its pure state is poisonous when retained 
in the blood. It is at all times exhaled in the breath, and is one 
of the chief agents in inducing that languid state experienced in 
crowded apartments. It is the principal ingredient in the choke- 
damp, so fatal to miners after an explosion. It causes death by 
arresting all change in the lungs, so that the whole blood be- 
comes black and impure. By itself it is not greatly used in 
medicine, but in the form of soda-water it is often exceedingly 
useful. It is this agent contained in effervescing liquids which 
gives them their sparkling character, and which enables them to 
be retained on the stomach, which would otherwise reject them 
in fevers, and such like disorders. It is partly due to the car- 
bonic acid in it that champagne is frequently retained when 
nothing else is. To manufacture soda-water, the so-called gazo- 
genes now so plentiful, may be made use of, carbonate of soda 
and tartaric acid being employed in the process. On the large 
scale sulphuric acid and chalk or marble are employed, but the 
gas requires to be carefully washed, otherwise the taste of the 
soda-water is bad. The gas itself has been employed to relieve 
the pain of cancerous, especially uterine affections. 

The extensive use of carbonic acid exhausts the sexual ap- 
petite, in the base of the brain. 



The leaves of the Jacarando procera and other 
Caroba. species are largely used in the United States and in 
Europe for chancres, buboes, chronic catarrh of the 
urethra, syphilitic lesions, and pains in the body from misuse of 
mercury. The fluid extract has proved successful in this country 
for the treatment of gonorrhoea. It is given in doses of ten to 
sixty minims according to the virulence of the case. 



1272 DISEASE GERMS. 

A species of sea-weed, which grows on the 
Carrageen, rocks, along the sea-shores of the greater part of 
temperate Europe and North America, used to a 
considerable extent medicinally and as an article of food. The 
species which constituted the carrageen of commerce is Chondrus 
crispiis, of which there are numerous varieties. It contains 
eighty per cent, of active medicinal properties, a vegetable jelly 
with iodine and ozone, which renders it invaluable in microbial 
disease of the pulmonary organs. 

When half an ounce of carrageen is placed to steep for ten 
minutes in three pints of cold water, and then boiled and strained^ 

it yields up its therapeutic proper- 
ties, and with or without spices 
forms a valuable drink. With a 
larger proportion of carrageen, a 
thickish liquid or mucilage is ob- 
tained, and on further boiling this 
strong decoction, and cooling, a stiff 
jelly is procured, which can be ren- 
dered quite acceptable to the most 
delicate stomach by the addition of 
spices and sugar. 

Now that its true bactericide pro- 
perties have been made clear, that 
there is a something more intrin- 
sicall)' in it than emollient and demulcent, its use should not be 
overlooked. Milk may be used in its preparation instead of 
water, and various other germicides can be added, to still further 
increase its efficacy. 




The fluid extract prepared from the root 
Cascara Sagrada. of the cascara-sagrada is a standard remedy 
for constipation. Various other prepara- 
tions are in use, but are comparatively worthless, except the cas- 
cara sagrada ozonized lozenge^ prepared with the purest chocolate. 
Cascara sagrada is a tonic laxative. It also aids the general 
processes of digestion, especially promoting those of nutrition 
and assimilation. Cascara sagrada seems, when given in suffi- 
ciently large doses, to exercise a soothing influence on the rectal 
mucous membrane. 

Originally introduced by ourselves, w^e have paid particular at- 
tention to the importation of the most carefully selected bark 
{Rhamnus purshiana), and used the greatest care in the manipu- 
lation of the various preparations we have from time to time 



BACTERICIDES. 



1273 



introduced, and their superiority over the various imitations that 
are now made has been verified by the profession, after careful 
and extended trials. 

In its crude state, cascara has an intensely bitter taste ; and on its 
first introduction this was found one of the great objections to its 
use, especially with ladies and children. We have, however, 
succeeded, after careful experiments, in rendering the different 
products perfectly tasteless, and the presentation in the form of 
an elegant and pleasant lozenge renders its administration, espe- 
cially to children, a matter of the greatest ease. 
• The lozenges are carefully prepared in our own laboratories 
with our especially prepared Extract, rendered tasteless by our 
new process of manipulation, and are combined with the purest 
eating chocolate, and can be taken as easily as the ordinary bon- 
bons of the confectioner. 

Dose : Each lozenge contains two grains of pure tasteless ex- 
tract cascara.. For adults, one, two, or three may be taken at 
bedtime ; children may take from half to a whole lozenge for a 
dose at bedtime. 



Grows in the marshes and dried-up rivers of 

Cassia Alata Porto Rico. It is a beautiful shrub, with yel- 
low flowers, growing to a height of six or 
eight feet. The entire plant, 
leaves, flowers, and stem, is 
highly germicidal ; they owe this 
property to the large amount of 
chrysophanic acid they contain. 

Simmering the fresh leaves, 
buds, flowers, bark in lard gives 
us an ointment of rare value in 
all skin affections. 

A decoction of the bark, leaves 
and flowers applied to the skin 
in chronic eczema, promotes a 
very rapid healing. An infusion 
of the flowers and leaves, one 
ounce to the pint of water, and drank freely during the day, is 
•of s^reat efficacy in all skin affections. 

The seeds are a reliable vermifuge administered fasting, are 
almost certain to bring away any form of tape worm. 

In overdoses it produces copious, watery evacuations, and is 
highly esteemed as a remedy in syphilis. 




Cassia Alata. 



1274 



DISEASE GERMS. 



Celona Glabra. 




The entire herb possesses strong germi- 
cidal and parasitical properties, acting effi^ 
ciently on the liver, stomach, and 
bowels, cleansing all the alimentary- 
tract of germs and parasites ; hence 
its utility in dyspepsia, jaundice, mal- 
assimilation ; especially valuable in all 
conditions of debility. 

The best form in which to admin- 
ister it is in the form of a fluid ex-^ 
tract. 



gentian, and 

Balmony {Chelone Glabra). ^^^^ pOWCr. 

extract is the best form ; the for- 
mer applied to old indolent ulcers 
promptly kills the bacteria in the 
sore and promotes a healing pro- 
cess. As an application to all 
forms of tissue it surpasses many 
modern drugs, kills the spores of 
tinea capitis and versicolor, re- 
moves freckles and all microbial 
spots and marks upon the skin. 

Internally, it is a good parasiti- 
cide, no species of worms can re- 
sist its action ; most effective in 
jaundice and torpid liver ; and 
completely sterilizes the germs of 
rheumatism. 

The remedy is best administered 
in the form of tincture. Beginning 
with small doses until it acts freely 
upon the liver ; then decreasing to 
such doses as will move the bowels 
once in twenty-four hours. A 
cerate for parasite skin affections is 
usually made by simmering the 
green or dried plant in some ole- 
aginous body, as petroleum ointment. 



A parasiticide and 

Centaury, germicide, having all 

the tonic properties of 

an anti-periodic of no 

A decoction or fluid 




Erythrea Centauriunu 




BACTERICIDES. 1 275 

Highly bactericidal, destroys the 
Cerastinum Vulgatum. bacteria on old ulcers, and pro- 
(Moiise's Eaj^) motes rapid cicatrization ; 
used alternately with the 
resorcin ointment and Chian turpentine mixtura in- 
ternally retards and kills all cancerous tumors ; the 
green herb cut up fine and bruised and applied to 
a wound speedily promotes primary union; boil the fv^ 
plant in vinegar, add sugar to make a syrup, cures 
bronchitis by sterilizing the germ. As a general 
remedy in all diseases, it wipes out their micro- ^"^lo^se Ear. 
organisms. 

Cerebrin is a soft, light amorphous hygroscopic 
Cerebrin. powder— isolated from the white substance of 
the brain. As it is liable to chemical change, it is 
best administered in the glycerite of kephaline or phosphated 
tincture of oats. Dose : One to five grains at meals thrice daily. 
Kephaline, a soluble form of cerebrin, is best adapted for gen- 
eral prescriptions, being a stable and reliable form. 



Oxalate of cerium is a white granular powder, 

Cerium, odorless, tasteless, insoluble in water, alcohol or 

ether, but dissolves freely in sulphuric acid. It is 

a valuable sedative in all irritation of the stomach and bowels. 

Until the introduction of the ozonized liquor cerii it was our best 

remedy in the reflex vomiting of pregnancy. 

The oxalate is entirely superseded by the ozonized liquor cerii 
which is most valuable in the nausea and vomiting of pregnancy, 
and in similar symptoms associated with dysmenorrhoea, flexion, 
and other uterine disorders, and with hysteria from anxiety, 
grief, overwork, and the like. It is also used with good results 
in pyrosis and in phthisical and atonic dyspepsia, as well as in 
cases of gastric ulcer. It is serviceable in the violent morning- 
cough accompanied with dyspnoea on exertion and sickness on 
the patient getting out of bed. Cerium has also been employed 
with benefit in epilepsy, when belladonna and bromides had 
failed to relieve. The liquor cerii, ozonized, is therefore, worthy 
of trial in obstinate cases of epilepsy and similar complaints. 



One of the most valuable remedies in the Ma- 
Cinchona, teria Medica, being an antipyretic, tonic, stimulant^ 

antiseptic. 
The alkaloid quinine is the best form for antipyretic purposes. 
There are two functions which quinine serves. The one is 



12/6 



DISEASE GERMS. 



that quinine has the power to lower the temperature in febrile 
conditions which are not due to malaria ; the other is that 
quinine has no extraordinary power of arresting the movements 
of leucocytes, causing them to draw in their pseudopods, and 
to contract into a sphere. In the case of free cells like the white 
blood corpuscles we can see that such a contraction as this will 
considerably lessen the surface of protoplasm exposed to oxida- 
tion, but one can hardly see how the change of form is likely to 
interpose any obstacle between the oxygen contained in the 
serum surrounding the cell and the protoplasm. The case is 
different, however, if we take such a structure as the pigment 
cell of the frog. Here the protoplasm does not fill the whole 
cell equally at all times ; occasionally it stretches itself out into 
all the ramifications of the branching cell, and then it will not 
only allow a large surface for oxidation, but will be separated by 
a comparatively thin layer of paraplasm from the lymph or in- 
terstitial fluid by which the cell is nourished. When the pro- 
toplasm contracts it forms a rounded mass in the centre of the 
cell, and then presents a minimum of surface for oxidation, 
and at the same time a maximum thickness of paraplasm is inter- 
posed between it and the cell wall. If we suppose that quinine 
produces an effect upon the protoplasm of cells composing the 
tissues of the body similar to what it has upon leucocytes, we 
can at once see how. it will lessen oxidation in the tissues, and 
thus act as an antipyretic. Nor is it necessary to assume that it 
exerts this effect directly upon the tissues themselves. The re- 
sult will be the same if it stimulates thermal centres in the brain 
and spinal cord, and causes contraction of the protoplasm through 
them. 

Quinine is best administered either dissolved with tartaric acid 
or aromatic sulphuric acid. The best time to give it : after de- 
termining at what time during the twenty-four hours the temper- 
ature is lowest, administer the dose during the fall. We have 
seen a fall of half a degree the next day follow this course, and 
the evening temperature would not rise. 



The constituents of cinnamon are a volatile 
Cinnamon, oil and resin. The oil is prepared chiefly in 
Ceylon, by grinding the coarsest pieces of the 
cinnamon, soaking them in sea- water for a few days, and then dis- 
tilling. Two oils pass over, one lighter, the other heavier than 
water. It varies much in color, from yellow to a cherry- red, 
the yellow variety is the best, and most highly esteemed. 



BACTERICIDES. 



1277 




Its medical properties are aroma- 
tic, carminative, germicide, hemas- 
tatic. An arrester of uterine hem- 
orrhage. A remedy of great value 
in nausea, vomiting, and diarrhea, 
especially when such states are 
caused by the presence of micro- 
organisms in the alimentary tract. 

Stick cinnamon, boiled in milk, 
forms a valuable remedy in diar- 
rhea. 



Cinnamon; a, end of branch, with leaves 
and flowers ; b, four-celled anther. 



Perhaps the 
Camomile. most highly es- 
teemed of all do- 
mestic remedies. It is a bitter aro- 
matic tonic, yielding its properties 
readily to water ; it has an excel- 
lent action upon the stomach as a vitalizer, promoting an ap- 
petite and assimilation of food, but its use is contra-indicated 
in all derangements of the brain. 

A highly aromatic essential oil abounds in the entire plant, 
which is of a greenish yellow color, and highly germicidal, being 
most destructive to the vibrios of 
typhoid fever, to the spirilla and 
cocci of cholera infantum. 

The oil is best administered in 
a high state of trituration, a few 
drops being added to a drachm of 
sugar of milk, thoroughly tritu- 
rated, divided up and adminis- 
tered as indicated. It is besides 
a valuable stimulant to the ab- 
dominal sympathetic. 

Matricaria, or German camo- 
mile, is altogether a very differ- 
ent drug from the above, being 
one of the most valuable of all 
tonics, in cases where there is a 
poverty of nerve force, such as 
nervous debility, paralysis, a gen- 
eral failure of brain power, premature decay ; it has a most vital- 
izing action on the brain, and the most minute periphery of 
nerves. Besides, it is a germicide of great power, a true ozone 




Camomile. 



1278 



DISEASE GERMS. 



generating drug. The compound tincture is the form in which 
it is usually administered, and in doses of from five to ten drops 
in a glass of water before meals. 

It is perfectly compatible with avena sativa or kephaline ; com- 
bined or alternated with those, it is a most reliable remedy in 
functional disturbance of the brain, threatened softening, loco- 
motor ataxia. The action of matricaria upon all organs supplied 
with ganglia of the great sympathetic, is most marvellous. The 
larynx, lungs, heart, stomach, spleen, bowels, left kidney, and 
reproductive organs, are all rejuvenated by its use. 



Chelidonium. 




This is a peculiar germicide, the fresh juice 
of the plant applied externally to corns, warts, 
excrescences, stimulates them beyond what 
their languid vital power can 
bear, and they exfoliate. Mixed 
with cream or boroglyceride and 
applied to the eye, it will re- 
move opacities of the cornea. 

A saturated tincture in large 
doses, is a drastive purgative 
and poison ; in small doses, it 
acts beneficially on the entire 
glandular system, pink marrow, 
mesentery, lymphatics, and the 
liver. It is upon the liver that 
the entire force of the remedy 
falls, acting upon that gland as 
efficiently as the mercurials. 

Under its use the symptoms 
of torpidity disappear. 



Common Celandine. 



Or carbon, occurs in nature, as black lead or 
Charcoal, plumbago, but is ordinarily made artificially from 

animal or vegetable substances. Wood charcoal 
is mostly employed externally, and that most frequently in the 
form of poultice, combined with linseed meal and bread. This 
poultice is of very great value when sores are fetid and parts are 
sloughing away, keeping them moist and warm, whilst prevent- 
ing smell. The powder may be used with similar intent. It is 
sometimes given internally, when patients are suffering from or- 
ganic diseases of the stomach and intestines, accompanied with 



BACTERICIDES. 12^9 

the formation of foul-smelling gases and acrid fluids. It is also 
recommended as a temporary antidote for certain organic poisons, 
as aconite and strychnine. In either case a tablespoonful should 
be given suspended in water. 

The ozonized chlorate of carbon. — Specially indicated in cancer, 
syphilis, tuberculse, all fevers, and whenever there are disease 
germs in the hurrian blood. This remedy has acquired a world- 
wide reputation in the cure of cancer. Its high repute is well 
merited. It is introduced into the ozonized saxifraga and Phyto- 
lacca, to render those invaluable alteratives most extremely effi- 
cacious as a germicide in the radical cure of all morbid states of 
the blood. Locally, it can be introduced into all cancer plasters, 
being compatible with extracts of sheep sorrel and red clover 
tips, with bichloride of mercury, arsenic, chloride of zinc plasters, 
and the chloride of chromium, ozonized. 

Dose, Five grains, added to some alterative syrup or water, 
every three hours. 

Pulverized willow charcoal. — Efficient bactericide, whenever 
we have reason to suspect microbes in the alimentary canal. Ox 
gall and pulverized charcoal make an efficient pill for gall stones 
and sluggish liver. 

The bisulphide of carbon^ although an unpleasant remedy, has 
immense bactericide properties ; it kills the microbes of typhoid 
fever, diphtheria, dysentery. A" saturated solution of the bisul- 
phide in water, mixed with milk, taken half an hour before meals, 
promptly kills those germs. In the case of dysentery, the tenes- 
mus is at once relieved, stools lose their offensive odor. 

Bisulphide of carbon, local use of in neuralgia and headache, 
used as follows often acts like magic : Take a wide-mouth 
bottle of convenient size, fill it half up with cotton or a sponge, 
then pour on two or three drachms of the bisulphide. Apply the 
open mouth of the bottle over the seat of pain closely, so as to 
prevent escape of the vapor ; continue the contact four to ten 
minutes, according to the severity of the pain. In a short while 
a sensation of tingling, which will shortly be raised to feeling of 
smarting and burning, then remove the bottle. The pain soon 
departs. Headache is treated successfully by applying the bottle 
to the temples or nape of neck. 

The bisulphide of carbon acts as a solvent for phosphorus, and 
in itself has a beneficial effect in intestinal catarrh. 



This oil is one of the most powerful 
Chaulmogra Oil. germicides in the Materia Medica. It 
{Gy?iocardia odoj^ata) has a most remarkable affinity for cer- 
tain germs, as the bacillus of leprosy, 



j28o DISEASE GERMS. 

ainylobacta of rheumatism, tubercle, lupus, and obstinate skin- 
affections. 

C. B. Stevens, M. D., 21 Hanover Street, Manchester, N. H.,. 
who may be regarded as an authority on the use of this oil, 
says: 

" The kernels of the seed of the fruit of the gynocardia odorata 
yield a fixed oil, by compression, or boiling with water, which 
possesses potent germicidal properties, so strong and energetic 
that when administered in tuberculosis, psoriasis, lepra, elephan- 
tiasis, rheumatism, or sciatica, prove effective in destroying the 
germs of the disease. Internally the dose is from five to twenty 
drops three times daily after meals. Larger doses are apt to 
nauseate and constipate. Locally, to parasite eruptions, one 
part of chaulmogra oil to ten parts of olive oil. The active prin- 
ciple of chaulmograoil is gynocardic acid, which is a most excel- 
lent form for administration. This acid in doses of half a grain 
three times daily after meals, in the form of a pill ; the dose can 
be increased. It has many advantages — definite in composition, 
positive in action, small dose. Haifa drachm of the acid to one 
ounce of petroleum ointment is very valuable in leprosy and 
psoriasis. 



or better still, antkrarobin, which is an innocu- 

Chrysarobin, ous succedaneum for chrysarobin, the so-called 
chrysophanic acid. It is a bactericide of great 
power. Very favorable results are reported of its action in cu- 
taneous affections. 

Prof. D. K. Hitt, M. D., of Prospect, Marion, Ohio, employed 
with success, in a large number of cases of hemorrhoids, the 
plan of using chrysarobin. In the cases where the hemorrhoidal 
tumors are external he uses the following formula : 

Chrysarobin, 80 centigrammes ; iodoform, 30 centigrammes ; 
extract belladonna, 60 centigrammes ; vaseline, 25 grammes. 

Mix. A small quantity of the ointment is placed several times 
daily upon the hemorrhoids, after previous washing with a 1:50 
solution of carbolic acid, or of 1:100 of creoliri. If the hemor- 
rhoids are internal, suppositories after the following formula may 
be employed : 

Chrysarobin, .08 centigrammes ; iodoform, .02 centigrammes; 
extract of belladonna, .01 centigramme; cacao butter, 2 grammes. 
Mix. For one suppository. 

In two or three days the pain caused by the tumors disappears, 
and after two or three months a complete cure is said to follow. 



BACTERICIDES. I 28 1 

Chian turpentine mistura, highly 

Chian Turpentine, ozonized, is an emulsion of Chian tur- 
pentine with ethereal peroxide of hydro- 
gen, resorcin and thallin ; we have a mixture devoid of all irritat- 
ing properties, easily absorbed and taken into the blood, and at 
the same time possessing the highest bactericide properties. 

Chian turpentine, which we use, is specially collected for us in 
the Island of Chio, from the Pistacea terrebirithce. 

This, as we have prepared it, is an energetic ozone producer, 
an agreeable aromatic, with an odor resembling the pinaceous 
turpentine. 

Its special action, when admini:5tered, passed in the blood 
tissues, is to search out the cancer germ, which it surely finds, 
and slowly, silently kills it. Under its use pain ceases, the tumor, 
or aggregation of germs, with it also die. If there is an open 
breeding, eating surface it becomes covered with a characteristic 
grayish slough, indicating a perfect annihilation of the cancerous 
microbe. Tumors also dwindle in atrophy under its use. 

Dose : One teaspoonful of the Chian turpentine mistura three 
times a day, which is to be gradually increased to nine teaspoon- 
ful in the twenty-four hours. 

r. 5. Dozvney, M. D., Maitland, Mo., and G. W. Moble, M. D., 
Edon, Ohio, both of whom have had a most extensive practice in 
the treatment and cure of cancer; both eminent members of our 
profession, speak in glowing terms of their success with this pre- 
paration in the management of cases deemed incurable. 



Chinoline Salicylate Tartrate. — Powerful antiseptic, capa- 
ble of destroying the malarial germ and the mycelia of hooping- 
cough. 

Dose : Two to ten grains every three hours. 



is a true liver tonic, in the sense that 
Chionanthus Virginica it innervates the secreting protoplasm 

of the hepatic cells, and stimulates the 
local vasomotor centres in the organ. The medicament is de- 
serving of all the praise which the entire profession have bestowed 
upon it. It is remarkably curative in the conditions that lead to 
cirrhosis ; infantile jaundice yields readily to its action. It is 
undoubtedly a fine cholagogue. It relieves abdominal plethora 
and quickens the circulation in the hepatic capillaries. No dri5g 
past or present can excel it in jaundice. 
81 ■ 



1282 DISEASE GERMS. 

Dose : Fifteen grains, added to syrup 
Chloral Hydrate, of orange peel, every hour, or every three 
hours. Externally, efficacious in pro- 
ducing sleep in delirium tremens. Combined with bromide of 
potassa it will control raving mania, puerperal convulsions. 

Its persistent use creates a habit, and exhausts the ophthalmic 
tract ; causes amaurosis. 

Applied locally to the breasts, during lactation, it will arrest 
the secretion of milk ; it is also an invaluable counter-irritant ; 
more penetrating than cantharides. 



Dose : Five grains in syrup 
Croton Chloral Hydrate, every half hour. Indicated as an 

anesthetic for deep sleep and relief 
of pain. Croton chloral contains more hydrogen than chloral 
hydrate. It is, in fact, butyl chloral. Its practical value is the 
property of diminishing sensibility before producing narcosis. 



An excellent hypnotic and germicide, of 
Chloralamid. great utility in all microbial diseases. 

Insomnia and restlessness resulting from 
pain were little, if at all, influenced by chloralamid. In two 
.cases — one suffering from disease of the ankle with starting of 
the foot at night, and the other from dysentery with cramp-like 
pain in the abdomen — doses of 45 grains caused, indeed, sleep, but 
with an attack of pain readily broke. From these few observa- 
tions, it would appear that the new hypnotic is not altogether 
free from some of the disadvantages attending those already in 
daily use. Doses of 30 and 45 grains have been followed by 
giddiness, feeling of sickness, dryness of the mouth, and even 
slight delirium — symptoms which, though not alarming, are cer- 
tainly disagreeable, but which seem to be inseparable from the 
action of almost all our sleep-producing agents. A comparison 
of the action of chloral with that of the amide shows that the 
latter is not so rapid, sleep coming on half an hour to an hour 
after its administration ; whereas after chloral it often results in 
fifteen minutes. This slight disadvantage, however, is more than 
compensated for by the almost entire absence of action which 
chloralamid has on the circulation. 

Dr. Patterson has paid special attention to the dose of this sub- 
stance, and says : "Usually 30 to 45 grains suffice in the case of 
a man, while 20 to 30 grains will give satisfactory results in a 
woman. In experiments carried out by Alt, 60 grains produced in 



BACTERICIDES. 



1283 



two strong, healthy women severe giddiness, symptoms of intoxi- 
cation, with great excitement, and in one great nausea and 
retching. Chloralamid has no action on the digestive organs, 
-and the appetite remains unimpaired. That this drug will be a 
valuable addition to our therapeutical armamentarium is un- 
doubted." 

Dose of the wine chloralamid, two fluid ounces ; dose of the 
elixir, half a fluid ounce ; of the pellets, three. 



Chlorine water in the treatment of infec- 

Chlorine Water, tious and contagious diseases should never 
be lost sight of, and as it is so easily pre- 
pared every physician should have recourse to it in diphtheria, 
scarlatina, small-pox and even typhoid fever. 

To prepare it : Place powdered chlorate of potassium, three 
drachms, in a quart bottle, then pour on it three drachms of mu- 
riatic acid. After a moment or two cork the bottle and allow the 
gas to form and fill up the whole space. Then slowly add cold 
water, the colder the better, and shake well so as to mix the gas 
and water and insure the solution of the chlorine ; add more 
water, shake again, continue in this way till the bottle is full. The 
water will be nearly saturated with chlorine. Here you have the 
chlorine water. 

Order a wine-glass full to be given to the patient every hour or 
two. This water must be kept in a cool place, and should be 
prepared fresh every day. Its value in diphtheria and scarlet 
fever is too positive to be neglected by progressive physicians. 

An excellent bactericide in measles, scarlatina, variola ; if it 
does not kill, it at least sterilizes the micrococci. 



The cancer antidote, for external 
Chloride of Chromium, use only. The liquid chloride of 
[Ozonized.) chromium is added to pulverized 

blood-root, or any other inert 
powder ; is made into a paste of the consistency of tar, spread 
on leather the size desired, and applied over the cancer, the adja- 
-cent parts being carefully protected by plaster. Spread fresh 
every morning, and apply until the cancer drops out, then discon- 
tinue. Indicated in all external cancers, whether they be covered 
by cuticle or open, ulcerating. The moment it is applied, by en- 
dosmosis, it penetrates the cancer germ, unites with it and kills 
it. To this germ it has a chemical afiinity, as the mass of cancer 
germs are, when destroyed, a perfect ozonoid. The destruction 



1284 



DISEASE GERMS. 



of the germ is effected without pain, but the surrounding tissues 
are so blended in and through it that they suffer oxidation, which 
gives rise to some pain in the separation of the germinal mass 
from the healthy tissue, but much less than what is caused by any 
other remedy, except the ozone paste. 



Both the red and white clover are valuable bacterid 
Clover, cides. 

Trifoliiim, red clover. — An extract obtained from the 
leaves, stem and flowers, by pressure or by boiling and evaporation 
to the consistency of molasses, spread on leather and applied to any 
cancer colony or infiltration will gradually kill it and painlessly 
cause its separation from the sound tissues ; very slow but effi- 
cient in its action. 

Infusion of red clover tops, drank ad libitum, destro5^s the can- 
cer microbe. The compound syrup trifolium is prepared as fol- 
lows : 32 parts of red clover; 16 stillingia, burdock, Phyto- 
lacca roots, berberis and prickly ash. Mix. Make like com- 
pound syrup stillingia. Substantial efficacy ; curative by being a 
microbe killer in the blood. 

Meleotus — zvhite or sweet clover. A mother tincture, active, 
energetic in sterilizing the germ of degraded nerve-bioplasm, 

vibriones, hence is of great 
utility in chorea, convulsions 
and fits generally ; superior to 
simulo, as it prevents recur- 
rence. 




The flower 
Cloves, buds of the clove 
tree are its prin- 
cipal product. When ripe 
they are gathered, and dried 
by the smoke of wood fires, 
or by exposure to the sun. 
When first gathered they are 
reddish, but soon become a 
deep brown color. The medi- 
cinal properties, which are 
germicidal, reside in an es- 
sential oil, which occupies, by weight, one-fifth of the entire 
quantity of buds. This oil is obtained by repeated distillations 
with water. While this process is going on two sorts of oil pass 



A branch of the clove tree, with buds. 



BACTERICIDES. 1 285 

over, the one lighter than water, the other heavier. When pure, 
this oil has a light yellow color ; a brown red when not so pure. 
This oil is soluble in ether, alcohol or fixed oils. 

Cloves are a germicide of the first rank, and should be freely 
used in every household to kill the floating aerial bacteria of all 
large cities. They are powerful enough to destroy the ordinary 
malarial germ. Thus, a very favorite, crude, but extremely effi- 
cacious formula is the following : Take one ounce of pulverized 
cloves ; one ounce of Peruvian bark, finely pulverized ; one ounce 
of cream of tartar, and one drachm of capsicum. Mix thoroughly. 

Dose : One teaspoonful every three hours. This rarely fails in 
ordinary cases of malaria. 



The part used are the leaves, the 

Coca Erythroxylon. extract from the green leaves, and the 
wine. The drug is a stimulant, hav- 
ing a vitalizing action upon the motor cells of both the gray and 
white matter of the brain and spinal cord. It is an admirable 
tonic and restorer, and maintains the vital force of the user under 
most extraordinary efforts of mental and physical tension. 

The fluid extract^ in teaspoonful doses, thrice daily, imparts to 
the nervous system a strength, a vigor, or an endurance that en- 
ables it to resist the severest fatigue. It is the most effective 
tonic plant in the vegetable kingdom. It possesses the virtues 
of all tonics. It is a powerful restorer of the vital forces. It 
strengthens, exhilarates, sustains, and refreshes, aids digestion, 
imparts new energies to the worn-out or exhausted mind or 
body, and excites every faculty to healthy action. It invigorates 
the genital organs, and is a specific for all nervous complaints, 
such as sick headache, neuralgia, wakefulness, loss of memory, 
nervous tremorsj loss of appetite, depression of spirits. It vital- 
izes the blood in all brain workers ; there are elements of 
strength in it, induces cohesion of, and great accumulation of 
nerve force. 

Coca et Celerina, causes a cohesion of all the finer elements of 
the nervous system, effectually eradicates the opium, whiskey, 
chloral, and other habits. 

Wherever there is a poverty of nerve force, as in neurasthenia, 
in alternation with kephaline, its action is unexcelled. 

Wine of Coca Erythroxylo7t Ozonized. — This wine is prepared 
from the finest Florida oranges ; the green coca leaves, and per- 
oxide of hydrogen. It forms one of the finest and most elegant 
preparations ever introduced to the medical profession. 

It is the only wine which possesses in an eminent degree the 



1286 



DISEASE GERMS. 



valuable tonic and invigorating properties of the erythroxylon 
coca, the celebrated Peruvian restorative, an invaluable remedy- 
to be administered when the nerve forces are shattered, deficient^ 




Erythroxylon Coca. 



or exhausted, being thus a powerful tonic for fatigue of mind or 
body. 

Taken in small doses, at intervals of three or four hours apart, 
it is a gentle excitant to the motor cells, giving the consumer 
great powers of endurance of both mind and body. It acts as a 



BACTERICIDES. 



287 



scavenger to diseased blood, cleanses it from all microbes, im- 
parting a marvellous freshness of vigor to the whole body. It 
lessens metamorphism, at the same time increases the appetite ; 
its use in fevers lowers heat, pulse, and respirations. 

As a voice tonic to preachers, public speakers, singers, it is 
indispensable, being tenser of the vocal chords, thereby greatly 
strengthening and increasing the tone and volume of the voice. 
Indicated: In all deviations from a normal standard of health; 
in all acute and chronic diseases ; wherever microbes or pto- 
maines exist, neuralgia, insomnia, malaise, despondency, and a 
positive cure for all habits. 

It is a powerful muscular, nerve, and voice tonic, giving un- 
usual power of endurance in both mental and physical labor ; it 
is also remarkable in its food-replacing power, persons being 
able to abstain from food for many 
hours after a full dose of this wine 
of coca. 

A powerful nerve stimulant. 
Restores the functions of the di- 
gestive organs, strengthens the 
mental and physical powers, as- 
suages thirst, relieves the dulness 
and drowsiness of nervous debility. 
Given with benefit in cases of 
opium and morphia habit. 

The North Am. Med. Chir. Re- 
view, March, 1880, has the follow- 
ing : — ** In large quantities, it is 
said that this drug produces a 
general exaltation of the circula- 
tory and nervous systems; impart- Young plant of Er>'throxylonCoca. 

ing increased vigor to the muscles, as well as to the intellect, 
with an indescribable feeling of satisfaction.'^ 

In small doses it increases appetite and promotes digestion. 
In cases of sleeplessness from exhaustion and fatigue, it is in- 
valuable, producing a sound and refreshing sleep without the 
distressing sensations so common after opiates, bromides, and 
hydrate of chloral. 

One wineglassful is equal to one drachm of the leaves. 

Dose, as a tonic : one wineglassful before or with each meal. 
Children, half or quarter of a wineglassful. 

For sleeplessness from nervous exhaustion : place a wineglass- 
ful at the bedside, and take a sip about every half hour until 
asleep, or take the whole at one dose, and repeat during the 
night if wakeful. 




1288 DISKASE GERMS. 

The spermatorrhea pill which has acquired such a celebrity in 
the cure of seminal weakness, is prepared as follows : 

Cocaine, one drachm ; jerubelin, fifteen grains ; hypophosphate 
of lime, thirty grains ; gelsemium, six grains ; extract ignatia, 
three grains ; leptandra, thirty grains ; glycerin, q. s. Mix, Ft. 
sixty pills. 

Millions of pills from the above have been sold for arrest of 
spermatorrhoea with most gratifying results. Cocaine in that 
formula being a mere abstracta. 

The Cocaine Suppository from the divine plant is prepared as 
follows : 

Butter of cocoa, six ounces ; cocaine hydrochlorate, two to four 
grains ; solid ext. hyoscyamus (English), one and one half ounces ; 
Ft. lOO suppositories. Mix. 

The addition of either the hyoscyamus or conium, modifies the 
action of the cocaine. 

This suppository positively cures spermatorrhoea, impotence 
and sterility, continence or incontinence of urine, inflammation 
and enlargement of prostate, piles, stricture of rectum ; also 
cures coccydynia, dysmenorrhoea, or painful menstruation, cancer 
of the rectum. 

is the common name for a berry of a 
Cocculus Indicus climbing shrub, which grows in Cey- 
lon. It is used in large quantities by 
brewers for increasing the bitterness and intoxicating power of 
malt liquors. It is also used to destroy fish. As a microbicide, 
its power is immense, but its use demands great care and caution, 
Picrotoxicon, its alkaloid, a most irritant poison, is used in the 
form of a cerate to kill parasites on the skin. It has also been 
used with some success in epilepsy. Best to try it in pill form. 




The whole herb is 
Cochlearia Officinalis, officinal. The bac- 
{Scurvy Grass) tericide properties 

are most abundant 
in the green plant. This resides in an oil which 
is obtained by distillation from both the green 
and dried plant, most abundant in the former ; 
this oil is identical in germicide properties with 
the oil of mustard. The tincture of either the 
Scurvy (irass. green or dried plant, best made with dilute alcohol. 
It is, take it all in all, an excellent energetic stimulating alterative 
and germicide, very useful in dormant liver or spleen ; often suc- 
cessful in paralysis ; of great utility locally in ulcers, sores in the 
mouth, and spots upon the skin. 



BACTERICIDES. 



289 



Cocoa Theobromo. 



The fruit of the gods, 



from 



tree 
which is extensively cultivated in the 
tropical parts of Asia, Africa and Amer- 
ica. It is a tree which rises with a bare stem to the height of 
six or seven feet, dividing into many branches, and attaining a 
height of from sixteen to twenty 

feet ; oftentimes tw^ce that height. ^^^^{iy////» 

It attains its full growth in seven ^ M\^I^^^Uiiw<'^^^f/ 
years. The fruit has the appearance 
of a cucumber in shape, six or eight 
inches long, yellow, but red on the 
side next the sun. The rind is thick 
and Avarty, the pulp sweetish, not 
unpleasant, the seeds quite numer- 
ous, easily compressed, with a thin, 
pale, reddish brown, fragile skin or 
shell, covering a dark brown, oily, 
aromatic bitter kernel, which con- 
sists mostly of wrinkled cotyledons. 
These seeds are the beans of com- 
merce ; the larger seeds decorticated, 
Ijruised, ground, yield that delicious, 
nutritious beverage — cocoa. The 

principle constituent of the 
bean, aside from this more solid 
constituent, is the oil or butter of 
cocoa, which forms fifty per cent, 
of their weight, a glucoside, t/ieo~ 
droma, which is identical with 
caffeine, slightly more nitrogenous. 
The butter is extracted by com- 
pression of the seeds, or by de- 
coction, or by the action of a sol- 
vent; the method of expression 
is preferable. The butter is an ex- 
cellent germicide ; useful for mak- 
ing bougies, cones, pastiles, sup- 
positories and ointments. 




Theobroma Cacao. 




•Coffee ; a, a branchlet with leaves, flowers 
and fruit ; b, section of fruit. 

hilarating and refreshin| 



The important con- 
CofFee. stituents of the coffee 
bean is caffeine, a sub- 
stance to which it, tea, kola nut, 
guarana, cocoa nut, owe their ex- 
The effect of caffeine is not 



1290 



DISEASE GERMS. 



identical witli tea or coffee, or the other drugs containing it ;. 

all possess a germicidal action. 

Extensive clinical experience have demonstrated caffeine to 

stimulate the heart and respiratory movements ; increase the 

peristaltic wave ; excite the brain and spinal cord ; retard tissue 

change, and augment the flow of urine. 

It is the remedy which excels all others in the so-called 

nervous headache, or in that due to fatigue or overwork, or the 

abuse of intoxicating li- 
quors. It is used as an 
antidote to opium poison- 
ing; as a diuretic in drop- 
sical effusions due to 
cardiac disease. 

Dose : from two to five 
grains. Of the various 
salts of caffeine, the citrate 
and bromide have m.et 
with most favor, being 
soluble and not deliques- 
cent. 

The caffeine soda salts 
are the best germicides,, 
because they are per- 
fectly soluble in water, 
and make permanent 
solutions, and will, if 
brought in contact with 
the amceba of catarrh, the 
bacteria of erysipelas, kill 
those micro-organisms. 




American Columbo. 



The an- 
American nexed wood 
Columbo. cut is an il- 
lustration of 
the columbo or frasera, 
which grows so abun- 
dantly in our Southern 
States. Frasera is a 
mild, bitter tonic, of a 
rather fine order. In 
many particulars it re- 
sembles columbo in its 



medical properties as well as in its appearance, and experience in. 



BACTERICIDES. 



I29I 



its use has given us a high opinion of its virtues. It neither 
astringes nor stimulates, and is a bitter above all others that is 
most acceptable to the stomach. It answers admirably as a 
remedy in simple dyspepsia and in all enfeebled states of the 
alimentary canal. ' Its very mildness and absence of all irritating 
properties render it a tonic of great value in the convalescing 
stages of all acute diseases. Even in inflammation of the stom- 
ach it will be tolerated when all other remedies will be rejected. 

The article termed fraserin is simply a solid extract in a state 
of trituration. 

Columbo is regarded as next to coUinsonia as a tonic to the 
stomach and bowels. There are many preparations of it, all of 
great excellence. 

The following formula is very efficient : an ounce of columbo, 
half an ounce of ginger, the same of leptandra, and thirty grains 
of capsicum, to one pint of boiling water. 
Dose, a wineglass three times a day. 



Colchicum, 



as employed in medicine, 
is either the bulbous under- 
ground portion (more cor- 
rectly termed a corm) or the seeds of the 
meadow saffron. From the corm are pre- 
pared an extract and a wine of colchicum, 
and from the seed a tincture. Colchicum 
seems to have the effect of increasing the 
flow of bile, of diminishing the force and 
rapidity of the heart's action, and if large 
doses are used, causes vomiting and purg- 
ing. The specific action of colchicum is, 
however, on the pain of the gouty par- 
oxysm, which it relieves in a marvellous 
manner. Its use is followed by some pros- 
tration, and a tendency to faintness which 
is far from agreeable, even though the pain 
has gone. It is sometimes used in acute 
rheurhatism, but does not produce the same 
wonderful effects as in gout. There is, how- 
ever, one fact which is of vital interest to 
those who suffer from gout, they may kill 
the pain with colchicum, but they do not 
cure the disease, and in all probability this will return sooner or 
more violently after being chocked off with colchicum, than had 
it been allowed to exhaust itself, or other remedies, as alkaline 
purgatives, employed. Of the ordinary extract, about a grain 




Colchicum. 



1292 



DISEASE GERMS. 



should be given for a dose ; of the wine and tincture ten or fifteen 
drops every four hours. 

Its bactericide action is exerted chiefly on amylobacta and 
urate of soda of gout. 

Indicated where there is a rheumatism of joints, worse by 
motion. Dysentery of a bloody mucous character, with loathing 
of food, and nausea. Dose, one-half to one drachm of the wine, 
or twenty-five to thirty drops of the normal tincture. In small 
doses it is valuable in pericarditis, gout and rheumatism of the 
small joints. It may be used in any heart affection connected 
with rheumatism. In dysentery, with stools like the scrapings 
of flesh, colchicum is a good remedy. In tympanitis, three drops 
of the tincture every half hour is a very positive relief And 
where there is a pain after urinating, twenty drops three times a 
day gives relief In dropsy after scarlet fever small doses, say 
three to five drops with thirty to fifty drops of the tincture of 
asclepias syriaca is apt to be followed by a cure. Colchicum 
with apocynum androsem, in doses of ten to thirty drops, ac- 
cording to age, cures dropsy or rheumatism. 



Commonly known as '' stone 

CoUinsonia Canadensis, root," or " knob root," is one of 

the most valuable of indigenous 
American medicinal plants. It is widely distributed, being found 
in richly-wooded soils from April to October in all sections of 
the United States. It possesses a rank aromatic odor, and is hot 
and somewhat pungent to the taste. Its principal medicinal con- 
stituent appears to be a volatile oil, which is driven off by boiling 
or drying. 

All parts of the plant may be used in medicine ; but the root 
is the most powerful, and the portion usually employed. As it 
yields its virtues to water and alcahol, it may be administered in 
the form of a powder, or as the tincture, the fluid extract, or the 
infusion. The dose of the powdered root varies from ten to 
sixty grains, that of the tincture from twenty drops to two 
drachms ; the fluid extract from fifteen minims to a drachrrt ; the 
infusion from one to four ounces. 

The physiological action of collinsonia, very much resembles 
bayberry and stone crop, intermediate between the two. It is 
an astringent to mucous surfaces and a bactericide of consider- 
able power, besides equalizing chaotic nerve centres. 

It is very highly esteemed in all disordered states of the ali- 
mentary canal, starves out both gastric and intestinal sarcinae. 

Its action upon all organs contained in the pelvic region is 



BACTERICIDES. 



1293 



good, relaxes the ureters, promotes an increased, flow of urine, 
facilitates the expulsion of calculi, diminishes the irritability and 
general sensitiveness of the 
bladder. 

Acute cystitis is most effi- 
ciently treated with collin- 
sonia in alternation with gel- 
semium. So is constipation, 
hemorrhoids, rectal neuralgia. 

Again in chaotic nervous 
affections, like chorea, it is 
equal to cimicifuga in its ac- 
tion; very valuable in neuroses 
of the vagina. 

Its germicidal action is best 
seen in its sterilizing the mi- 
crobe of hooping-cough. 

Upon the urethra, prostate 
and rectum its action is very 
similar to the stone crop. 

It has some peculiar action 
upon ptomaines, as when it is 
being used, all odors of the 
body disappear. 

CoUinsonia is of great utility 
in piles, as follows : Tincture 
hamamelis, tincture collinsonia, 
tincture euonymus of each 
equal parts. Teaspoonful in 
water four times daily. Take 
the first daily dose early in 
the morning in a tumbler of 
water in which ten grains of 
soda bicarbonate are dissolved, 
then at night just before retiring; remaining two doses between 
meals. 




CoUinsonia. 



The product of gun-cotton dissolved in ether 
Collodion, and alcohol, when exposed to the air, the ether 
speedily evaporates, leaving it in such a state that 
when painted on it leaves a thin film on the surface to which it 
is applied. This film is impervious to the air and is very useful 
for cuts. Steeping gauze in collodion and applying in gaping 
wounds, supersedes the use of sutures. Tannic acid and collo- 
dion are useful for sterilizing the microbe of corns. 



1294 



DISEASE GERMS. 



A preparation called flexible collodion, made by adding Cana- 
da balsam and castor oil to ordinary collodion, is however much 
more useful in many instances than ordinary collodion, as it does 
not crack on being bent or stretched. 

To this various germicidal remedies can be introduced and 
painted over parasite skin affections — creolin, resorcin, ichthyol, 
creosote, naphthaline, added render it an application of the 
most powerful germicidal character. 



The com- 
Colt's-Foot, mon name 
of a British 
plant, known to botanists as 
tMssilago farfara. It is a com- 
positous plant, and has had a 
good reputation as a remedy 
in diseases of the lungs. 

Colt's-foot contains an en- 
ergetic active principle, a 
glucoside, which is a most 
valuable germicide. This 
principle sterilizes the microbe 
present in asthma, bronchitis, 
and incipient pulmonary dis- 
ease. 

Cigars made of the leaves 
and smoked afford prompt relief in the violent paroxysms of 
asthma. Infusion excellent for colds. 




Coltsfoot. 



The root of this plant 

Comfrey. yields to water a peculiar 
mucilaginous substance, 
highly antiseptic, which renders it of 
great value in the treatment of all 
bronchial affections. It has a sterilizing 
action on the amoeba of chronic catarrh, 
and on the conferva of long-standing 
bronchitis. It yields its properties to 
hot water ; hence an infusion is the 
best form for administration. 

It makes a most admirable tonic for 
female weakness as follows : 

Take one ounce each of the fluid 
extract comfrey, Solomon's seal, uni- 
corn root ; half an ounce each of fluid 
extract camomile, compound gentian, sassafras, cardamom ; 




Common Comfrey. 



BACTERICIDES. 



295 



alcohol, four ounces ; sherry wine, one pint and a 
Dose : A tablespoonful every three hours. 



half. Mix. 



Convulvus 
Panduratus. 



Common name, Indian 
Turnip, man of the earth. 
Its properties are that of 
a most active bactericide, 
mild but efficient alterative, without pro- 
ducing any drastic action either on the 
bowels or kidneys. 

The milky juice of the fresh root is so 
powerful a germicide that it will, if applied 
to the part freshly bitten by a rabid animal 
or venomous reptile, kill or antidote the 
poison. 




Indian Turnip. 



One or two drops in a carious 
Concentrated Ozone, tooth will instantly relieve most vio- 
lent toothache ; rubbed over a painful 
nerve the pain of neuralgia ceases ; two to twenty drops in sweet- 
ened water will afford most refreshing sleep ; cloths saturated 
with it and applied (covered with oiled silk) over any portion of 
the body suffering from inflammation, will instantly arrest it and 
cause a renewal of life ; to the abdomen in cholera and typhoid ; 
to the throat in diphtheria and scarlatina. Successfully used in 
parturition to alleviate its pains by rubbing it over the abdomen 
and lumbar plexus of nerves ; if applied over the mammae when 
secreting the lactiferous fluid it is a more efficient arrestor 
of secretion than belladonna. Dose : For internal use five to 
ten drops ; for local use rub freely over the painful part ; repeat 
as indicated. 



has been chemically examined. It con- 
Condurango Bark tains two or three glucosides and a resin, 

all of them manifesting the same action. 
These substances form collectively the condurangin. It coagu- 
lates when heated in an aqueous solution, even at 40° C. and, 
like albumen, is precipitated from an aqueous solution by sodium 
chloride. Its action on the central nervous system is decidedly 
a poisonous one. In small doses it produces symptoms like 
those of tabes dorsalis in ataxic change of gait. It also appears 
to act on the peripheral nerves and muscles, at first increasing 
and then depressing their electric excitability. Loss of appetite, 
and in the earlier stages a plentiful flow of saliva, as well as 



1296 



DISEASE GERMS. 



;)'mptoms in mammals. The poisonous 
dose of condurangin is about 0.02 gramme per kilogramme of 
the body weight for carnivorous animals, and about three times 
as much for herbivorous animals. 

It was brought forward as a remedy calculated to destroy the 
microbe of cancer, but for this purpose it is utterly useless. 



An'ozonized extract prepared from the conium 
Conium. maculatum is one of the most valuable remedies 

when the blood is germ- 
laden with the micrococci 
of cancer. 

From one to three grains 
should be given every four 
hours. 

It sterilizes the cancer 
germ, it aids in rectifying 
the defect in nutrition upon 
which the degradation of 
bioplasm takes place so as 
to give us the germ. So 
valuable is this remedy that 
no case of cancer can be 
successfully treated with- 
out it. 

Excellent results are ob- 
Conium Maculatum. taincd from the administra- 

tion of conium in the cure of chorea with violent movements. 
Large doses at first are best, until the system is thoroughly 
under its influence, when smaller doses, more frequently repeated, 
will keep up its action. 

The uncertainty of action of certain preparations necessitates 
care in its administration. 

An ointment prepared from the green leaves is an admirable 
remedy in rectal irritability and fissure. 




Two glucosides from the 
Convallamarin — Convallarin. flowers of convallaria maja- 

lis, or lily of the valley, con- 
vallamarin and convallarin, whose physiological effects were 
determined by Marme, in 1 866. Convallamarin is of a persistent 
bitter taste, readily soluble in water, insoluble in ether and chlo- 
roform. . Upon boiling it with diluted acids, it is split up into 



BACTERICIDES. 



1297 



cofivallamaretin and sugar. According to Marme, it is emetic 
in small doses, and affects the heart similarly to digitaliu, arrest- 
ing its action in systole. 
The commercial pro- 
ducts vary widely in 
strength. Merck's con- 
vallamarin may be ad- 
ministered hypodermi- 
cally in doses of .005 to 
,02 grammes several 
times daily. Given by 
the mouth, .05 to .06 
grammes every hour or 
two up to .1 gramme 
per diem, produce the 

full effects of the drug. Lllyofthe Valky. 

Convallamarin is indicated in weakness of the heart, oedema from 
myocarditis and other cardiac diseases, as well as in exudative 
pleurisy and Bright's disease. 

Convallarin has a scratchy taste, sparingly soluble in water, 
insoluble in ether, but readily soluble in alcohol. It is also 
separated into convallamaretin and sugar upon being boiled with 
diluted acids. In action, it is purgative only. Dose : About 
one-fiftieth orrain. 




An alkaloid from the coto bark ; of great utility 
Cotoin. in diarrhea and cholera. Cotoin is insoluble in the 
gastric juice of the stomach, and passes unchanged 
into the intestines, where it is dissolved. It is specially indi- 
cated in the diarrhea of those affected with ulcer of the bowels, 
as in the insane, in phthisis, in the diarrhea of detention. It is 
contra- indicated if there be congestion. 

Dose : One grain for adults ; half grain for children, in powder 
or emulsion ; several times a day. 



A leafless herb, sending up 
Corallorhiza Odontorhiza. from a coral-like rhizome a 
{Coral-Root.) simple flower, from si^ to six- 

teen inches high, furnished 
with sheaths, instead of leaves, of a light brown or purplish 
color, and bearing small, greenish-brown flowers in a long: 
spike. 

It is a parasite plant, growing from the roots of trees, and 
82 



1298 



DISEASE GERMS. 



nourished by them. The root is the part used. It is much 
branched, toothed, of a brown color, and from its resemblance 

to coral in appearance, has derived its 

name. 

Like numerous other parasite plants, it 

has a peculiar action in morbid states in 

which micro-organisms play an important 

part. 

Administered in doses of thirty grains, 

every three hours, either in powder or in 

jelly, it acts precisely like exalgine, lower's 

heat, respirations, pulse. 

Corallina. 




Corn Smut. 



piles, epistaxis 



Ustilago, fl. extract, ten 

to sixty drops in uterine 

hemorrhage, bleeding 

aids parturition when 

uterine contractions are feeble. Useful in 

enlarged 
p r o s t a te ; 
s permator- 
rhoea, im- 
potence. 
The re- 





Maize, or Indian Corn. 
\Zea Mays). 



putation* of 
stigmata 
maidis, as a 
diu retic , 
demulcent, 
and anti- 
septic in all 
affections of the genito-urinary 
tract, is well established. 

In order to obtain a most 
efficacious preparation, the fluid 
extract should be prepared from 
freshly-gathered silk. 



Cotton Plant. 



The bark 

Cotton Root. of the root 

of this plant 

is emmenao-ogue, parturient, abortive and diuretic. As it causes 
a condition^ of .engorgement, in true congestion, it is very apt to 



BACTERICIDES 



1299 



be followed by hemorrhage in patients of a sanguine tem- 
perament. 

The bark of the green root is the most active, the so-called 
active principle gossypium, is worthless, perfectly inert. 

Those desirous of procuring a reliable article of cotton root, 
must procure it from some one who will dig the root, slice off 
the bark, and at once put it into alcohol. To imagine that it 
can be prepared otherwise is absurd. Dried root preparations 
are all worthless. 



This is the active volatile constituent of the 
Coumarin. tonka bean, a germicide of great power, capable 
when administered in hooping-cough of kiUing 
the microbe of that disease. This 
active principle is sometimes found 
in a crystallizable state, between the 
two lobes of the kernel, but more 
commonly it is thus prepared : The 
beans are coarsely ground, heated 
for some days with twice their bulk 
of alcohol. This tincture is poured 
off, set aside, and the tinctured mass 
subjected to the same process. 
After this is completed, the two 
tinctures are mixed together, the 
alcohol distilled off until it appears 
turbid, when twice its bulk of water 
is added, which precipitates the 
coumarin and fatty matter. This 
precipitate is then heated to the boiling point and passed slowly 
through a wet cloth, which attracts all the fatty matter, and the 
coumarin passes through. The fluid extract may be used with 
great advantage. 




Tonka Bean. 



is a substance composed of carbon, hydrogen, 
Creatine, nitrogen, and oxygen, and is found in the juice of 

the flesh of all animals. A pound of flesh yields 
upon an average about five grains. The quantity varies in dif- 
ferent animals. The flesh of fowl yields the largest quantity. 
The flesh of fish contains it in larger quantities than beef or mut- 
ton. Creatine is obtained in colorless, transparent crystals, and, 
dissolved in water, it has a slightly bitter taste. It unites with 
the various acids forming salts. If creatine is boiled with 



I^OO DISEASE GERMS. 

alkalies, a new alkaloid is produced called sarkosine. If boiled 
with hydrochloric acid, it produces creatinine. This substance 
also forms salts with the various acids, and is found normally in 
flesh. These alkaloids are probably the result of the decompo- 
sition of the flesh of animals. They are found with the extract 
of meat, but whether they exert any power on the system is not 
known. 

B. F. Shepherd, M. D.y Frankford, Ind., in an able and elabo- 
rate article on creatine, entertains a most favorable action of it 
and recommends its use in doses of two grains, four times a day,, 
as a remedy of great value, as an excitant of muscular action in 
atonic conditions of the general muscular system, especially of 
the heart. The remedy is placed dry on the tongue, and fol- 
lowed by a draught of water. 



A bactericide of the very highest order, pro- 
Creosote, duced in the destructive distillation of wood for 
the purpose of obtaining acetic acid. It is a 
colorless, transparent liquid, with a peculiar odor and burning 
taste. 

It is an invaluable drug in medicine, its germicidal action is 
prompt, decisive. It completely annihilates the bacillus of 
tubercle, the sarcinae ventriculi of gastric catarrh, the microbe of 
diarrhea and dysentery. 

Inhaled through hot spray atomizer, it kills the germs in the 
bronchial tubes. It is not well to use it in lotions or gargles, as 
it does not mix with water. 

It is freely soluble in alcohol and acetic acid. On account of 
its remarkable property in coagulating albumen, it has acquired 
quite a reputation in coagulating aneurisms. Externally applied 
to the germ-laden veins in phlebitis, its power of penetration is 
so great by endosmosis, that it kills the entire bacterial colony ; 
of great value in destroying the microbe of dental caries ; com- 
bined in various proportions with salicylic acid, it is capable of 
destroying the microbe of lupus, and other forms of skin germs 
and parasites. Internally, in all affections where the tubercular 
bacilli are present in the blood, it has the power of sterilizing and 
partially annihilating that germ. It should be given internally 
in syrup of tolu or some emulsion in drop doses, and by inhala- 
tion of various strengths. 

This well-known germicide has been demonstrated by Pro- 
fessor Bigger^ M. D., of Atlanta, Ga., to be fatal to micrococci in 
the strength of i to 200. While he admits that it may not be 
from its antiseptic or germicidal powers that it benefits, but that 



BACTERICIDES. 1301 

it may be simply from its favorable action upon digestion, still 
he advises that it be pushed to its utmost limit of toleration, as 
here is where so many fail in its use. Pushing it to this extent 
would be unnecessary if its beneficial action was expended only 
upon the process of digestion and assimilation ; for experience 
with the drug plainly shows that it is the small doses, and not 
the large, which assist digestion, and that the large ones which 
he advises, occasionally irritate the stomach. He says that dis- 
appDintment arises through timidity. " The more creosote that 
can be borne the better the effect," is his dictum. He claims to 
have treated 500 cases during the past nine years, and of those 
treated by this formula, twenty-seven per cent, recovered. Others 
were treated by the following formula, which gave the best 
results : 

Creosoti, fifteen minims ; tr. gentian, forty-five minims ; spir. 
vini rect., six and one-half fluid-drachms ; vini xerici, q. s. ad 
three fluid ounces. 

Of this, one ounce was taken three times a day. The creosote 
was gradually increased to thirty grains. He obtained the best 
results by following treatment for from three months to a year. 
The most benefit was seen in the young, and in the first stages 
of the disease, when the symptoms were not well defined. Good 
results were always secured when tubercular glands were pres- 
ent. It generally relieved irritation and cough, and secretion 
and expectoration diminished, so that narcotics could be dis- 
pensed with. 

Dr. T, E. Quick, of CarroUton, N. Y., after trying various 
formulae, settled upon the following as the best : 

Creosoti purissimi, two parts ; alcoholis, thirty parts ; tr. gen- 
tianae ; ext. caffeae, aa ten parts; aquae destillatae one hundred 
parts. M. Sig. — Shake well and take a tablespoonful in half a 
glass of milk twice daily. 

From most extensive experience, and merited success, he 
formulated the following pill : 

Creosote, one-half minim; iodoform, one-tenth grain; ext. of 
opium, one-quarter grain ; balsam of tolu, turpentine, of each, 
one-third minim. Mix. Of these, from three to ten may be 
taken daily. 



is a product of the dry distillation of coal, and is an 
Creolin. oily, dark-brown, fluid, smelling of tar, but differing 

from carbolic acid in being easily and completely 
miscible with water, forming a milky solution which tends 
to become brown. We have tested its action on several 



I302 



DISEASE GERMS. 



varieties of organisms. A two per thousand mixture of creolin 
killed the gholera bacillus and the streptococcus of pus 
and of erysipelas in . two minutes, the bacillus anthracis 
in five minutes ; but the typhoid bacillus, the staphylococcus 
pyogenes, was not affected in an hour's treatment. A two-per- 
cent, mixture, however, killed the staphylococcus and tertragenes 
in about fifteen minutes. Creolin is a more powerful germicide 
than carbolic acid ; a three-per-cent. mixture killed the spores of 
bacillus anthracis in two days, a six-per-cent. in twenty-four hours, 
whereas a carbolic acid mixture up to eight per cent, did not 
affect the spores in seven days. Many other experiments con- 
firmed the superiority of creolin over carbolic acid. Given in 
large doses to animals, creoHn is not found to be poisonous. It 
is eliminated by the kidneys, and the urine is not discolored, 
although tribromophenal may be separated from it by the 
addition of bromine water and of hydrochloric acid. Creolin 
has been used therapeutically both for external and internal ad- 
ministration. Externally, we have used a one-per-cent. mixture 
in a severe case of puerperal joint affection, in ulcers of the leg, 
in old operation wounds, and also in recent wounds. Good re- 
sults were obtained in all these cases ; the growth of granulations 
was stimulated, and the excessive discharge was stopped. Ulcers 
may be treated with a gauze-compress soaked in a one-to-two- 
per-cent. solution and bandaged up for about four days. We 
strongly recommend the employment of creolin in gauze or as an 
emulsion in surgical practice, in conditions similar to those 
indicated above. We have employed it with good results in otitis 
media. We use an injection of the strength of ten drops to one- 
half pint of warm water in acute otitis. It relieves the pain, and 
owing to its innocuousness, it may be used as an injection in leu- 
corrhoea. As regards its administration, it effects big results in 
gastric catarrh, in diseases of the stomach and intestines. It was 
found free from poisonous effect and non-irritant. It may be 
given in doses of three to fifteen grains-, in gelatine capsules, 
three times daily, and relieves meteorism and catarrh, and is 
serviceable in the severer forms of local inflammation of the in- 
testines, such as typhlitis. In simple dilatation of the stomach, 
in flatulence and in diarrhea, it is of great service. It is of great 
utility as an injection in cystitis. • It is always well to be a little 
cautious of taking too rose-colored a view of the action and 
effects of a newly-introduced drug. If all that has been stated 
about creolin be correct, we have in it a drug of great import- 
ance, a powerful antiseptic with no poisonous qualities. Experi- 
ence will determine the extent of its utility. 

The germicidal properties of creolin has been thoroughly in- 



KACTERiCiDES. 



1303 



vestigated bv 



'enns\'lvania's great bacteriologist, 



J allies M. Bunii, 
non-toxic disin- 



mixing a certani per- 
culturcs of the organism. 



M, D., of Altoona, Pa., who pronounces it 
fectant bactericide. 

The experiments were performed by 
centage of the antiseptic with bouillon 

from which mixture, after a certain time, the presence of living 
bacteria was tested by a fresh cultivation free from creolin. It 
was found that a two-per-iooo mixture of creolin killed the 
cholera bacillus and the streptococcus of pus and of erysipelas 
within two minutes ; the bacillus of anthrax was killed in five 
minutes, while the typhoid bacillus and the staphylococcus of pus 
were still alive after one hour. The last organism, as well as 
tetragenes, was killed in ten to fifteen minutes by a two-per-cent. 
mixture. Compared with carbolic acid, it was found that a two- 
per-cent. mixture of creolin killed the spores of the anthrax 
bacillus in two days, a six-per-cent. mixture within twenty-four 
hours, while a carbolic acid mixture up to eight per cent, had no 
effect on the spores within seven days. A similar comparative 
result was obtained with the hay bacillus, and the superiority of 
creolin over acid was further shown by its great power of pre- 
venting the growth of organism in culture. Creolin is not poison- 
ous, as it maybe given in large doses to dogs without deleterious 
effect. Biinn earnestl}' recommends its use in surgery in place 
of corrosive sublimate, carbolic acid, and iodoform. He has 
strongly recommended its use. He has applied it in the form of 
emulsion or a creolin gauze, and found that it stimulates the 
growth of granulations, and aids in 
separating sloughs without the pro- 
duction of any toxic symptoms. The 
urine does not present the green 
color of carbolic acid urine, but tri- 
hromophenol may be separated from 
it on the addition of hydrochloric 
acid and bromine water. 



Curarin Curarin is found in 
Sulphate, the form of a sul- 
phate in the arrow 
poison of the South American In- 
dians, the so-called curari or 
woorari which is derived from a 
number of plants of the strychnos 
family. Curari was first brought 
to Eu-rope by the celebrated traveller, Waterton. It has long- 
been used as a remedy in the treatment of convulsive affections. 




Woorari Poison. 



I304 



DISEASE GERMS. 



tetanus, hydrophobia, etc., with more or less success. The dose 
of the curari is one-tenth grain. Great care must be exercised 
in its use. The sulphate of curarin is used for the same disease, 
but as it is more powerful than curari, the dose must be propor- 
tionately smaller. From one-twentieth to one-sixtieth of a grain 
has been given. 

The remedy is worthy of trial in cases of tetanus, when the 
combination oi lobelia, capsicum and valerian cannot be procured. 




Cyclamen 



Europseum ; a, the 
b, the fruit. 



^hole plant; 



point of 
until the 
germ dies. 



an emetic cathartic 
spasm gives way ; 



This is a glu- 
Cyclamen. coside isolated 
from cyclamen 
europseum, a powerful germicide, 
capable of destroying the microbe 
of tetanus, producing effects on 
the animal system analogous to 
those of curari. This prepara- 
tion is soluble in water, sparingly 
so in alcohol. Upon shaking an 
aqueous solution it assumes a 
frothy appearance. 

Besides being destructive to the 
germ of tetanus, it has the same 
action on the red corpuscles of 
the blood. 

Either orally or hypodermi- 

cally, its administration must not 

be prolonged or carried to the 

, small doses frequently repeated 

then at longer intervals, until the 



Turiiera aphrodisiac a, is used in renal and vesi- 

Damiana. cal diseases, nephritic albuminuria, diabetes, and 

has proved successful as a nervine tonic in a case 

of blindness from tobacco amaurosis ; also as a tonic for the 

genito-urinary tract. 

The fluid extract when ozonized is indicated in all cases of 

sexual debility in young or old of both sexes. It is a true sexual 

invigorator, its merits are sustained by extensive experience, and 

it is of the greatest efficacy in every case of genital debility. 

Dose: From ten to thirty drops added to water; every three 

hours. 



BACTERICIDES. 



1305 



Foxglove, a powerful car- 
Digitalis, diac tonic in small doses in 
enfeebled heart action, a stim- 
ulant which gives permanent improvement 
by increasing the nutrition of the heart. 
It exerts a contractile or tonic action upon 
the capillaries, unlocks the absorbents, and 
sterilizes disease germs. 

Where the heart is feeble, there is no 
more direct remedy than digitalis. 

In all forms of serous effusion, the infu- 
sion of digitalis is a drug of great efficacy, 
and can always be relied upon in the 
gravest cases of dropsy. 

The tincture is the best form for general 
administration. 

In all cases it exercises a special influence 
on the circulation ; a sedative, calming in- 
fluence, which can only be explained by its 
excitant action on the ultimate branches 
of the sympathetic system. 




Foxglove or Digitalis- 



The bark of the 
Dogwood, cornus Florida 
forms one of our 
best ozonized fluid extracts and 
may be prescribed with great 
certainty as a tonic, germicide, 
stimulant. 

It acts chiefly upon the brain 
and spinal cord as a stimulant. 

Some think that it is a good 
substitute for quinine; in this 
they are mistaken. It is much 
inferior to cinchona preparations. 
Still it is an excellent tonic in 
dyspeptic cases. 

Its internal use increases the 
strength and frequency of the 
pulse, and elevates normal, while 
it depresses abnormal tempera- 
ture. Dose of the bark from 
thirty to sixty grains. A fluid extract in doses of from a half 
to one teaspoonful every four hours is a good form in which to 
administer it. 




Dogwood. 



I306 



DISEASE GERMS. 




Sunde 



patient relief from bronchial 



This plant is highly 
Drosera. germicidal and has a 
wide range of action. 
Its effects are best exhibited when 
administered in diseases of the re^ 
spiratory organs, as in nasal catarrh,, 
laryngitis, hooping cough, asthma, 
bronchitis, pulmonary phthisis. It 
promotes a renewal of vitality, bet- 
ter innervation of the lungs, at the 
same time it sterilizes all germs in 
the air passages. 

The special action of this drug is 
upon the great nerve centres, having 
a special action in getting rid of 
congestion. Its action is mild, but 
invariably effective, affording the 
irritation. 



Eggs. — In addition to eggs being a nutritious food, they are 
also of value as a medicine. The albumen, beat up in water and 
salted, is an excellent remedy in diarrhea, also very useful in. 
the vomiting of cholera infantum. 



Or squirting 
Elaterium. cucumber, in its 
mature state, is 
a plant rough all over with stiff 
hairs, has a trailing branch stem 
without tendrils ; the leaves are 
heart-shaped, bevelled and tooth- 
ed on long stalks ; the flowers 
axillary, yellow ; the male-flcw- 
ers in small racemes ; the fruit 
oblong, about an inch and one- 
half long, grayish green, covered 
with soft prickles and finally 
parting from the stalk and ex- 
pelling its seeds along with a 
thick mucus, through the aper- 
ture, where the stalks are in- 
serted. This remarkable phenomenon is 
action within the fruit : a thin membrane 




Wild Cucumber {Ecbalium agresti'i . 

ascribed to osmotic 
separating a. mucus 



BACTERICIDES. 



1307 



which immediately surrounds the seeds from a less dense juice, 
which abounds in the succulent part of the fruit, and the quality 
of the former being gradually increased at the expense of the 
latter, till on the perfect ripening of the fruit, the much-distended 
central cell is open to permit its ejection. It is this mucus 
surrounding the seeds — a thick green mucus of a very peculiar 
character which contains the elaterin. To collect this the juice of 
the ripe fruit is allowed to stand a short time and become turbid, 
when it deposits a sediment. This sediment, carefully collected 
and dried, is elaterium, from which the crystalline principle 
elaterin is prepared, one of the most powerful of all drastic 
cathartics, but invaluable in certain forms of dropsy. 

The patient should be, in all cases, suitably prepared for the 
remedy by drinking rather freely of an infusion of digitalis for a 
few days, and then the elaterin in one-twelfth of a grain, in a fine 
state of trituration, should be given every few hours until copi- 
ous evacuations of serous fluid takes place. 

Elaterin. — Indicated in all dropsies — the most active agent 
known to remove large serous accumulations. Its use should be 
preceded by infusions of digitalis. Dose : one-twelfth to one- 
twentieth of a grain triturated in sugar of milk, as indicated. 



A bac- 
Elecampane. tericide of 
great pow- 
er, exercising a peculiar ster- 
ilizing action on all microbes ; 
has a most remarkable action 
on the bacillus of tubercle. 
It is worthy of further inves- 
tigation. 

It is a good remedy, of in- 
trinsic value in rabies ; it has 
a powerful germicidal action, 
faint aromatic odor, a bitter, 
acrid and a somewhat cam- 
phor-Uke taste. It is a stimu- 
lant to the organs of secre 
tion, promotes expectoration, 
and is a diuretic and soporific. 




Elecampane {Inula Helenium). 

It contains two active principles^ 



one called inulin, which resembles starch, but is deposited un- 
changed. 

An old author speaks of it thus : " Elecampane root, taken with 
honey made in an electuary, cleanseth the breath, ripeneth the 



i3o8 



DISEASE GERMS. 



tough phlegm and maketh it easier to be spit forth, and prevaileth 
mightily against the cough and shortness of the breath, com- 
forteth the stomach and helpeth digestion." 



The bark, leaves, shoots, flowers and berries of the 
Elder, common elder are highly antiseptic, diuretic and 
slightly narcotic. These properties reside in a vola- 
tile oil which is present in the entire plant, but most abundant in 
the flowers. 

A decoction of the leaves is so strongly antiseptic that if ap- 
plied to the bacterial blush of erysipelas, it will in a few hours 

destroy the germs. Elder 
water is unexcelled as a 
local antiseptic in skin affec- 
tions. 

An ointment prepared by 
simmering the inner bark, 
flowers and leaves, in lard, 
is very highly esteemed by 
rectal specialists as a local 
application to rectal ulcers 
of a tubercular character. 
The following is their for- 
mula: 

Unguentum sambucus, 
one ounce ; hydrargyrum 
mur. sub., thirty grains; 
pulverized opium, solid ex- 
tract belladonna, of each, 
seventeen grains. 
Mix. The bowel is first washed out with castile soap and tepid 
water, subsequently the ointment is brushed over the ulcer. . This 
repeated several times at intervals of a week apart until the germ 
colony is destroyed and the ulcer heals. 

Elder flower soap excels in therapeutic value all other germi- 
cidal soaps. The berries make an agreeable sub-acid wine, con- 
taining much malic and citric acid, sugar and glucose. 




Flower-stock, leaves, and cluster of berries of com 
mon elder {Sambucus nigra). 



Elm Bark. The pulverized bark makes an excellent ger- 
micide poultice, to which bicarbonate of soda in 
any given quantity can be added.' 

An infusion of the bark is one of our best remedies in gastritis 
and gastric ulcer. 



BACTERICIDES. 



1309 



Slippery Elm Bark in the successful treatment of tapeworm 
is well presented by recent authors. Pulverized slippery elm 
bark, four ounces ; water, one pint. A tenacious mucilaginous flyid 
is thus obtained. 

The following directions for use are given : The patient to fast 
two days ; the evening of the second day to take a purgative 
dose of castor oil sufficient to move the bowels the following 
morning, and while still fasting take one-half the medicine, and 
in half an hour the remaining half along with the full dose of 
castor oil. In a case so treated the entire parasite in a mass was 
expelled in one hour after the last dose of medicine, measuring 
forty feet in length. 



Epilobium 
Angustifolium. 

{WiU(m) Herb) 



This indigenous 
plant has very nearly 
identical properties 
with the willow tree, 
and even yields sali- 
cine, hence it is germicidal, bracing, se- 
dative, astringent action. 

It yields its properties freely to both 
water and alcohol. 

It seems to have a special affinity to 
unite with and destroy the micro-organ- 
isms of diarrhea and dysentery. 

Its sphere of action 
is best exhibited 
upon all organs in 
the genitourinary 
organs, hence it is 
valuable in catarrh of 
prostate. 

The tincture is the 
for administration. 





Willow Herb. 

the vagina, bladder, 
most eligible form 



Erigeron 
Canadensis. 



The oil is equally effi- 
cacious as terebene, and 
as powerful a germicide, 
also astringent, styptic. 
Five drops of the oil on sugar repeated 
as indicated, exerts a well-marked influence 
over the heart and arteries, and is a most 
efficient remedy in chronic bronchitis. Re- 
cent extensive clinical experience with this 
ancient reputation as an invaluable haema- 
static to the uterus, bladder and rectum. Its chief sphere of action 



druor 



Erigeron. 

confirms 



Its 



I^IO DISEASE GERMS. 

is upon the genito-urinary organs, it is essentially a uterine styp- 
tic, stops the flow, lessens the irritability ; it is also of great effi- 
cacy in haemoptysis. It acts well upon the kidneys, checks 
haematuria ; greatly lessens the flow of albumen in chronic inter- 
stitial nephritis, and in chronic cystitis it exerts a good effect in 
lessening; the mucous exfoliation from the coats ot the bladder. 
If the oil dropped on sugar and administered excites any heart- 
burn, administer in mucilage or syrup of tolu. 



The degradation of the primary elements of nutri- 
Ergot. tion of certain grasses, cereals, fruits, vegetables, by 
adverse states, as poverty of soil and absence of 
nutritive pabulum, into a fungus or microbe, has nothing in com- 
mon with the normal gland. 

The principal use of this fungus, up to a lecent period, has 
been its efficacy in parturition. When administered during 

labor, it produces a constant, unremit- 
ting contraction and rigidity of the 
pregnant uterus. Consequently, un- 
less the OS uteri and external parts, 
are sufficiently relaxed, it is apt to 
prove disastrous to the mother and 
child. 

The indiscriminate use of this fun- 
gus gives rise to thrombosis or em- 
bolism, hence sudden deaths during 
its use is the rule from clot and rup- 
ture of the heart. 

It is, however, a spinal stimulant of 
great efficacy, and this, together with 
its faculty of causing a coagulum to 
form in the blood, renders its use of 
rare value in all hemorrhages from or- 
gans in chest and abdomen.- So 
are its properties as a spinal stimulant, that hypodermic 
injections of ergotine, will, in short time, reduce an enlarged 
prostate, or cause absorption of a uterine fibroid ; so with en- 
largement of the thyroid. 

The Glucoside Ergotine. — By stimulating the spinal cord (lum- 
bar portion) it causes contractions of the uterus ; used in paraly- 
sis of the sphincters ; enuresis ; incontinence of urine ; impot- 
enc}^ ; to absorb uterine fibroids ; diminish enlarged prostate. 
Dose : one-fourth to one grain every four hours. 




Ergot ©f Rye. 



great 



BACTERICIDES. 



31 



or adder's-tongue. All parts 

Erythronium Americanum, of this plant are active in the 

destruction of microbe. 

The plant in its green state is most 
■energetic, its activity is much diminished 
by drying. 

The crushed leaves and bulbs, added to 
diluted alcohol, macerated four weeks, 
percolated, make an elegant preparation 
for emetic purposes, as an alterative and 
germicide; in very small doses it is often 
of advantage in the cure of chronic 
eczema and herpes. 

In the form of a preparation made from 
the green plant we derive the most efifi- 
cient results. 

Cerate is of great utility in nearly all 
skin affections. 



Eryngium, 



This is 
ive 
tonic 



a most effect- 
valuable 
active stimulant 



germicide 



and restorative. 

Its special action is upon the genito- 
urinary organs, being a diuretic and 




Adder's-Tongue {Ophioglo 
su»,- 7>ulgatnm\. 




Sea Holly; {Efyngiiun 7naritimu)ii) ; a, a 
floret; b, a petal; c, a stamen; d, the 
pistil. 



aphrodisiac. In its action it re- 
sembles apio], allays vesical and 
urethral irritation from what- 
ever cause. 

Some claim that it will destroy 
the microbe of snake bite, but 
this is not correct. 

It acts well in some cases of 
dropsy, dependent upon conges- 
tioh* or obstruction of the kidneys 
with liric acid. 

Its use in alternation with the 
saw palmetto, has a most excel- 
lent effect in atrophy of the testes. 

It has been used with great 
success in dropsical effusions. 
It acts well in all such cases, in 
alternation with strophanthus. 



1 2 12 DISEASE GERMS. 

This plant has been thoroughly 

Eschohltzia Californica. investigated, and three distinct 

products have been isolated : a 
glucoside, a new alkaloid, resembling codia, and a very small 
percentage of morphia. Two pounds of the dried plant yielded 
about six grains of morphia. 

The tincture, or fluid extract of the entire plant is a most ex- 
cellent, efficient germicide, and entirely well adapted to combat 
the various diseases of infancy, especially the green diarrhea of 
the summer season. 

From a large number of cases in which the remedy was used 
in cholera infantum during the heated term of July, August, and 
September, in crowded-up abodes, devoid of all sanitary precau- 
tions, and among a class of cases, with great vital disorder, pain, 
fever, spasm, prostration, it has demonstrated itself to be a rem- 
edy of vast importance, and one destined to supersede lactic acid, 
salicylate soda, resorcin, in the treatment of those formidable af- 
fections. It can be administered with safety to the youngest 
child in any stage of the disease, and always wjth the most satis- 
factory results. * 

In infantile diarrhea, when the common bacillus are liberating 
ptomaines, as is manifested by the symptoms of utter goneness, 
pallor, distress, tense abdomen, drawing up of knees, screaming 
or crying, etc., with green stools, in this stage the action of the 
ramedy is seen to the best advantage, for when administered 
right here, a complete change to the better at once takes place, 
and if persevered with, the green stools, with the bacillus and 
ptomaines, disappear and recovery is rapid. 



the name applied to an extensive genus of 
Eucalyptus, trees of the myrtle family, natives of Australia 
and Tasmania, all possessing great germicidal 
properties. The eucalyptus globulus, or blue gum, one of the 
species, has come into high esteem and deserved repute as a 
sanitary tree, and has exercised in regions of the warm temper- 
ate zone, a greater influence, scienic, industrial, hygienic, bacteri- 
ological, than any other species of arboraceous vegetation, even 
the pine not excepted. It is a great ozone generator, liberates 
that agent in great abundance. 

The planting of this tree in the most pernicious paludal and 
malarial marsh, where ozone never penetrated, and human life 
could not exist, rendered them perfectly habitable and healthy. 

There are numerous preparations made from the selected 
leaves, such as a fluid extract, which is almost inert, as in the 
mode of extraction, the essential oil is virtually lost. 



BACTERICIDES. I o i ^ 

All the bactericidal properties of the leaves are in this essen- 
tial oil, which can readily be prepared in the form of a glycerite, 
and five volumes of hydrogen dioxide added, in this form we 
have a germicide of great efficiency in sterilizing and annihilat- 
ing the microbes of croup, diphtheria, catarrh ; and is capable of 
neutralizing offensive discharges from the vagina, or ulcers. 

An ozonized distillation from the leaves is the most efficient 
remedy ever discovered for promptly killing the gonococcus of 
gonorrhea ; one ounce of the distillation, added to four ounces 
v/ater, gives us an injection of intrinsic value in gonorrhea, leu- 
corrhea, ophthalmia. 

Suppositories prepared from the fresh leaves kill the tuber- 
culse bacilli of a germ-eaten rectum. A cerate prepared from the 
oil is valuable in erysipelas. 

Eucalyptus honey, contains all the ozone-generating properties 
found in the tree, and to the presence of which are due all its 
wonderful germicidal properties. This honey plays an important 
part in the cure of all laryngeal, 
bronchial, pulmonary diseases, 
as well as in hooping-cough and 
influenza. 

Eucalyptol^ active principle in 
solution. — -In the administration 
of this remedy for malarial 
fever, open the bowels freely. 

Three hours before the chill, ^°^'^ Eucalyptus, 

give two tablespoonfuls of the extract undiluted; drink of all 
kinds to be strictly forbidden ; twenty minutes before the rigor, 
another half-ounce. 

In place of the chill, a violent perspiration sets in, which has 
the peculiar odor of a marshy swamp, which is due to the dead 
germs on the skin. 

Dose : from ten to fifteen drops on sugar thrice daily. Utterly 
insufficient to destroy the tubercular bacilli, but acts powerfully 
on the bacteria. 

Eucalyptus Folia. — (A distillation from the fresh leaves, ozon- 
ized.) In gonorrhea, use as an infection after urinating, or three 
times a day ; for leucorrhea, use as an injection by fountain 
syringe morning and night ; for ophthalmia, keep a cloth con- 
stantly wet with it, loosely applied to the eye. An energetic 
agent to destroy the germs of gonorrhea and leucorrhea. It not 
only destroys the germ, the factor of gonorrhea, but its use be- 
fore a suspicious connection acts as a prophylactic. In the 
various forms of purulent or gonorrheal ophthalmia, it com- 

83 




iSH 



DISEASE GERMS. 



pletely kills the bacteria or gonococcus present. Dose : add one 
fluid ounce to four fluid ounces of water. For external use only. 



This new drug has proved most 
Euphorbia Pilulifera. successful in cases of asthma, bron- 
chitis, coughs, influenza, affections 
of the chest, and is now being tried for hay-fever. 

Preparations. — As this plant is a poison, great care should be 
taken not to make too strong a decoction, or ill instead of good 
results may be expected. The decoction is prepared as follows : 
Place one ounce of the weed in an enamelled saucepan contain- 
ing two quarts of cold water, boil, and then allow it to simmer 
for a couple of hours, or until the quantity of water is reduced 
to one quart ; strain it, allow it to cool, and bottle for use, adding 
a teaspoonful of alcohol and chloroform to fortify and prevent 
fermentation ; also a tincture. 

Doses : Decoction, two fluid ounces to be taken at night be- 
fore going to bed, on rising in the morning, and an hour before 
dinner. Tincture : one-half to one teaspoonful, two or three 
times a day in water. 

^^Most favorable reports reach us from all quarters, of the 
prompt beneficial results in asthma, promoting easy breathing 
;and soothing the irritation of bronchial tubes. It succeeds when 
all other remedies fail. 




This decoction has, from 
Euphrasia, time immemorial been famous 
{Eye Bright}) as a remedy for dimness of 
vision. 
On account of its astringent and antiseptic 
action, it is invaluable in all forms of ophthal- 
mia. Add to one pint infusion one ounce of 
boroglyceride, and we have an eye lotion of 
great efficacy, one which will purge the visual 
organ of all microbes, and in granular con- 
junctivitis act as an absorbent to effused 
lymph. 

Besides its utility in eye effections, it is 
often of great service as a diuretic. The in- 
fusion to be taken freely. 

An excellent extract may be prepared 
by macerating the coarsely ground plant with 
equal parts of water and glycerine for fourteen days, and then 
percolating. 



Euphrasia Officinalis (com 
mon Eye Bright). 



BACTERICIDES. 



I315 



The extract may be administered in all acute and painful af- 
fections of the eyes ; it is even successful in opacity of the 
cornea, in twitching and paralysis of the lids. 



Eupatorium 
Purpureum. 



Queen of the mead- 
ows, or gravel root, is 
a decided tonic to the 
granular structure of the kidneys ; an 
infusion of the root is very valuable in 
alternation with nitro-glycerine in 
Bright's disease of the kidneys. There 
are few remedies so beneficial as this 
one in affording relief wherever there is 
painful suppression of the urine, either 
from inflammation or from calcareous 
accumulations. It is of great benefit 
in the treatment of almost all affec- 
tions of the kidneys and bladder. 

In dropsy, strangury, haematuria, 
gout and rheumatism, it is a valuable 
auxiliary agent, and of decided benefit 
in dropsy, on account of its stimulating 
influence on the vessels, as well as its 
diuretic powers. 




Queen of the Meadows, or Gravel 

Root. 

The name (ex, privative, and algos, pain) is sig- 
Exalgine. nificant of its qualities. The formula is CgHnNO 
(or C6H5.O2H3O.NCH3), and the substance is one 
of the three isomeric (para, meta and ortho) methyl derivatives 
of acetanilid. It occurs either in fine acicular or long tablet-like 
crystals, accordingly as it is obtained by evaporation from solu- 
tion, or by fusion thereafter. It is sparingly soluble in cold 
water, more soluble in hot water, and extremely soluble in very 
dilute alcohol, or in water slightly alcoholated. Physiologically 
it acts very much like analgesine, having, however, more effect 
^pon the sensory and less upon the thermogenic centres than 
this substance. Its therapeutic effects are obtained in doses of 
from four to six grains, administered at once, or from six to 
twelve grains taken in two doses in the course of twenty-four 
hours, and are powerfully analgesic, subduing the element of 
pain in all forms of neuralgia, including visceral. Like all new 
remedies of this sort, it is at present on trial. It is claimed by 



3i6 



DISEASE GERMS. 



eminent authority that it has in their hands up to the present 
exhibited no evil sequelae, being free from the rash, cyanosis, etc., 
so frequently observed after the ingestion of antipyrine and ace- 
tanilid, Exalgine is eliminated by the urine, upon the quantity 
of which it exercises a marked effect, acting like the antipyretics 
of the same group, diminishing the quantity of the secretion. In 
diabetes it also diminishes the quantity of sugar eliminated. 
Like all of the derivatives of the aromatic series, it is antiseptic 
and antithermic, as well as analgesic, and possesses the latter 
quality in a comparatively superlative degree, being more effi- 
cient, in doses less than half so great, than antipyrine. 

The following is an excellent formula for its administration : 
Dissolve two drachms of exalgine in two ounces of diluted 
alcohol, 45 per cent. ; add the same to either two ounces of the 
syrup of tolu or fluid extract of licorice, and administer in tea- 
spoonful doses as indicated. 



Nearly all our essen- 

Fennel. tial oils are germicides 

of the first order, and 

their use is sadly neglected in 

practice. 

For example, the oil of pepper- 
mint has an antiseptic property in 
it, a potency for good, a field of 
therapeutic utility, vast in extent and 
importance, greater than yet known 
or suspected. 

The greatest of all desiderata in 
diphtheria is a germicide like this, 
which can be fearlessly applied, in 
the greatest quantity and frequency, 
which is innocuous, whether it be 
absorbed or swallowed. 

The oil of fennel has not such 
active germicide properties, although 
a grateful aromatic and carminative. 
Fennel seed exercises an important action on the broad liga- 
ments of the uterus, and is utilized with rare success in all cases 
of prolapsus. An infusion of the powdered seeds, twenty 
grains to a drachm to a pint of water, is an excellent form for 
administration. 




Fennel {^Fceniculuin vulgare) \ 
a, a flower. 



BACTERICIDES. 



1317 



A gliicoside froiii fiunarina officinalis or fiinii- 
Fumarine. tory ; a most remarkable vegetable bactericide. 
A simple decoction used as ^yf^ 

a mouthwash or gargle kills the oidium 
albicans. As an eye lotion, completely 
sterilizes all bacteria and other micro- 
organisms in ophthalmia. A fluid extract 
is exceedingly useful in congestion of the 
liver and spleen. It is a very valuable 
remedy in sterilizing the micrococci of the 
eruptive fevers. The general properties 
of this remedy are tonic, alterative, and, in 
large doses, laxative and diuretic. Its pro- 
longed use diminishes plethora and will Fumitory. 
produce anaemia ; so it should be administered for about ten 
days, left off for four or five days, and then resumed. 




The whole plant has an agreeable, aromatic 
Gaultheria. odor and taste, owing to the presence of a vola- 
tile oil, which is stimulant and highly germi- 
cidal. 
An ordinary fluid extract of the plant has in ordinary doses a 
direct sedative action upon the genito-urinary organs of both 
sexes. It is an anaphrodisiac, allays irritation and inflammation 
■of the bladder, prostrate urethra ; ovaries, uterus and vagina. 

The oil of partridge-berry yields 
salicylic acid in great abundance. 

The glycerite of wintergreen is 
prepared from the oil, and is with- 
out a doubt the most valuable of all 
its preparations, being a cerebral 
stimulant and vitalizer, and when 
administered in proper doses, in 
acute rheumatism, having such a 
chemical affinity for the lactic, buty- 
ric ferment or germ in the blood and 
tissues, completely neutralizes and 
annihilates it. It lowers tempera- 
ture, equalizes the circulation. It 
is a perfect substitute for salicylic 
acid and its salts, the latter being a chemical derivative of the 
former. In its use in rheumatism, it has many advantages ; it is 
prompt and efficient in action — few relapses when used ; no 
cardiac complications. It is best to administer it in frequent 




Procumbent Gaultheria {giultheria 
procumbens) ; a, fruit : b, flower. 



I3i8 



DISEASE GERMS. 



doses, till temperature is lowered. It is a local anodyne to» 
inflamed joints. 

The best method of administration is in frequently repeated 
doses, continued in diminished doses throughout convalescence. 
Its use possesses the advantages of being unattended with any 
toxic effect or gastric disturbance. 

Glycerite of Wintergreen. — In acute rheumatism this remedy 
supersedes its derivatives, salicin, or salicylate, in neutraliz- 
ing the lactic and butyric acid ; besides, it is a great promoter 
of nutrition. Salicylate of ammonia is useful when we desire 
ammonia administered; salicylate of potash is an excellent 
substitute for the soda salt ; it is to be preferred whenever we 
desire to introduce potash into the system, as in the gouty dia- 
thesis ; salicylate of lithia is the ne plus ultra of all drugs in gout ; 
salicylate of quinine is used with considerable success in neuralgia 
and rheumatic pains ; and the salicylate of cinchonidia is verj^ 
useful as a tonic and anti-periodic in neuralgia, gout, rheumatism. 
Cinchonidia (C2H24N2O) is an isomer of cinchonia, but possesses 
left instead of right polarization and is more soluble. In chronic 
rheumatism, as a stimulant to the appetite and general tonic, it is 
of great utility. 

Glycerite of Wintergreen (Ozonized^, Gaultheria. — Indicated in 
all cases of acute or chronic rheumatism. When administered 
it unites with the lactic and butyric acids, and renders them 
inert, at the same time its tonic and antiseptic action upon the 
organs of digestion and assimilation prevents the formation of 
those acids ; hence its use stamps and starves out the disease. 

A perfect substitute for salicylic acid and soda. The superi- 
ority of this preparation is seen in the rapid cure of both acute 
and chronic cases, the infrequency of relapses, and the prevention 
of cardiac complications. 

All physicians who use this prefer it to the various compounds, 
produced by artificial means. 

Perfectly annihilates the bacillus amylobacta of rheumatism. 

Dose: From one-half to one teaspoonful every two hours. 



The bark of the root of the yellow jessamine 
Gelsemium. is a nervine, antispasmodic and an energetig 
genital sedative. A pure nerve tonic of the 
highest order and a germicide of great power, being capable of 
destroying the malarial germ, so that it is used either alone or 
combined with quinine with the greatest success in all malarial 
fevers. 

It has a powerful influence on the sympathetic nervous system^ 



BACTERICIDES. 



319 



siological 



allays nervous irritability, as may be seen by its use in all nervous- 
diseases, neuralgia, headache, tetanus, epilepsy, delirium tremens,, 
hysteria and convulsions. 

It is invaluable in all forms of reflex irritation, arresting the 
symptoms so produced. As a genital sedative, exceedingly 
valuable in gonorrhoea, allays urethral irritation, and is of the 
greatest efficacy in nocturnal emissions when they are dependent 
on irritation of the prostatic portion of the urethra, or if there 
is an inflamed prostate or rectal ulcer. In all cases of sperma- 
torrhoea it is invaluable, soothing to the damaged parts, cuts off 
for the time being all sexual desire which, when its use is discon- 
tinued, are restored to their full 
vigor. To secure its full phy- 
action it should be 
large doses at bed- 
time ; a tincture of the fresh 
root is the best form. The 
active principle is unfit for use, 
being toxical and unreliable in 
its action. 

In puerperal eclampsia lobelia 
and gelsemium combined are 
excellent. In severe cases ad- 
minister a teaspoonful by the 
rectum, first emptying the lower 
bowel by enema. The dose 
maybe repeated in half an hour, 
and so on till the convulsions 
are abated. When given by 
the mouth half teaspoonful 
doses are in order. 

Very useful when a person 
is under the influence of an 
alcoholic stimulant or is men- 
tally excited, the face is flushed 
and the eyes have the appear- 
ance of being bright. The excitement is in the base of the 
brain and the vaso-motor tract at the same time is in a s^ate- 
bordering on paresis. Here are found the centres for respiration,, 
circulation and secretion. Here are points wherefrom emanate 
controlling influences that either stimulate or inhibit ganglia and 
their nerves. It is in this state that gelsemium is remarkably- 
valuable. Vasomotor dilator excitation prevails. There are 
vaso-dilator centres through the medulla and cord. When these 
are excited we have full capillaries and veins, and low arterial- 




Gelsemium. 



I320 



DISEASE GERMS. 



pressure, dilated pupils. Pulse soft and temperature high, func- 
tional excitement and the vital energies of the centres are being 
depressed. 

Gelsemium is a wonderful medicament in all these conditions. 
The irritation of nerve centres, restlessness, fever, bright eye and 
flushed face, soft pulse, low blood pressure, weak heart sounds, 
pains of that kind that indicate irritation of centres and not of 
nerves. Gelsemium must be fitted to the case in each person. 
Some require larger doses than others to be of value ; too small 
a dose is worthless, too big a dose is paralyzing. Remember 
g-elsemium is a stimulant. 



Gentian. 



This remedy possesses in a high degree the 
tonic properties which characterize simple bitters. 
It excites the appetite, invigorates digestion, in- 
creases the vital forces of the 
body. It may be used when- 
ever a tonic is indicated in all 
conditions of debility, but it is 
the condition of the stomach 
and of the system generally,. not 
the name of the disease, which 
must be taken into considera- 
tion in prescribing it. 

It is a germicide of some 
value, destroying the bacteria 
and oidium albicans in malig- 
nant and sloughing ulcers. It 
can either be sprinkled on or in- 
corporated in a poultice and 
applied to the sore. 

It kills the germ streptococ- 
cus, or chain of micrococci, 
which is present in impetigo. 
The powdered gentian is incorporated in ozone ointment, and 
applied to the scalp morning and night. 

The same ointment, as a hair dressing, is a prophylactic to this 
disease, which has been epidemic in our public schools and certain 
streets. 




Common Gentian; a, capsule; d, capsule cut 
across , c, vertical section of seed, magnified. 



The root of the cranesbill, or spotted geranium. 

Geranium, is an astringent and antiseptic; a decided tonic, 

bracing to all mucous surfaces. It is a vitalizing 

and restorative agent, promotes instead of suppressing the normal 

mucous secretion. It is most efficacious in cholera infantum and 



BACTERICIDES. 



I32I 



the summer diarrhea of children ; pecuHarly serviceable if there 
is much pain, griping or flatulency. 

On account of its pleasant taste and efficient action, it is par- 
ticularly suitable for administration to children and persons of a 
delicate constitution. It is of great service alone to check the 
vomiting of cholera, and can be combined with salicylate soda 
when a powerful antiseptic action is needed. 

It cannot be valued too highly as a safe and efficient astringent, 
and it is indicated in all forms 
of infantile diarrhea. 

In fissure, ulcer of the rec- 
tum, it is of the greatest effi- 
cacy. 

A tincture is the most eligi- 
ble form for administration. 

Probably one of the most 
profound of our physicians and 
certainly one who is a keen ob- 
server of morbid action, says : 

*' There are few remedies 
which possess a wider range of 
usefulness than geranium ma- 
culatum, and which are so de- 
void of harmful properties. In 
all forms of hemorrhage, 
v/hether internal or external, it 
is without a superior. Haemop- 
tysis can usually be promptly 
arrested by drachm doses of 
the fluid extract given hourly 
until the attack subsides. Re- 
lapses may be prevented by 
continuing the same dose at 
longer intervals for three or 
four days. Hsematemesis may be effectually controlled in the same 
manner after ergot, matico, sulphuric acid, iron, ice and other 
styptics have failed. In hemorrhage from the kidneys and the 
intestinal canal better results can be obtained from the adminis- 
tration of smaller doses twenty drops four times daily, for an 
extended period. Epistaxis may be speedily checked by plug- 
ging the nostrils with cotton dipped in a solution composed of 
one part of the fluid extract of geranium and three parts of 
water ; or by syringing the nasal passages with the same solution. 
Hemorrhage resulting from the extraction of a tooth is occasion- 
ally obstinate in character, persisting for days, defying the cau- 




Cranesbill. 



1322 



DISEASE GERMS. 



tery and other methods, enfeebling the patient and alarming the 
family ; but it can invariably be promptly arrested by filling the 
socket with a piece of cotton saturated with the undiluted extract 
of geranium maculatum, and applying firm pressure for a few 
minutes. Hemorrhagia can be most effectually abated by the 
internal administration of geranium combined with vaginal injec- 
tions of the same remedy." 



Ginger. 



A well-known root, indi- 
genous to both the East and 
West Indies and China, but 
the best is grown in Jamaica. It is a 
diffusible stimulant, and aromatic and an- 
tiseptic. To weak, germ-laden stomachs 
it is a remedy of rare value. It makes 
an excellent tea, which should be taken 
either warm or cold, as desired. In the 
preparation of an infusion of ginger it 
should never be boiled, as that impairs 
its antiseptic properties very much ; 
valuable carminative, useful in colic, de- 
bility and laxity of the stomach and 

uterus. It is invaluable combined with 

quinine in uterine hemorrhage, either in 

infusion, say half an ounce of pulverized ^^ vp >r^a^ ^ 

ginger to a pint of water; or, syrup of ^ '/ ^'^ ^^l^ 

ginger, three ounces ; sulphate quinia, 

twenty grains. Mix. A teaspoonful as 

indicated. 




Common Ginger {Zingiber offici- 
nale) ; a, flower, detached ; b, 
perfect anther. 



Gillenia Trifoliata. 



Bark of the root 
of the gillenia tri- 
foliata is a safe and 
mild emetic ; a most reliable and effica- 
cious agent in diseases where emetics are 
indicated. 

Besides it can be employed with great 
benefit in all dropsical conditions. It is of 
most value in gastric catarrh, where the 
sarcinae ventriculi and yeast plant are on 
the stomach. 

It might fairly be named an emeto- 
hydragogue, cathartic and antiseptic. 

For an alterative action, best to administer 
doses, and continue for some time. 




Indian Physic. 



in very small 



BACTERICIDES. 



1323 



The fluid extract is the best form for general use. When it is 
desirable to administer it in large doses, it should be combined 
with fluid extract of collinsonia, which entirely mitigates its irri- 
tating effects. 



An invaluable germicide and parasiticide. 

Glycerine. Glycerine is a sweet substance, the basis of fats, 
being combined in them with the peculiar fatty 
acid characteristic of each. Accordingly, when these fats are 
decomposed by the addition of an alkali, as is done in making 
soap, the glycerine is set free, and the new combination of fatty 
acid and alkali constitutes soap. It is also obtained by distilling 
the fats by means of superheated steam. Thus obtained, the 
glycerine is a sweet liquid, colorless, and syrupy, oily to the 
touch, yet mixing readily with water. The solution of it in 
water does not ferment with yeast, and it does not dry up on ex- 
posure to heat of a moderate temperature. Its properties are very 
valuable, it readily dissolves many substances, and not drying up 
readily, it constitutes an excellent basis for applying them to the 
skin. It is chiefly as an adjunct to lotions that glycerine is of 
use. Lotions containing it do not dry up, and so the skin is 
kept soft and moist, and the bad effect of drying in forming scabs 
is avoided. It has been tried internally instead of cod liver oil, 
and it is used as a basis for some remedies, as gallic acid and 
tannic acid, when they are applied to the throat. In this way,, 
too, borax may be made of use in aphthae with advantage. 

Dose: one drachm, locally applied, in the proportion of a 
desert- spoonful to eight ounces of water, and taken internally, in 
doses of one to two drachms, is curative of impetigo, prurigo, 
pruritis, lupus, and herpis exedens. It is a good application to 
fetid ulcers, skin scurf, dandruff, chapped hands, chilblains, acne, 
rosacea, eczema, and to prevent pitting in small-pox. It is a 
good application, alternated with boroglyceride, for cracked nip- 
ples, cracked lips, and hands, burns, scalds, wounds, and erysipe* 
las. It is valuable in dry eczema of the ear, alternated with 
boric acid. It prevents fermentation of the stomach, and given^ 
with nux, is a tonic. 

Glycerine has been lauded in constipation ; glycerine when 
brought into contact with the mucous membrane of the rectum,, 
withdraws water from it, thus causing hyperaemia and irritation 
of the sentient nerves of the rectum, which in its turn leads re- 
flexly to powerful peristaltic contraction, ending in defecation. 
The larger the accumulation of faeces, the greater is the effect. 
There is no discomfort or pain, but the action takes place at 



1324 



DISEASE GERMS. 



once. Sometimes, however, a little throbbing is felt in the rec- 
tum for a few minutes afterwards. 

This repeated exhausting of the serous coat of the rectum 
renders it weak, liable to prolapse or deposit of the cancer germ, 
so that the so-calied " glycerine suppository " so freely adver- 
tised, is productive of great damage. 

Internal nse of Glycerine. — Prof. C. L. Souder, M. D., Burrows, 
Ind., prescribes it as a stimulant to the digestive organs in the 
non-febrile stage of phthisis, when for any reason cod-liver oil 
ceases to be tolerated. The following mixture is given daily in 
two or three doses : glycerine, forty grammes, and rum or cog- 
nac, ten grammes, with one drop of essence of mint. This aro- 
matic alcoholized compound, of agreeable flavor, is well tolerated 
by the stomach, and even after long uninterrupted use, it causes 
neither satiety nor disgust. The addition of the rum or brandy 
has simply in view the modification of the insipid taste of the 
glycerine, and to assist its digestion. The amount of the gly- 
cerine may be raised to fifty or sixty grammes, but only in per- 
sons who do not exhibit any signs of abnormal excitability of 
the heart or nervous system ; and restlessness, unusual loquacity, 
obstinate insomnia, or an increase of temperature, announces that 
the proper dose has been exceeded. It diminishes constipation 
in almost all cases, and yet moderates diarrhea when it is pres- 
ent ; and under its use sleep becomes calmer. It has an evident 
effect on nutrition, its employment in most cases, leading to an 
increase in weight after the first fortnight. In tuberculous cases 
it induces a considerable amendment in the functional manifesta- 
tions of the disease, such as dyspnoea, cough, and sweating. 
The expectoration is the symptom which is least influenced. 
The local condition of the lung also remains stationary, and the 
physical signs undergo no change. The action of glycerine on 
the liver is exhibited by the increase of its size, and by the more 
abundant flow of bile. With respect to its action on the kid- 
neys, there are observed a more abundant diuresis and an 
absolute and relative increase of the urea, chlorides, and phos- 
phates eliminated by the urine. In affections of the genito- 
urinary organs, it has been found that under the use of glycerine 
the alkalescence of the urine seems to diminish, while purulence, 
when present, becomes considerably lessened. 

Glycerine -Gelatine Preparations. — Their nse iii Skin Diseases. — 
The glycerine gelatines are distinguished above all the agents 
used for promoting the absorption of secretions, and especially 
in comparison with the pastes, by their adhesiveness, which con- 
stitutes a most useful addition to their other valuable character- 
istics. The most important of them is the germicide preparation. 



BACTERICIDES. 1 325 

which finds a very extensive field of utiHty, no less as indepen- 
dent therapeutic agents than as auxiliaries to the use of other 
agents. Slight superficial eczemas and erythemata, especially 
such as occupy the flexor surfaces of the joints, or are distributed 
over large tracts of the body-surface, can be treated by means of 
it both quickly, safely, and pleasantly. The preparation is ren- 
dered fluid in a water-bath, then painted on to the skin whilst 
still warm with a broad bristle brush, after which the layer is 
dabbed over with a flock of cotton-wool. By this means the 
layer is soon dried, and takes on the nature of a fabric. From 
places which are free from hair, it can be stripped off in a single 
sheet on the following day, but from places which are covered 
with lanugo, it must be washed off with warm water. 

A gelatine covering does not interfere with the perspiration of 
the skin, but rather tends to increase it, so that there need be no 
hesitancy in painting the patient all over with it, if the case de- 
manded it. 

Glycerite of Kephaline, (ozonized). — Indications. As this is a 
true brain essence, it is of the greatest efficiency in all nervous dis- 
eases, as mental and physical exhaustion, wasting diseases, loss of 
memory, vertigo, worry, struggle, nervous debility, decay of 
brain power, premature and otherwise, nervous prostration, neu- 
ralgia, loss of vital power, general vital deterioration, sleepless- 
ness, paralysis, white softening, typhoid, effectual and permanent 
cure in all cases of nerve debility ; builds up the brain, restores 
lost energy, refreshes the nerves, stimulates the sexual appetite 
and supplies it with nervo-vital fluid. It thus is a positive cure 
for seminal weakness, impotency, or loss of power in the genera- 
tive organs. It is also of great efficacy in leucorrhoea, female 
weakness, and change of life. Gives intellectual vigor and 
vivacity. 

/. /. Tempest, M. D., D. C. Z., 32 Bank st., Bradford, England, 
Europe, a close clinical observer, and eminent physician, when 
speaking of kephaline, says : ** I regard it as an excellent brain 
food, a nervo-vital essence ; when administered, it will repair, or 
reconstruct chaotic nerve force, deepen the typical fissures of 
thought, refresh the nerves when tired by worry or study ; re- 
pair lost energy, stimulate and supply the elements of the 
molecular growth of brain tissue, by its vitalizing action on the 
lymph glands, or blood raisers. 

" It is of pre-eminent utility in this age of cerebral exhaustion, 
and anaemia; every man and woman should use it." 

More recently, this great English physician has used kepha- 
line in paralysis, white softening, and various other so-called in- 
curable conditions, with great success. 



1326 



DISEASE GERMS. 



Whenever the tubercular bacilli ap- 
Glycerite of Ozone, pear in the blood or any weakened 
part, it annihilates the microbe in all 
the fluids and solids of the body ; the factor of pulmonary con- 
sumption being destroyed — wasting ; debility ; cough ; loss of 
voice ; expectoration ; night sweats ; haemoptysis, and difficult 
breathing cease ; under its use the pulse slows ; heat, respirations 
diminish; phosphates and chlorides in urine become normal. 
The remedy either in stomach or rectum liberates its ozone, which 
enters the blood, acts as a scavenger and vitalizer to germ-laden 
blood, cleansing it. It is very efficacious in tubercular menin- 
gitis, tabes mesenterica, diabetes, pink marrow engorgement, 
typhoid fever, Bright's disease, and in all diseases due to the 
presence of micrococci in the blood. Dose : fifteen to thirty 
drops for the first fourteen days, then increase it slowly to sixty- 
drops every three hours. 

Joseph Redman, M. D., Carson City, Nevada, an eminent bacte- 
riologist and excellent physician, one who is regarded as standard 
authority, says : 

'' Of all germicides the glycerite of ozone stands unrivalled in 
tuberculosis, for both annihilating and sterilizing the germ, in the 
following manner : Beginning with ten drops three times daily, 
the dose is run up rapidly to twenty, twenty-five, or even thirty 
drops. Short interruptions were allowed, and this remedy was 
universally well borne and exhibited no toxic effects. In cases 
of laryngeal phthisis, in addition to the glycerite of ozone inter- 
nally, resorcin was used locally in substance with the best results. 
Even in advanced cases the treatment was carried out, not so 
much in the hope of curing as for the reason that it seemed 
equal to any other in alleviating the symptoms of the later 
stages. Even in such cases real benefit often followed. Con- 
trary to expectation, in intestinal tuberculosis and the diarrheas 
referred to it, glycerite of ozone was of benefit. In general 
miliary tuberculosis it is efficacious, and the forms of disease 
most benefited have been those with hemorrhages, or with 
caseous or fibroid degeneration. During actual haemoptysis the 
use of the remedy is suspended. The author thinks the most 
decided value of the treatment results from improvement of the 
gastric and intestinal digestion, the immediate cause of whfch he 
leaves undecided. The rapid improvement of appetite and assimi- 
lation soon appears manifest in increased weight and renewed 
vigor, and through the latter the patient is rendered more capa- 
ble of withstanding fresh inroads of disease. So evident was the 
effect on the alimentary tract that the author was led to use 
glycerite of ozone with benefit in ordinary cases of dyspepsia 
and gastric catarrh. In bronchitis it was used with satisfaction.'^ 



BACTERICIDES. 



1327 



Though not a germicide, is an invaluable 

Gutta-Percha. agent for the purpose of holding germicidal 
and parasiticide remedies in direct contact 
Avith a microbe, fungi or parasite, in order to insure their destruc- 
tion. The method of preparing and applying it is as follows : 
Take of purified gutta-percha, in thin slices, one ounce ; chloro- 
form, eight ounces ; carbonate of lead, in fine powder, one ounce. 
Add the one ounce of gutta-percha to six ounces of the chloro- 
form in one bottle. Shake frequently till a solution is effected. 
Add the carbonate of lead to the remaining two ounces of chloro- 
form. Shake ; after both have become thoroughly incorporated, 
mix the two together. 

This is a most elegant menstruum for the exhibition of germi- 
cides in cutaneous disease ; it is applied by painting it on the 
skin with a brush, and allowing it 
to dry. This forms a delicate neu- 
tral, durable dressing, perfectly 
elastic, and exceedingly well adapt- 
ed for the treatment of chronic skin 
diseases. Nothing so convenient, 
so effective, as the preparation itself 
to protect the skin in light burns ; 
the rapidity with which the chloro- 
form evaporates, leaving a thin 
elastic, nearly colorless coating, is 
astonishing. It does not shrink, 
but is soft, and abraded parts heal 
almost immediately under it. 

The following germicides are 
added to it and used with brilliant 
success : Resorcin, thallin, chry- 
sarobin, iodol, naphthol, ichthyol, 
oil of cade, salicylic acid, siegesbeckie. In the large proportion 
of skin affections, as eczema, psoriasis, lepra, scabies, the different 
forms of tenia, they prove most efficacious. 

Traumaticine consists of a solution of one part of purified 
gutta-percha in ten parts of chloroform. This forms an admirable 
adhesive, and continues unchanged and adherent to the skin for 
two or three days, or even longer. On the contrary, in his expe- 
rience, the layer of gelatine is apt to separate in a few hours, in 
consequence of friction by the clothes or movements of the 
limbs, and needs frequent renewal. Again, the traumaticine pro- 
duces a much thinner and more delicate film than does either 
collodion or gelatine, and therefore occasions neither tension nor 
pain. The traumaticine is more readily applied than gelatine ; 




Guttapercha, i, a flower : 2, a pistil; 3, 
a branch with leaves and flowers ; 4, 
transverse section of ovary ; 5, vertical 
section of ovary ; 6, transverse section 
of fruit; 7, fruit, scarcely mature; 8, 
anther. 



1328 



DISEASE GERMS. 



it does not stiffen so quickly, and the brush does not become 
matted into a stiff mass. The solution in traumaticine is perma- 
nent ; the gelatine tends to become mouldy, even with the addi- 
tion of salicylic acid. Psoriasis can be admirably treated with a 
solution of chrysarobine in traumaticine as follows : After the 
chief part of the scales have been removed by means of a simple 
bath of soap and water, a ten-per-cent. solution is not only 
painted on, but rubbed in, with a narrow, short-haired painter's 
brush, to the patches. The application can be repeated every 
day, or every second or third day, in proportion to the extent of 
the disease. A bath is taken after each three or four applications. 
After at most twelve paintings the infiltration and scales will 
have disappeared, and in place of them are visible white patches 
bounded by a red or violet-brown areola. Neither in children 
nor in adults did any untoward results follow even a very exten- 
sive application to the body and face of the chrysarobine- 
traumaticine. 



Gold Chloride et Soda. 



A bactericide of some power in 
the destruction of the bacillus of 
tubercle and syphilis ; it acts best 
when the microbes are on the bones. 

Dose, i-iooth grain of muriate doses, is especially called for 
in the treatment of chronic bone and glandular affections, and 
attended with mental gloom. It is also of value in hypertrophy 
of the liver. In ozaena, especially, where the nasal bones are 

affected, it is a very positive 
remedy. In chronic nasal 
catarrh it acts well, but is only 
applicable in this form. In 
chronic otorrhoea it is also used 
with benefit, as also in syphilitic 
bone affection. 




Gold 
Thread 



resembles hydras- 
tis in all its varied 
properties, only 
more feeble, yields 
the same alkaloids. Borogly- 
ceride and an infusion of gold 
thread make a valuable remedy 
in nasal catarrh. 
The fluid extract is prepared in the same manner as that 
of hydrastis. 

Makes an excellent combination with peroxide of hydrogen. 



~-?^~ 



:-^^^ 



Gold Thread. 



BACTERICIDES. I^20 

This remedy has become well estab- 

Grindelia Robusta. lished in cases of asthma and kindred 

diseases ; in asthma and hay fever ten 

to twenty drops of the fluid extract may be given in sweetened 

water or milk every half hour until the microbe is killed and 

relief is obtained. 

Preparations : Fluid extract (one drachm represents one ounce 
of the plant) and tincture. 

Doses : Fluid extract, one half to one fluid drachm, repeated 
every three or four hours, as required. Tincture, one half drachm 
every one or two hours in hooping-cough. 

An excellent formula for asthma is the following : Fluid ex- 
tract grindelia robusta, one ounce ; fluid extract lobelia, three 
drachms ; fluid extract belladonna, one and a half drachms ; 
iodide potassium, two and a half drachms; syrup tolu, q. s. ad 
four ounces. Teaspoonful as needed to keep down the attacks. 



from which the resin is obtained, grows in the West 
Guaiacum, Indies. The wood is known as lignum vitae, and 

is excessively hard. The wood is employed for 
various purposes, and the chips and turn- 
ings obtained in preparing it for these are 
saved and made use of in medicine. The 
resin is also got by boring a hole in the log, 
and putting one end of it in the fire ; as it 
burns the resin melts and runs from the 
hole. More commonly it is obtained b}' 
boiling the chips already referred to in salt 
and water, when the resin floats on the top. 
The resin is insoluble in water, but soluble 
in alcohol. The preparation commonly em- 
ployed is the ammoniated tincture, con- 
sisting of the resin dissolved in aromatic Guaicum officinalis, 
spirit of ammonia, and an ordinary alcoholic tincture. Either 
taken internally is a powerful stimulant and bactericide. It steri- 
lizes the bacillus amylobacta of rheumatism ; the venereal bacil- 
lus and sterilizes the tubercular microbe. By steeping ordinary 
blotting paper in the alcoholic tincture and drying, then placing 
it beneath the leaves of a book for preservation, it affords one of 
the best characteristic tests for ozone, being colored blue by that 
and all oxidizing agents. It contains guaiacic acid which closely 
resembles benzoic acid, and yields, on distillation, certain definite 
compounds known as guaiacine, pyroguaiacine and hydride of 
guaiacyl. 

84 




I330 



diseasp: germs. 




Sunflower {Helianthus annuus). 



pneumonia. A 
colds, influenza, 

A glucoside has 
are feeble. 



syrup from 
catarrh. 

been isolated 



Common sun- 
Helianthus. flower ; is an in- 
valuable germicide 
and ozone generator. Planted in the 
vicinity of a deadly malarial marsh, 
they yield, if properly cared for, 
enough of ozone to destroy the ma- 
larial germ as fast as it is evolved 
from the decaying vegetable matter. 
Its ozone generating properties or 
faculty is even greater than the 
eucalyptus, although its antiseptic 
properties are much less. 

The seeds yield a fixed oil which 
is a valuable article of diet in all 
bronchial complaints, and as a local 
application to the chest in infantile 
the seeds is of great efficacy in 



but its medicinal properties 



Hepatica. 

(Liverwort)) 



The entire plant yields to 
boiling water a peculiar ac- 
tive cholagogue, which 
effects remarkable results 
m chronic hepatitis. The formulas in use 
are either drinking ad libitum a decoction of 
equal parts of liverwort and chionanthus 
Virginia, rr: fluid extract of hepatica and 
chionanthus Virginia, equal parts of each. 
Mix. A tablespoonful thrice daily. 




An effective and most powerful 

Hoang-Nan. germicide, sterilizes and kills the 

{Strychnos Gaultheriana) microbes of rabies or hydrophobia, 

elephantiasis, leprosy, cancer, snake- 
bite, malignant ulcers. 

Its physiological effects* are most potent on the nerve-centres ; 
rrioderated doses produce a feeling of intense fatigue, general in- 
disposition, vertigo, tingling in the hands and feet, invokmtary 
movements of the jaws. 

This remedy effectually annihilates the microbes above enu- 
merated; when administered, the microbes imbibe this poison 
and die. 



BACTERICIDES. 



I33I 



The remedy should be boldly and energetically given in all 
suspicious cases, until its physiological action is experienced. 
As soon as this takes place the microbe is killed. Dose is very 
variable. 



The root of 
this plant 



is 



highly 



trmgent 



Hound's Tongue. 

( Cynoglossum.) 

cidal and as- 
it is thus an excellent 
alterative wherever there are disease 
germs in the blood, and its astringent 
mucilaginous properties are of great 
utility in diarrhea, dysentery, coughs, 
catarrh and haemoptysis ; locally to 
burns, ulcers, tumors, infiltrations and 
goitre. 

Administered internally or applied 
locally, it sterilizes and kills numer- 
ous of the disease germs. 

An inspissated extract, or the juice, or succus of the green 
root, applied to a snake-bite or the bite of a rabid animal, effec- 
tually kills the poisonous breeding germs, and at the same time 
paralyzes the motor and sensual nerves of the part to which it is 
applied. It is an herb which merits further inxestigation. 




Hound's Tongue (Cynoglossum 
officinale) . 



>-^X//\ 




Hop {Humulus Lupulus"). 



The action 
Hops, of the hop, 
when admin- 
istered in almost any 
form, is tonic, soothing, 
anodyne, germicidal. 

The infusion is thus 
prepared : To one pint 
of boiling water add six 
drachms of hops, mace- 
rate for four hours in a 
loosely covered vessel 
and strain. Dose, from 
one to two ounces. 

The tincture is pre- 
pared thus: Six ounces 
of hops are added to two 
pints of alcohol ; mace- 
rate for fourteen days 



1332 



.disp:ase (ierms. 



and percolate. Dose, from one to two ounces, or ten drops of 
the fluid extract. 

These are tonic and vermifuge. 

Hop-bitters are made thus : Haifa pound of hops, two ounces 
of buchu, boiled in five quarts of water, and two ounces of the 
essence of wintergreen, added to flavor. 

A pillow stuffed with hops is valuable in insomnia. 

A glucoside is prepared from the hop. 

Lupuline, combined with equal parts of the glucoside from the 
black willow is invaluable in seminal emissions. 

A poultice of hops relieves pain and prevents suppuration. 



Horse- Chestnut. 



The fruit of this tree is an antiseptic, 
astringent, narcotic, cholagogue, etc., and 
is often successfully used in intermittent ; 
locally in the form of 
ointment to ulcers, swell- 
ings ; also of great utility 
in hemorrhoids. To the 
latter it relieves the rec- 
tal congestion by its stim- 
ulant and depurant action 
on the liver, and applied 
to the piles in any con- 
venient form, its astrin- 
gent action causes them 
to disappear. 

Its stimulant and anti- 
septic action renders it of 
great utility in nasal ca- 
tarrh, relieving the con- 
gestion of the sinuses of 
masses of germs that are 
blocking up the nasal fossa. 

The oil of horse-chestnuts on the painful joints of rheumatism 
affords almost instant relief. An excellent liniment may be 
made of it, thus : To eight ounces of alcohol add one ounce 
each of the oil of horse-chestnuts, menthol, oil of cajeput, and oil 
of wintergreen. Mix well. Apply three times a day. 

Horse- Chestnut fluid extract. — Useful in piles, by relieving the 
portal circulation ; also in ointment form. 

Dose, fifteen to thirty drops, added to water, every three 
hours. 

The powdered kernel of the nut is a sternutatory of utility in 




Horse-Chastnut — Leaves, flowers 

the head, and often bringing away 



BACTERICIDES. 



1333 



nasal catarrh. The fixed oil which the nuts contain is very use- 
ful as a local application in rheumatism. 



The flowering summit 
Hyssop, and leaves are the parts 
used. They have an agree- 
able, aromatic odor, and a warm, pun- 
gent, bitterish taste, which is due to the 
presence of a volatile oil, which is highly 
germicidal. Its infusion has been much 
employed in chronic nasal catarrh, as it 
retards germ evolution, facilitates ex- 
pectoration. It is a most excellent drug 
in hoarseness and bronchial obstruction. 

An acetic syrup makes an excellent 
remedy for difficult breathing and or- 
dinary colds. 

It is a drug specially indicated for the 
aged or debilitated suffering from any 
affection of the respiratory organs. 

The leaves, crowded in and simmered 
in olive oil, make one of the finest ger- 
micides for local use to the throat in 
diphtheria and scarlet fever, and to old, 
germ-eaten ulcers. 




Common Hyssop {Hyssopiu 
officinalis). 




Hydrastis Canadensis. 

{Golden Seal.) 



Hydrastis Canadensis. 



The fluid 

hydrastis, 
made by 
digesting 
the root in water or glycerine, or by 
displacement with this vehicle, is the 
best medicament in the treatment of 
gastric and duodenal catarrh. 

Hydrastis is a powerful local remedy ; 
acting on the blood supply of parts it 
is applied to in virtue of its vaso- 
constrictor action on the arterioles. A 
decoction of the ground root, made by 
boiling four ounces of the root in a 
mixture of sixteen fluid ounces each of 
water and glycerine for two or three 
hours, adding water from time to time 
as the fluid boils away ; at the end of 
the boiling process the quantity of fluid 



1334 DISEASE GERMS. 

must measure thirty two fluid ounces. This is the most univer- 
sally successful local application known in the treatment of gon» 
orrhea, chronic inflammations of mucous membranes, diseases 
of the uterus of a catarrhal and leucorrhoeal nature, ophthal- 
mia, etc. 

The influence of hydrastis over inflamed parts locally used, is 
well known to eclectics, and has been used for years by them 
as a local medicament in lieu of other astringents and local 
stimulants. 

The white principle of hydrastis, in my experience, is nearly 
worthless ; so is the sulphate of hydrastine. The combination 
of fluid hydrastis and hamamelis forms a valuable medicament 
in the treatment of menorrhagia. 

Hydrastis and pulsatilla combined is one of our best prepara- 
tions in the pains and nervous troubles, and the hemorrhagic 
gushes often encountered in women entering the. climacteric of 
life. Pulsatilla and belladonna combined afford us a fine heart 
sedative in nervous excitement of women in the menopausis. 

Hydrastis canadensis is indicated where there are thick, ropy 
discharges from mucous membranes, loss of appetite and feeble 
digestion. 

Dose : twenty to sixty drops of the tincture, twenty to thirty 
drops of the fluid extract. In small doses, this article acts well 
in all cases of feeble digestion, especially if from catarrh of the 
mucous membranes. It is recommended in jaundice, chronic 
bronchitis, constipation, if given in drop doses. In chrOnic oph- 
thalmia, or for granulated lids, a solution in water, of the sul- 
phate of hydrastia two grains, in distilled water one ounce, 
applied three times a day, often cures this trouble. 

The fluid extract of hydrastis canadensis is indicated as a 
tonic in all weakened states of the digestive organs ; its obviates 
constipation by stimulating a free flow of bile from the liver ; 
added to water, makes an excellent wash for ulcerated sore 
throat or in ophthalmia. 

Dose : ten to thirty drops, added to water, every four hours. 

Hydrastine sulphate is indicated as a stomach tonic and to 
increase the flow of bile ; in atonic dyspepsia, tubercular diar- 
rhea and enlarged spleen. Valuable astringent, antiseptic gargle 
in syphilitic sore throat. 

Dose : two to five grains, in pill or powder, every four hours. 



A most valuable bactericide, hav- 
Hydrocotyle Asiatica, ing the power, when administered 

persistently in small doses, of utterly 
annihilating the venereal bacillus. 



BACTERICIDES. 



1335 



It is extensively used in Hindostan, and is being gradually 
introduced into this country. 

The dose is from five to ten drops of the tincture, added to a 
little water. 



This valuable derivative of coal tar is no 

Hydronaphthol. longer an experiment, but has fairly won 
a permanent place high up in the list of 
modern antiseptics. After severest tests and experiments in both 
hospital and private practice, it has been accorded a place second 
only to mercuric bichloride in point of germicidal power, ,an.d 
being non-poisonous and non-corrosive, it is preferable to that 
well-known agent for all the purposes for which it is recom- 
mended. Hydronaphthol is free from the odor and escharotic 
properties of carbolic acid and other phenols, hence it is a pleas- 
ant and valuable internal antiseptic. Therefore, aside from its 
value as a general antiseptic, disinfectant, germicide and pre- 
servative, it is being used with great satisfaction as an internal 
remedy in cancer of the stomach, chronic dyspepsia, gastritis, 
typhoid fever and in other diseases of the alimentary canal ; also 
in enuresis, cystitis, rheumatism and gout. 

The very learned 5. H. Holbrook, M. D., of Salem, and other 
eminent dermatologists of Massachusetts, have found hydro- 
naphthol an excellent remedy in ulcers, eczema, scabies, all forms, 
of tinea. 

It is a most excellent bactericide for the preservation of ana- 
tomical preparations without shrinkage or decay. 

Hydronaphthol is a secondary compound of betanaphthol, 
differing from it in having a molecule of hydrogen displaced 
by an equivalent of hydroxide. Considered as a germicide, it 
is one of the highest rank, sufficiently powerful to destroy the 
bacillus of anthrax, subtilis, variola, leprosy. Administered in- 
ternally in small doses as an antiseptic ; but it is found to be of 
the greatest service in washing out septic or germ-laden cavities 
or wounds. It is most convenient either to make use of a solu- 
tion in alcohol, in which it is soluble to the amount of i in 2 
parts, or with glycerine added to the alcoholic solution, so as to 
make it of the strength of i in 10. It is soluble in oil to the ex- 
tent of I in 20, but it is only dissolved in cold water to the 
amount of i in i ico. In making this last solution it is best to 
see that the water is tepid. A solution of i in 300 in warm 
water possesses very great germicidal powers. 



nP 



DISEASE GERMS. 



is a peculiar product obtained from a bituminous 
Ichthyol rock found in the Tyrol. It occurs iii the form ol 
a ^reddish brown liquid, clear and syrupy, of a 
peculiar herb- like odor, and of a faintly alkaline reaction. It is 
soluble in Avater, partially so in alcohol and ether, but more 
soluble in a mixture of alcohol and ether. From its aqueous 
solution it is precipitated by hydrochloric acid. It is a remedy 
of intrinsic value in all parasite skin affections, as in impetigo, 
eczema, sycosis and other forms of tinea, where fatty agents in- 
crease their growth. A most reliable formula consists in three 
parts of ichthyol to glycerine and dextrine each ten parts, 
mix. 

Equal parts of ichthyol. and spirits of turpentine, a mixture of 
great efficacy in dry and moist chilblains ; the burning and itch- 
ing passing away the moment it is applied. 

Three parts ichthyol to one of chloroform is a never-failing 
remedy for toothache. In burns and scalds, psoriasis, in prurigo, 
pruritus, ichthyol has been used both internally and external^ 
with success. As a germicide it stands unrivalled, being even 
efficacious in nasal catarrh, chronic bronchitis, and chronic 
rheumatism. 

Our best dermatologists regard ichthyol as a cutaneous germi- 
cide, most efficient, superior to many other remedies ; painted 
over the affected part it protects it from the air and dust by 
forming a coating over it ; relieves congestion by causing con- 
traction of the arterioles, thus diminishing the vascularity of 
the part. 

In eczema, one drachm of ichthyol to one ounce of distilled 
water, when painted over the affected part with a camel's hair 
brush, relieves the itching and tingling. 

For squamous eczema, an ointment made of one drachm of 
ichthyol added to one ounce of ozone ointment. 

The same ointment applied over affected parts in rheumatism 
has a sterilizing action on the micrococci of that affection, for 
it unquestionably relieves the fever; the swelling and the joint- 
pain leave — thus killing the germ where it was localized. 

Ichthyol has found a rival in thiol, a new product of chemical 
synthesis, obtained by artificially sulphuretting unsaturated 
hydro-carbons, and charging these with ten per cent, of sulphur. 
Chemical and therapeutical researches prove its exact identity 
with ichthyol. Thiol consists of a brown fluid of the consistency 
of syrup ; it is completely soluble in water, is totally inodorous, 
and has therefore a decided advantage over ichthyol. There 
exists also a dry thiol, which has two and a half times the 
strength of fluid thiol, otherwise having the same properties as 



BACTERrCIDES. 



f3^7 



the latter. Thiol is used like ichthyol in the following diseases: 
Acne, acute and chronic rheumatic arthritis, other rheumatic 
affections, contusions, decubitus, eczema, erysipelas, neuralgia, 
ischia, leprosy, frost-bites, prurigo, pruritus, ulcus cruris, burns 
and scalds. 

Thiol and ichthyol are identically alike ; thiol will replace the 
latter when the natural sources of that remedy are exhausted. 



is a remedial agent which, since its comparatively 

Ingluvin recent introduction to the medical profession of the 
United States and Europe, has gained for itself a 
repuation perhaps hardly equalled in so brief a period in the case 
of any other preparation Icnown in pharmacy. It is prepared 
from the ventricu'us callosus gallinaceus ; the gizzard of the do- 
mestic fowl- — pullus gallinaceus. Since its introduction no 
remedy of modern times has excited more attention among 
physicians far and near, or received a higher endorsement, than 
ingluvin. As the source of its manufacture and the substance 
from which it is derived are made public, the profession has not 
hesitated to prescribe it in all cases where pepsin is indicated as 
a. remedy, and its use has been attended with more uniform bene- 
ficial results than that afforded by pepsin, which has been found 
so variable, perhaps on account of its various strengths and dif- 
ferent modes of preparation. Ingluvin, unHke pepsin, is not in- 
compatible with alkalies. ' 

The diseases in which the use of ingluvin is indicated are 
indigestion m its various forms, known as dyspepsia, and 
sick stomach or nausea caused by debility of that organ. It 
was originally discovered to be a remedy, indeed a specific, for 
vomiting in pregnancy ; in this respect it stands above all other 
medicinal agents. In all that is here set forth the manufacturers 
claim no more than is sustained by medical authority of the 
highest standing. 

The practitioner is especially cautioned to avoid fraudulent 
substitutes and imitadons, which the manufacturers are aware 
have been offered, and which are but the crude powdered gizzards 
of the fowl. Ingluvin diff-rs from this by its extreme refinement, 
and its association wdth simple substances for its preservation as 
animal matter. It is therefore essential to his success, and for the 
welfare of the patient, that the practitioner should be guarded 
against unscrupulous competition that would offer powdered 
gizzards, and seek to profit by the success of the true prepara- 
tion. 

Dose : From five to ten grains. 



338 



DISEASE GERMS. 



Indigo. 



A substance derived from a great variety of plants ; 
many compounds of great chemical and medicinal 
value have been derived from it. Indigo, itself, and 
all its alkaloids and glucosides,. 
are potent germicides, it was from 
this agent that aniline was first 
derived, from which such a host of 
invaluable antipyretics have been 
prepared. 

The wild indigo, or its gluco- 
side baptisin, is of great efficacy 
in the destruction of microscopic 
life; one ounce of the crude plant 
(root) to a pint of boiling water, 
infuse over night, and drink freely 
the following day, will kill the 
germs of typhoid fever, epidemic 
dysentery, chronic diarrhea, sore 
throat. The glucoside baptisin 
has been effectually used in epileptic and nervous cases. 

It is also a valuable remedy in chronic irritation of the liver^ 
with albuminuria. 




Indigo Plant (Indigo Tinrtoria) 
b, block of indigo. 



pod; 



The bark of the root of this plant yields an active 

Ipecac, principle of great value called emetine. This vege- 
table alkaloid in very small doses is an active stimu-^ 
lant to the mucous membrance of 
the bronchi. 

All preparations of this bark are 
of great value. In large doses it 
is a mild and efficient emetic ; 
whereas in small doses it allays ir- 
ritation of the gastric nerves. 

In medium doses it does good 
work either alone or combined 
with muriate of ammonia in bron- 
chitis. 

Also a good remedy in the treat- 
ment of infantile pneumonia. It is 
an excellent remedy in small doses 
for nausea and vomiting, and exer- 
cises a sedative action on the 
mucous membrane, whether diar- 
rhea or dysentery be present. 




Ip«cac. 



. BACTERICIDES. I 33^ 

All preparations of iodine are highly germicidal. 

Iodine. Its use is indicated wherever there are disease germs 
in the human blood. 

Dose, ten to fifteen drops of the officinal tincture, five to seven 
drops of Lugal's solution. lodol in pills, one to two grains. 
Dose of iodide of soda, five to six grains. 

Uses. — Iodine is a remedy for croup, of the membranous 
variety, or spasm of the glottis. It is a good remedy for cancer. 
It is a good injection in a corrosive leucorrhoea, diluted to pre- 
vent irritation. One part to ten or fifteen of water at first. 

Lugal's solution in doses of six to eight drops, three times a 
day, is a good remedy for chronic malarial poisoning, where 
there is induration of the liver and spleen or other glands. It is 
a good inhalation in the early stage of pneumonia. It prevents 
suppuration, if used in time, especially if iodoform is used on 
the ulcer. For tubercular and skin affections, iodine, in doses 
of one to six drops three times a day, 
is almost a specific, and it is valuable in 
syphilis. It is a positive remedy for 
leucorrhoea. Alternated with diluted 
bromine, the inhalation of iodine is a 
remedy in hay asthma and hay fever, 
bronchitis and catarrh. Iodine is a good 
mouth wash, as it removes tartar from 
the teeth, and cures diseased gums, and 
heals ulcers of the mouth and gums. 
Iodine (tincture) kept applied, cures 
orchitis. Iodoform lotion, one part to 
fifteen of water, constantly applied, re- 
moves abnormal growths of the mam- »;?,f?jH?m:L"lngorgrd" u^,h°/ 
mary glands. It also cures house-maid's pneumococcus; an lodoi jacket 

-' o 1 1 1 • *vas applied for 24 hours, every 

knee, and also purulent ophthalmia. microbe disappeared, leaving ihe 

An ointment of iodoform, applied fre- 'ung dear on percussion. 
quently, cures enlargement of the prostate. In powder it is the 
best antiseptic dressing for ulcerations of the external surface. 

lodol, containing as it does nearly eighty nine per cent, of iodine^ 
is next to iodoform, the strongest iodine preparation extant ; and 
is much superior to iodoform in germicidal power, and its ab- 
sence of odor and of toxic properties makes it preferable to 
iodoform. An iodol jacket in consolidated lung either with the 
bacilli of tubercle, or the pneumococcus of pneumonia, is most 
effective in the annihilation of the germs, thus clearing up lungs 
partially dead. 

Iodol sprinkled on chancres, specific. Iodol as a snuff in 
nasal catarrh and ozaena, destroys the amoeba in the former, and 
the oidium albicans in the latter. 




I340 



DISEASE GERMS, 



It destroys the tubercle in the thyroid, and thus cures goitre ; 
annihilates the bacteria of erysipelas and boils ; kills all fungi, as 
the different forms of tijiea. It is destructive to all microscopic 
life, vitalizing to the higher grades of animated existence. 

Iodized oil for external application has numerous advantages, 
it is readily absorbed ; does not stain ; may be applied to the 
most delicate skin without irritation; it is of immense value in 
pulmonary consumption and in tubercular disease of joints. 

Dr. W, H. Flesher, Green Ridge, Mo., a physician of great 
culture and experience, says : 

" lodol, or tetraiodopyrol, has a light-brown color, and is 
almost odorless, in which respect it offers a decided advantage 
over iodoform. Unfortunately, it is not very soluble in water, 
only in a proportion of i to 5000. In alcohol it dissolves in 
three times its weight The drug is employed in the following 
manner: i. As a powder, in the same manner as iodoform. 
Being a finer powder, it enters and covers the part more com- 
pletely than the former. It forms no scurf (in opposition with 
iodoform) on the wound, renders the secretion odorless, favors 
the formation of healthy granulation, and has^a general salutary 
influence on the nutrition of the affected parts. 2. As solution, 
in sixteen parts of alcohol and thirty-four parts of glycerine, for 
the saturation of uterine or rectal tampons. It is also injected in 
this form into empty or scraped-out abscesses. 3. As gauze. 
4. In combination with vaseline and collodium. In no instance, 
in spite of its extensive use, were any symptoms of intoxication 
observed, nor was ever any iodine after its use discoverable in 
the urine. It is probable that its action depends on the genera- 
tion of free iodine, though we have no definite data yet regarding 
this point. At all events, its action is prompt and harmless, and 
offers no small advantage over the iodoform in the absence of 
any odor, though its poor solubility and its (at present) high 
price are equally great objections.'^ 

Its special advantages are : when applied, the iodine which it 
contains is set free by lung bioplasm, kills microbes ; when 
sprinkled on a wound, movements of leucocytes, renders the sur- 
face dry, prevents suppuration, and encourages granulation, 
while at the same time its local anesthetic action lessens pain. 
It seems to have a special destructive action on the tubercle 
bacillus, and is therefore employed with advantage as a local 
application for tubercular disease of the larynx and tubercular 
abscesses. One great convenience of iodoform consists in the 
fact that it can be applied as a powder over any surface, and will 
there exercise its antiseptic action for a long time without the 
necessity of any dressing being applied over it, but as I have 



BACTERICIDES. 



said, it is not without its dangers, and, although sparingly -oiu 
ble, it may yet be absorbed from wounds or cavities to such an 
extent as to produce poisoning. The symptoms of poisoning 
are particularly interesting, as they consist of a peculiar combi- 
nation of the action of iodine 









itself with that of an alkyl. 
Like an iodide, it may pro- 
duce unpleasant taste and 
smell, running at the nose, 
and gastric disturbance, but 
it behaves also like a mem- 
ber of the alcoholic series in 
causing special symptoms of 
poisoning which are connect- 
ed with the nervous system, 
and consisting of loss of 
memory, variable temper, 
headache, sleeplessness, and 
especially mental distur- 
bances, sometimes amount- 
ing to furious mania, alter- 
nating with coma. Fatty de- 
generation of the heart and other organs is usually found after 
death. 

Ozonized iodine is a remarkable active form, and has 
acquired a big reputation, which it justly deserves in sterilizing 
the blood. 

During a recent epidemic of influenza, it was administered 
with remarkable success in getting rid of the microbe, and re- 
lieving the intense pain in the muscles and bones. 




The microbe of epidemic influenza, which appeared 
in ihe U. S, I'go; which was completely ster- 
ilized by the administration of ozonized iodine in 
altei nation with the sulphate of quinine. Erery 
Case yields to these remedies. 



Sozoiodol is a compound of such well-known 
Sozoiodol. antiseptics as iodine, carbolic acid, and sulphur, 
and is chemically described under the name Di- 
iodoparaphenolsulphonic acid. It is destined to act as an odor- 
less substitute for iodoform. 

Sodium-sozoiodol occurs in colorless tubular crystals, which 
dissolve easily in water or glycerine at an ordinary temperature, 
to the extent of about one in twelve. The glycerine solution 
remains quite unchanged when exposed to sunlight, but the 
aqueous solution slowly alters its color on exposure. 

Potassium-sozoiodol dissolves only to a slight extent in water 
and glycerine, these fluids dissolving only about a fiftieth part 
of their weight of the salt. This property makes the potassium 



1342 DISEASE GERMS. 

salt preferable to the sodium salt in the treatment of cases which 
require the application of dusting powders, etc., because of the 
greater duration of their efficacy ; the effects of both salts are, 
however, the same. Sozoiodol has been applied not only in the 
solution, but in combination with talc, lanolin, sugar of milk, 
and with much success, in the pure state. It is perfectly odor- 
less, and experience has shown that it is without any injurious 
after-effects whatever, so that it seems to be entitled to promi- 
nent rank among antiseptics. 

Its chemical nature permits of combinations with almost 
every metal, opening thus a vast field for therapeutic treatment, 
and enabling the physician to combine the action of certain me- 
tallic bodies with that of the antiseptic substance proper, such as 
aluminum, magnesium, lead and zinc, which compounds are 
easily soluble. Also the ammonium, barium, mercury, and sil- 
ver salts, which are difficultly soluble. 

The sozoiodol salts have been used in skin diseases of a para- 
sitic character : eczema, even of long standing. Dry eczema 
may be treated with sodium-sozoiodol ; damp eczema with zinc, 
either as a powder or with talc ( i to lo), and in very obstinate 
cases of syphilitic eruption, mercury-sozoiodol has been used 
with great success. In diseases of the ear, nose, larynx, and 
pharynx, potassium- and sodium-sozoiodol, either pure or mixed 
with an equal weight of powdered talc, yield good results. For 
conjunctivitis, five to ten per cent, solution of sodium-sozoiodol 
forms an excellent lotion, and for gonorrhea, zinc-sozoiodol in 
one to three per cent, solution, and it can be applied to ulcera- 
tive cancer surfaces with advantage. Their application is indi- 
cated everywhere in the place of iodoform, and the fact that here 
the long-looked- for desideratum, an odorless substitute for iodo- 
form, has been found, should induce all medical men to give 
them a fair trial. 



a remedy of decided value in the treatment of a 
Jaborandi, large number of febrile and inflammatory dis- 
eases, is not a germicide, but possesses the 
most extraordinary faculty, when the blood is germ-laden, of 
driving the entire brood of bacilli and micrococci to the cutan- 
eous surface and salivary glands of the mouth, where they can 
be readily annihilated with bactericides. It does this by its 
potent diaphoretic and sialagogue action, consequently in a large 
percentage of fevers, and inflammations, as in oedema of the 
glottis, laryngitis, bronchitis, pleurisy, pneumonia, rheumatism, 
erysipelas, diabetes, malarial fever, etc., it is of signal efficacy in 
the management of the cases. 



HACrERLClDES. 



1543 



A good form to administer is to take of the fluid extract one 
■drachm, and add to it a cup of hot water, and if free salivation 
and diaphoresis does not occur 
in half an hour, give a second 
dose; it is rarely necessary to 
repeat. The saliva in all cases 
must be spit out as fast as it 
accumulates in the mouth, as 
it is invariably loaded with the 
micro-organisms of disease. 

Another formula is the fol- 
lowing : 

Fluid extract of jaborandi, 
four drachms ; aromatic spirits 
of ammonia, one drachm ; sim- 
ple syrup, one ounce. Mix. 
One teaspoonful to be given 
every ten minutes till free per- 
spiration is induced. 

The alkaloid pilocarpin hy- 
drochlorate, one-fourth grain 
in solution, injected hypoder- 
mically, has been extremely 
efficacious in dropsical effu- jaboraudi. 

sions, as the result of interstitial obstruction of the kidneys. 

Tetanus has been successfully treated 
by subcutaneous injection of the same 
alkaloid, but the dose used has been 
very large. The purport of treatment 
is to drive the microbe from the cerebro- 
spinal centres to the skin. 

The hypodermic use of the same 
alkaloid has been well spoken of in 
alopecia. 

Pilocarpin removes the urgent symp- 
toms of asthma. 





Jalap. 



Jalap. 



The therapeutic action of 
this remedy is so well known 
that it seems superfluous to 
enumerate it ; but as it has such a de- 
cided action in relieving modern cere- 
bral congestion, it is worthy of notice. 
It is of unquestionable utility, a most 
valuable cathartic in disease of the 



1344 



DISEASE GERMS. 



brain ; its derivative action is unexcelled. The best combination 
ifor use is one part of powdered jalap, two paits bitartrate 
potassa, and sufficient pulverized ginger to keep it from griping. 
It is also of value in dropsical effusions. 

With all our new remedies, this very frequently comes into 
excellent service. 

In small doses, combined with leptandra, it does excellent 
work in torpid states of the liver. 



Jamaica Dogwood. 



A fluid extract prepared from the 

bark of the root is a powerful narcotic, 

germicide and parasiticide — annihilates 

many species of germs when brought in contact with them — the 

root thrown into water will stupely fij^h. In five to ei^ht-drop 

doses, it will sterilize and destroy the 
mycelia of hooping-cough, the germs 
of toothache, erysipelas, and of bron- 
chial catarrh. 

Extremely valuable in insomnia, 
affords in all cases most refreshing 
sleep. It possesses all the desirable 
effects of chloral, bromide of potass, 
opium, urethan. If administered dur- 
ing parturition, it will lessen the pains 
of labor without interfering with uter- 
ine contractions. 

It is of great utility in all forms of 
neuralgia. 

The following is an excellent for- 
mula in gastralgia: Fluid extract of 
Jamaica dogwood, fluid extract 
American columbae, comp. tincture 
matricaria — of each one ounce. Mix. Dose: from fifteen 
thirty drops, added to a little water, as indicated. 




Jamaica Dogwood. 



of 
of 
to 



Jambul. 

{Syzygium Jambulanmn) 



The seeds and bark are power- 
fully germicidal, stomachic, carmi- 
native, diuretic, astringent. When 
introduced into the human stomach, 
and passed into the process of secondary digestion, thence into 
the blood, they have a specially destructive action upon the 
glucose or sugar fungus, not only annihilating it, but preventing 
its formation by some peculiar action upon the starch formed in 



BACTERICIDES. 



1345 



the liver. In this way it controls the disease, and all its promi- 
nent symptoms disappear under its use, such as prostration, 
debility, emaciation, thirst, ravenous appetite, extreme restless- 
ness, excessive secretion of urine of high specific gravity. 

• While taking iambul, there need be no restriction of diet, the 
urine becomes normal. 

For easy adminibtration, and better to preserve the properties 
of the drug, two and one-half grains are encased in a capsule; 
two of these should be taken three or even six times a day, 
according to the indications of each particular case. 

By taking these pearls in diabetes thrice daily, the specific 
gravity, the percentage of sugar and the quantity of water passed 
are astonishingly reduced. 



The berries are stimu- 

Juniper. lant, antiseptic, diuretic ; 
chiefly used in dropsical 
affections. Its antiseptic properties 
causes it to be a drug of great value. 
Whenever we desire to impregnate the 
body with a natural ozone scavenger, 
juniperus is indicated ; valuable in 
dropsy, in blood and cutaneous affec- 
tions, and in those states where there 
is a bleeding fungus in the bladder 
associated with retention of urine and 
catarrh of that organ. The compound 
spirits of juniper is thus prepared : take 
of juniper berries, well bruised, one 
pound; caraway and fennel seeds, pul- 
verized, one ounce and a half of each ; 
dilute alcohol, one gallon ; macerate 
two weeks, then add half a gallon of 
water and distill off one gallon. 

The infusion is an excellent one for 
administration, prepared by adding one 
ounce of crushed berries to one pint of boiling water, 
whole of this is to be taken in the twenty-four hours, 
extracts are worthless. 




Common Juniper. {J cn7!i7itiin{s) ^ 

a, branchlei with male flowers; 

b. part of branchlet with Icmale 
flowers; c, unripe fruit. 



The 
Alt 



Kaki, 

{^Pulverized Root Japanese 
Persimmott) 



8 



It is indicated in gastric catarrh, 
chronic diarrhea, typhoid fever, 
dysentery, ulceration of the bowels, 
catarrh of the colon and rectum. 
Decidedly one of the best reme- 



«346 



DISEASE GERMS. 



dies ever introduced, as it excites a renewal of life in the various 
coats of the entire intestinal tract; a sovereign remedy in the 
diseases enumerated. 

Dose : One to two teaspoonfuls to a half pint of boiling water ; 
when cool, permit patient to drink freely. 



Fluid extract; a bactericide of great efificacy in 
Kalmia, sterilizing the syphilitic bacillus. Dose for that 
(Laurel.) purpose, twenty to thirty drops thrice daily. 

Kalmia, in one-drop doses, has proved valuable in 
albuminuria, curing twenty-five per cent. It mitigates the pain 
of rheumatism very quickly, and acts positively in neuralgia. It 
wards off rheumatism of the heart. In headache, coming on in 
the morning and going off at night, this remedy acts like a charm. 
In influenza, with watery eyes, sore throat and much aching in 
the bones, the kalmia gives quick relief In all aches and pains, 
think of the kalmia. It may be given in drop doses, with two to 
five drops of gelsemium, every hour or for five or six hours, then 
lessen. 



Dose : fluid extract, twenty to thirty 
Kava-Kava, drops; tincture, thirty to sixty drops 

(Piper Methysticum,) three times a day. A remedy for tooth- 
ache, neuralgia, small doses of this drug 
will give relief quickly. 
in painful urination, this is a remedy, in doses of eight to ten 
drops every three hours, or in extreme cases give twenty-five 
drops. It may be combined with pareira brava, one drop 
at a dose. These remedies may also alternate benzoate of 
lithia in gravel, cystitis and catarrh of the bladder. It may be 
combined with hydrangea in gravel, or with liatris spicata in 
cystitis. These remedies often give relief, where there is excess 
of acid in the urine, then it will require lithia in addition. 

In gonorrhea, kava-kava paste entirely replaces the old reme- 
dies. It does not cause gastro-intestinal irritation ; neither does 
it impart any odor to the breath, but it kills the gonococcus, the 
discharge is very speedily reduced to a slight oozing. In chronic 
catarrh and suppurating nephritis, it very soon diminishes the 
amount of muco-purulent matter. Cures very obstinate cases of 
cystitis. The tincture and fluid extract are worthless, have no 
germicidal action. The paste invariably does its work well. Dose : 
A piece the size of a bean every three hours. 



BACTERICIDES. 



1347' 



The nut of cola acuminata, or stercidia, a native 

Kola Nut. of the tropical parts of the western coast of 
Africa, and cultivated in other tropical countries. 
The natives value the nuts very highly, and often take a portion 
of them before meals, believing that they improve the appetite 
and destroy all microbes in what they eat and drink, even render- 
ing putrid meat and stagnant water fresh. The nuts are the size 
of eggs and possess identical properties with the coca erythroxy- 
lon and caffeine. In all its forms it is a germicide ; it has marked 
aphrodisiac properties and retards tissue waste. It has a most 
decided action in heart disease with renal obstruction, promotes 
diuresis by increasing the general vascular tension. It acts as a 
nutrient and tonic, an aperient and gastric stimulant. It cannot 
be too highly extolled in chronic 
alcoholism, appeases the appetite, 
removes stupefaction, prevents dis- 
agreeable after-effects. It has a 
remarkable prophylactic action — 
■or rather guarding effect to the 
liberation of large doses of iodide 
of potassium in the blood in cases 
where the blood is germ-laden 
with the syphilitic microbe. 

The Liberia kola nut is the best, 
and it is from this that a laxative 
and refreshing fruit lozenge has 
been prepared for the relief and 
cure of constipation and its attend- 
ant maladies, as headache conges- 
tion of the liver and spleen, piles, 
dyspepsia, and all disorders of the 
alimentary canal. 

With Americans, who consume 
a highly concentrated diet, and 
possess a normal condition of the brain, liver and digestive 
organs, one evacuation of the bowels in the twenty-four hours, 
following the morning meal, is to be regarded as a healthy 
standard. When defecation is less frequent, slow, prolonged or 
retarded, it constitutes constipation. 

Habitual constipation is one of the most common affections 
incidental to young or old, in all sections ot our country, due to 
neurasthenia in nearly all cases, and this poverty of nerve force is 
aggravated by our highly ozonized atmosphere, by malaria, by 
the use of stimulants ; erroneous drug treatments, adulterated 
food, hasty mastication, nerve strain, worry, struggle for existence, 




Branch and nut of the Kola Sterculia. 



1348 



DISEASE GERMS. 



brain exhaustion ; chronic disease, sedentary habits, etc., give 
rise to ineitia or sluggi.-hness, deficiency of bile, which give rise 
to arrested perisaltic action, a faulty condition of the intestinal 
secretions and constipation. 

Assuming, then, that a lack of nerve force is the source of this 
vi'ide.^pread affection, it would seem to be most erroneous and 
pernicious to treat this affection with purgatives, and still further 
increa>e the debility. 

Constipation, or faecal accumulation, is a fearful source of 
headache, fetid breath, dyspepsia, torpidity of the liver and 
spleen ; piles, insomnia, mental depression, apoplexy, neivous 
disorders of all kinds — the brain and rectum suffer most in all 
cases. 

The poisonous activity of human faeces even in a healthy indi- 
vidual is very gieat. There are formed in the intestines of an 
adult in twenty-four hours a quantity of cadaveric alkaloids, 
which, if excretion were stopped and all were absorbed, would be 
sufficient to destroy life. No one can doubt the .seriousness of 
retained faeces and the injurious effects of constipation, for when 
it exists those poisons are absorbed at the rate of dimini^shed 
perisaltic action. 

The only true method of curing constipation is by increasing 
the vital jorce of the affected individual, and the removal of 
all apparent causes. The remedy must not be either a pur- 
gative or laxative ; it must increase the vital stamina; by this 
means procure a free flow of bile, remove congestion and unload 
the bowels. 

For this purpose the active nerve-stimulating principle of the 
kola nut has been isolated and made into a pleasing, palatable 
form which, when taken, relieves this difficulty. This active, 
isolated principle is free from all bitter and astringent prope'ties, 
incidental to the drug, while the nerve-cell elaborating principle 
is even more energetic by this elimination. 

This principle is one of immense power ; it not only stimulates 
the brain by its action in generating more gray matter, but in 
some mysterious manner vivifies the great sympathetic which 
covers the bowels and energies the eighth pair that supply the 
liver. Such a remedy speedily affects the liver, restores that 
gland to its pristine activity, the bowels become regular, the 
complexion clear, the breath sweet, and the whole body seems 
rejuvenated and pervaded by a feeling of buoyancy, which shows 
that the liver has resumed its normal function. 

The remedy is indispensable, not only in constipation, but in 
all diseases of the liver and bowels, as it increases cerebral force, 
acts upon the sympathetic which supplies the intestines and pro- 



BACTERICIDES. 



1349 



motes the nutritive assimilative forces, rouses up the secretion of 
the liver. It riQVQr causes any pain or f^ripin^r, or nausea, no de- 
ran ^ement or inconvenience, but in all cases constipation dis- 
appears. 

The individual taking the remedy must be the judge of the 
dose. EioucTh should be taken before retirin ^ to cause only one 
comfortable, ifree, copious evacuation after the m.ornin^ meal. 

It is a gentle and effective aperient for the mist debilitated as 
well as the strong, affording agreeable and effective relief from 
constipation. Its use, unlike other medicines, does not necessi- 
tate continuous repetition, and. however frequently taken, its 
action being so gentle, no evil effects can arise therefrom. 



A native of Abyssinia. The panicles are uni- 
Kousso. sexual. Both the male and the female flowers, but 
chiefly the latter, are collected and exposed to the 
sun to dry. As they reach 
this country, they are in com- 
pressed clusters, entire or 
more or less broken, or in 
subcylindrical rolls, bound to- 
gether with transverse bands, 
or in small fragments. The 
clusters or rolls vary from ten 
to twelve inches, of a green- 
ish-brown color, and have a 
pleasant, herby, tea-like odor, 
but very acrid and disagree- 
able. There is found in the 
entire plant a volatile oil, a 
bitter acrid resin, and the 
alkaloid koussin, which is inert. 

An infusion is the only form which is eligible for use. Two 
ounces to a pint of water, simmered down to half a pint. The 
usual precautions being observed, as to diet, it should be drank 
freely and is most effectual in destroying all forms of tape-worm. 




Kousso. 



prepared from the kurchicine, are most 
Hindoo Bitters, efficacious. 

These bitters excel all others in point of 
real merit, and their fine bitter orange flavor makes them as 
pleasant as they are useful. They are a reliable remedy for dys- 
pepsia, indigestion, constipation, ague, and diseases of the stom- 



I350 



DISEASE GERMS. 



ach, bowels, liver, and kidneys. They purify and enrich the 
blood, tone and impart strength to the system, stimulate the di- 
gestion, regulate the bowels, promote a healthy appetite, dispel 
nervous exhaustion, cure general debility, give buoyancy to the 
spirits, and are especially recommended as a true tonic and 
restorer for invalids, females and delicate persons. They will be 
found extremely beneficial in regulating the various functions of 
the body, and a reliable antidote and preventive for chills and 
fever and all malarial diseases. 

The Hindoo Bitters are not an intoxicating beverage, nor can 
they be used as such by reason of their cathartic properties, and 
being purely vegetable, they are classed strictly as a medical 
agent, and can be given at all times with beneficial results. 
When taken after meals they aid digestion ; when taken before 
meals, they produce a healthy appetite, and as a morning tonic 
they have a charming effect. In cases of dipsomania, or for 
persons having an unnatural desire for liquor, they will be found 
peculiarly suitable, as the use of these bitters will enable them 
to free therfiselves of the pernicious habit, by acquiring a strong 
and healthy appetite for solid food. 

The same remedy is put up in pill form, and there is also an 
alkaloid extracted from the same — sulphate of kurchicine. 

Concentrated tincture of kurchicine highly ozonized is of im- 
mense utility in the quotidian, tertian and quartan types of mala- 
rial fever, as it destroys the micro-organisms which give rise to 
that class of pernicious fevers. So definite and potent is its ac- 
tion that after the first dose the odoriferous character of the dead 
germs can be detected in the sweat, saliva, urine. The bowels 
must be opened ; all fluids strictly forbidden, either with the 
remedy or for several hours subsequently, or between doses, as 
watery fluids supply a pabulum to germ evolution in the blood. 
The remedy causes the malarial "germ to speedily disappear 
from the blood and tissues. It is valuable in small doses in all 
fevers or states of debility. It changes the electrical forces of 
the body from a negative to a positive state. 



This is a most eflficient germicide in certain 
Lactic Acid, forms of dyspepsia, and for the removal of 
phosphatic deposits in the urine. From one to 
two drachms is added to a half or a pint of sweetened water and 
drank like lemonade, this being the dose for twenty-four hours ; 
in one-half drachm to the pint of water, taken daily, of utility in 
diabetes. 

A solution of one part of the acid to five of water has been 



BACTERICIDES. 135, 

efficacious in dissolving the false membrane of croup and 
diphtheria. 

A small amount of the acid added to pepsin increases its sol- 
vent powers in a most remarkable degree. 

An eighty-per-cent. solution painted over ulcerating lupus is 
most effectual in the destruction of the tubercular bacilli. Obsti- 
nate cases of ulceration of a phagedenic or cancerous type are 
successfully treated with this acid. More recently it has done 
good work in the removal of large patches of epithelioma in, 
around and on the os uteri. The acid locally, and Chian turpen- 
tine internally in cancer of the uterus often effect radical cure. 
The application of the acid in all cases should be limited to the 
diseased parts. 

The great value of lactic acid in the diarrhea of infants is well 
established, especially in cholera infantum. The best result is 
obtained from small doses, frequently repeated. The following 
formula operates well : Lactic acid C. P., half a drachm; simple 
syrup, one ounce ; water, three ounces. Mix. In teaspoonful 
doses, repeated as occasion requires. 

For corns, acid salicylic, ten parts ; acid lactic, ten parts; col- 
lodion, eight parts ; carbolic acid, two parts ; apply to the corn 
several coats, allowing each previous one to dry. 

E. D. Reed, M. D., Frederick, Md., in a recent essay read 
before the Society in that State, says : 

" Lactic acid has been found to possess some very remarkable 
properties. It has no corrosive action upon healthy mucous 
membrane, but attacks and destroys unhealthy and sloughing 
tissues. The diseased tissues turn a dark, dirty brown under its 
application, and quickly slough off, leaving a healthy appearing 
surface which tends to granulate and heal. It is a valuable 
remedy when the pain is severe and the discharge very offensive 
and flooding frequent. These symptoms are greatly relieved by 
the application of the acid twice a week. 

It does not produce pain when applied, and when used freely 
twice a week relief is almost immediately experienced. The 
manner of application is as follows : An ordinary Furgeson 
speculum is introduced, the cervix cleansed; then a mop made 
of absorbent cotton and saturated with the acid is freely applied 
to the sloughing mass ; v/ater is then thrown in, and the acid 
again applied, after which a tampon of cotton is placed, and the 
patient allowed to go. The treatment should be practiced once 
or twice a week, according to the gravity of the case." . 

Disappointment in the use of lactic acid is frequently experi- 
enced on account of the poor quality of the drug. Hence the 
necessity of procuring the article of a reliable chemist. 



1352 



DISEASE GERMS. 



E. S. Pixley, M. D., Pittsfield, Mass., has had most extensive 
experience with dilute lactic acid in the treatment of summer 
diarrhea and cholera infantum ; he has also found it useful in 
headache and rheumatism, having the effect of clearing the in- 
testinal tract of all microbes. 

Children take the remedy easily; as it forms an agreeable 
beverac^e, and its continuous use does not in any way interfere 
with digestion. 



The whole herb in the form of a saturated 
Lachnanthes tincture, is a bactericide of considerable power ; 
Tinctoria. administered in pneumonia, typhoid, and other 
{Red Root) fevers, it kills the spores, and the full fledged 
microbes. It also has a most remarkable 
action in sterilizing the tuber- 
cle bacillus, hence it is of great 
utility in the cough of bron- 
chitis and phthisis. The tinc- 
ture is prepared as follows : 
Coarsely ground herb, one 
pound, cover with alcohol of 
a seventy-five per cent, 
strength. Let it macerate one 
month. Then percolate. A 
few drops of this tincture is 
excellent in hoarseness, laryn- 
geal cough, and for our hay- 
fever cough of spring and 
fall. 

In the recent epidemic, influenza, the physicians of New 
Jersey have been using the tincture of the red root with salicy- 
late soda with wonderful success. It certainly is a valuable addi- 
tion to our respiratory antiseptics. 




Red Root. 



There seems to be a considerable future before 
Lactose, lactose as a diuretic. Milk itself can be used as a 
diuretic, but it tends to produce a temporary gly- 
cosuria. Lactose has none of these disadvantages. Very con- 
siderable diuresis is produced by the administration of one hun- 
dred grammes of lactose, that is to sav. the amount contained in 
two litres of milk. The diuretic effect produced by a potion 
containing that amount of lacto.se is greater than any produced 
by drugs ; it quickly re iches two and a half litres of urine a day, 



BACTERICIDES. 



1353 



almost always risin^ to three arid a half and even four and a' 
half litres on the third day. During- this period dropsical effu- 
sions disappear, and the blood is dehydrated Its effect is cer- 
tain in cardiac dropsy; in renal dropsy, on the other hand, its 
action is much more doubtful. In cardiac cases it fails only when 
the complication of Bright's disease exists, and when the albumi- 
nuria amounts to from sixty to ninety centigrammes per litre of 
urine. Diarrhea or copious perspiration may also lessen the 
diuretic effect of lactose by dehydrating the blood. The remedy 
is, as a rule, well borne. It should be continued for eight or ten 
•days, when the administration should be interrupted for a few 
days, and afterwards resumed. The blood pressure is not raised 
hy lactose. It is far superior in this respect to strophanthus and 
digitaline. 



The milky juice of the lettuce, added to 
Lactucarium. the ozonized syrup of tolu, is a most valuable 

preparation. 
Possesses the hypnotic, sedative, and calming properties of the 

opiate preparations, without provoking constipation, cerebral 

congestion, want of appetite, etc. It is ^ 

one of the very few preparations that can 

be efficaciously employed for children 

without any inconvenience. In co4i- 

sumption it moderates the cough and 

expectoration, destroys the bacillus. 



A shrub of the ujint 

Lavender, family, possessing all the 
germicidal properties of 
its class; besides being an aromatic 
stimulant and tonic, it is much esteemed 
in the form of a decoction in nervous 
debility ; as a tonic to the stomach ; a 
gargle to the mouth and throat ; in cases 
of aphonia. Vinous tincture of the 
flowers make an excellent aromatic wine 
for colic, and where ptomaines are irri- 
tating the bowels. 

Its oil is obtained by distillation, 
forms a pleasant and invigorating per- 
fume, and the amount of ozone devel- 
oped in the atmosphere by this volatile 
antiseptic is immense. Thus it may be used in an atomizer for 
laryngeal irritation, or in the form of a cerate. 




Laveuuc 



354 



DISEASE GERMS. 



Oil of lavender, two ounces ; vaseline, two ounces ; oil of sweet: 
almonds, one ounce; oxide of zinc, two ounces; carbolic acid., 
thirty grains. Mix. Apply to the nostrils in catarrh. 



Lemon. 



AH the fruit germicidal, the rind stomachic. 
Lemon juice specific for the cure and prevention- 
of scurvy. 
Administered in large doses in rheumatism it annihilates the 
lactic ferment, but not essentially curative. 

It greatly intensifies the 
action of some alkaloids ; 
lemon juice and quinine 
added to strong mocha 
coffee is pre-eminently de- 
structive to the malarial 
germ. Citric acid or lemon 
juice added to caffeine affords 
us a reliable remedy for the 
headaches incidental to 
breathing sewer gas. As a 
local application, with a 
sriiall amount of cocaine 
added, never-failing in pru- ' 
ritis of the scrotum ; for 
freckles equal parts of lemon 
juice and glycerine, say two 
ounces of each, and one 
grain of bichloride of hydrargyrum added; for painting over the 
diphtheritic patch. Take it all in all; it is a remedial agent of 
much potency. ' ' 

Citric acid has powerful germicidal action. 
It is cooling and refreshing to the taste, and is decomposed in 
the system, acting, probably, in the same manner as sugar. 
When taken in the form of lemon juice, or in the fruits of the 
orange family of plants, it is eminently antiscorbutic. On this 
account ships going a voyage of more than six weeks are com- 
pelled to take a supply of lemon or lime juice, and sailors should 
take at least half-an-ounce a day. The crystallized citric acid 
does not appear to act as an antiscorbutic. Citric acid and the 
juices which contain it are employed for making effervescing 
d'-aughts, when mixed with alkalies. Fourteen grains of citric 
acid, or ha f-an-ounce of lemon juice, mixed with twenty grains 
of bicarbonate of potash, makes, with one ounce of water, an ex- 
cellent effervescing draught. 




Lemon {Citrus Lemonum). 



BACTERICIDES. 



355 



Black root or Culver's Physic, the root of 

Leptandra. leptandra virg., is a mild alterative, cholagogue 
and tonic. It is a slow acting remedy, but effi- 
cient, reliable and powerful in stimulating 
the granular structure of the liver, cor- 
recting the hepatic secretions and pro- 
moting a free flow of bile. It is an effi- 
cacious remedy in all diseases of the 
liver : if combined with phosphate of 
soda, it operates efficiently in jaundice 
or whenever the liver needs the aid of a 
remedy to promote biliary secretion. 

The fluid extract from the fresh root 
is the most reliable and best for ordi- 
nary use. 

The so-called leptandrin is simply a 
solid extract in a state of trituration, not 
entirely useless but nearly so. 

The glucoside leptandra (American 
preparation) is reliable, as it is prepared 
from the fresh root. It forms some 
splendid compounds. Glucoside leptan- 
dra, two drachms ; citrate of caffeine, one 
drachm ; strychnine, half a grain. Mix. 
Make sixty pills, one thrice daily of 
great efficiency in constipation of Bright's 
disease. 

Leptandra, hydrastin, quinine, of each 
thirty grains ; solid extract of nux- 
vomica, grains seven. Mix. Make thirty 
pills. One thrice daily, good tonic. 



Licorice root contains a 

Lficorice. valuable substance called 
glycyrrhizine, closely allied 
to sugar; yellow, transparent, uncrys- ^ ,. ,^^, 

tallizable ; soluble in both water and C^^Ji^SI^^^Vx^' 
alcohol, forming compounds with acids 
and their bases. Leptandra. 

It is much used, not only for its antiseptic properties, but for 
a vehicle to disguise the taste of bitter drugs. 

Fluid extract of licorice, for quinine mixtures, is very generally 
used by physicians, but all may not be aware how eifectually it 
disguises the bitterness of quinine. The desired dose of the 



1356 



DISEASE GERMS. 



quinine ia powder should be added to a teaspoonful of the licor- 
ice and thorouf^hly mixed before being swallowed. An aromatic 
elixir of licorice should be used like the fluid extract. 





Common Licot ice C Glycyrrhiza 
• glabra). 



Cocardu';. (Magn'fietl 225 diam.) 
A highly noiymorphic species 
of mould which is very prone 
to appear upon aqu ous ex- 
tracts of Glxcyrrhiza, and 
renders ihem worthless. 



Ammoniated Glycyrrhiza. — The sweet principle of licorice, 
glycyrrhiza, in combination with ammonia. Used to blunt the 
gustatory nerve and to mask the bitterness of quinine. Dose ; 
One grain every three hours. 



Instead of obtaining this by decomposing 
Liquid Ozone, the atmosphere, we can now more effectually 
obtain it in greater abundance and purity by 
compressing strongly ozonized oxygen to the extent of 125 at- 
mospheres at a temperature of — I02.5°C. ( — 153.5° f^ )• We have 
practically dispensed with pressure and employed cold alone. 
At a degree of heat — or shall we 'sdiy cold? — represented b)' — 
181.4° C.( — 194.5° F.), the temperature now known as that of 
the boiling-point of fluid oxygen, ozone condensed to a deep, 
purple-blue liquid, the color of which is so intense that a layer 
of it about two and a half mm. is to all intents and purposes 
opaque. The ozone remained liquid as the temperature was al- 
lowed to rise gradually (controlled by fluid ethylene), until at 
about — 106° C. ( — 168.8° F.), as indicated by a " hydrogen ther- 
mometer," the ozone begins to boil. The boiling-point of ethy- 
lene itself is not very different, being — 102.5° C. ( — [52.5° F.). 
Very great care must be taken in order that the ethylene and the 
ozone do not come into actual contact with each other, as if they 
do so. an explosion of terrific violence immediately occurs. Re- 
cent chemical manipulations have led to the discovery and intro- 



BACTERICIDES. 



1357 



duction of apparatus by the aid of which those wonderful 
products of modern science — liquid oxygen, hydros^en, nitrogen, 
et::., and even the solid form of these so-called " permanent " 
gases — were made. ■ 

Carbonate of lithia, valuable in relieving, cystis ; 

Lithia. affords relief in irritable states of the prostate. The 
bromide of lithia acts efficiently in all cases of gout 
or rheumatism. Benzoate of litiiia neutralizes uric acid in the 
blood and overcomes the uric acid diathesis ; it is also a remarka- 
ble solvent to calculi in the bladder. The benzoate of lithia in 
five-grain doses alternated with salicylate soda in the acetate of 
ammonia does g^ood work in chronic rheumatism. 

The carbonate of lithia rendered soluble by the peroxide of 
hydrogen is one of the chief ingredients of the uric acid solvent 
ozonized. 

The salicylate of lithia is an excellent bactericide, has a 
destructive effect upon the bacillus arnylobacta. 



Lobelia, 



Indian tobacco, the leaves and seeds are used 
medically for a variety of diseases, as it is an emetic, 
expectorant, sedative, antispasmodic, and has the 
invaluable property of sterilizing all disease 
germs. It is a most powerful and active 
emetic, provided its administration is pre- 
ceded by copious warm alkaline drinks, as 
it is not absorbed in an acid menstruum. 

It is very useful in all fevers, as it keeps 
the germs, the factor of fever, quiescent ; it 
relaxes the system, produces diaphoresis. 

As a relaxant and sedative, it is a most 
efficient agent in the treatment of epilepsy, 
hysteria, spasm, cramp, convulsions, tetanus. 

It acts well upon the motor nerves of 
respiration, hence it is often of the greatest 
utility in asthma, bronchitis, laryngitis. 
The immense resources of modern thera- 
peutics have not been able to supersede it. 
The vast future of medicine will require 
lobelia. 

Noses njay wither with the amoeba of 
catarrh ; eyes fail from steady use ; ears 
become dull by excesses ; tissued-starved teeth may vanish and 
drop out; but the cleansing of the stomach from the fungus 




■^^i^t 



b 



Lobelia. 



35« 



DISEASE GERMS. 



sircinae needs lobelia. We do not claim it to be an antiseptic, it 
cannot destroy micrococci, it sterilizes them and also the nutrient 
soil upon which they live. No drug has superseded it in teta- 
nus ; its action cannot be explained ; meets the etiological and 
vital condition, renders the germs of this fatal disease quiescent 
in the blood and retards organic changes. 



Lycopodium 




Vegetable sulphur, is an invaluable germi- 
. cide. The plant, moss or fern, possesses 
properties of a high anti-bacterial character, 
for a cecoction of it kills that terrible parasite 
malady \.\\q plica polonica. It is extremely useful 
in that peculiar burning of the cutaneous surface 
when it is loaded with the germs of disease, in 
painful boils ; in 



that aggregation 
of the germ syph- 
ilitica on the 
bones called 
nodes ; in all tu- 
bercular skin af- 
fections ; it ope- 
rates like ordi- 
nary sulphur 
upon the liver, 
stimulating that 
gland, removing 
that dirty, yellow hue of the skin, 
which is so common in torpid 
liver. Besides it is invaluable in 
relieving irritable bladder, espe- 
cially in the enuresis of children. 



Club Moss 
(Lycopodium) . 



Bugleweed, the 

Lycopus. herb either in de- 
coction, tincture or 
fluid extract, is astringent, tonic, 
sedative and narcotic. 

It is so soothing when admin 
istered that it diminishes heat, 
pulse, respirations, and its action 
is incomparable in incipient pul- 
monary tuberculosis, in retarding 
germ evolution and growth — in 
preventing bacterial development in diarrhea and dysentery. 




Bugleweed. 



BACTERICIDES. 



1359 



It is this peculiar germicidal action that renders this plant so 
efficient, so highly prized in all haemorrhages from the lungs and 
stomach. 

Its action upon the heart resembles that of bromide of soda. 

Besides, it is valuable in toning up and promoting digestion^ 
and allaying all uneasiness or irritability of the alimentary canal. 

The best preparation for use is either the tincture or fluid 
•extract, in doses according to the effect desired. 

The physiological action of bugleweed is directly on the nerve. 

The combination of this property and its germicidal properties 
is what renders it of so much value in pulmonary and intestinal 
tuberculosis. 



This invaluable anthelmintic consists of an 
Male Fern, ethereal extract or oleoresin extracted from the 
rhizome. This is the only preparation fit for 
medicinal use ; it is a thick, 
dark green liquid, has the 
odor of the fern, nauseous 
bitterish acrid to the taste. 
On standing, a granular, 
crystalline substance ap- 
pears on the surface, which 
is the active ingredient, 
and should not be sepa- 
rated. 

Dose from thirty to 
sixty grains is the proper 
quantity, administered in 
capsules. 

If capsules are not ac- 
ceptable, it may be ad- 
ministered conveniently in the following combination : Ethereal 
extract male fern sixty grains, rubbed up in mucilage of gum 
acacia one ounce. To be taken at one dose, followed by copious 
drinks of slippery elm. Castor oil to be taken two hours after- 
ward. 




Common Male Fern. 



is a powerful germicide, having a special affinity to 
Manaca destroy the microbe of syphilis, the bacilli of 

tubercle and the germs of rheumatism. It excites 
the action of the lymphatic system most energetically, and eli- 
minates morbid or waste material from the system. In alterna- 



1360 



DISEASE GERMS. 



tion with the saxifraga, it 
is the ne plus ultra of all 
drugs in syphilis. 

Prof. Day, M. Z>., of 
America, and E, Mather ^ 
M, D., of England, have 
had undoubtedly the most 
experience with this drug. 
They state, and both agree 
that, if very carefully 
guarded in its administra- 
tion, it will destroy the 
bacillus of syphilis and 
amylobacta of rheuma- 
tism. 

It is of special utility 
in phrenal syphiHs, affording relief in all cases from the noctur- 
nal pain. 




Manaca. 



Marjoram 



A perennial plant, with a stem about a foot 
high; ovate leaves; roundish, panicled, crowded 
heads of purple flowers, with large bracts. Its 
properties are germicidal, used in 
cooking for seasoning. Stimulat- 
ing and diaphoretic in the eruptive 
fevers, has a sterilizing action on 
germ evolution. The powder is 
nearly equal in antiseptic proper- 
ties to the horse-chestnut in nasal 
catarrh. An infusion is the best 
method of administering. Drink- 
ing it cold it warms, invigorates 
and soothes the nervous system. 
The essential oil of sweet marjoram 
mixed with olive oil in various 
proportions, is an excellent remedy 
for baldness, as it is inimical to the different forms of tinea of the 
scalp. 




, Sweet Marjoram {Ori^aKum Ma'rjo- 
rnnn); 2. Common Marjoram {Ori- 
g-iiumvuUare). 



Horehound is a most efficacious germicide 
Marrubium. upon all micro-organisms on the mucous mem- 
brane of bronchi and larynx, and also upon 
germ-laden sputum from the substance of the lungs, as we have 



BACTERICIDES. 



1361 



in pulmonary tuberculosis and pneumonia; consequently, al- 
though entirely ignorant of its annihilating action upon the 
germs of catarrh and bronchitis, j^^ 

and its sterilizing action upon the 
tubercular bacilli, and the pneumo- 
coccus, the remedy has been em- 
pirically prescribed with the best 
results in chronic catarrh and bron- 
chitis, attended with very copious 
germ-laden expectoration. 

Besides its action as a bronchial 
stimulant and antiseptic, it is a safe 
and efficacious tonic, acting as a 
most efficient stimulant to the kid- 
neys, skin, but especially the liver, 

giving us copious biliary secretion. UQTf:ho\xn^{Marrudiumvui!gare). 

An infusion of one ounce to the pint of boiling water. Dose: 
a wineglassful, either warm or cold, as desired, answers well; but 
better still is the tincture, which holds its aromatic properties in 
a more perfect state. 




Japanese peppermint, a camphoraceous body, 
Menthol, having the same bactericide properties as thymol. 
Menthol is somewhat soluble in water, as shown 
by its taste being imparted to water, and by the slug-like move- 
ments of the crystals when covered with water, and placed under 
the microscope. Sometimes the movements in the water to- 
wards and from the dissolving crystals, are as rapid as those 
formed by an active rotifer or vorticel. These movements are 
rendered visible by minute objects floating in the water, as infu- 
soria and algae. They approach the crystals of menthol with ve- 
locity, and are ejected with violent electric motion. 

Menthol left exposed, will evaporate and disappear at the ordi- 
nary temperatures of the rooms. Its smell is like peppermint, 
but less pungent. Taste is somewhat sharp, and penetrates the 
whole mouth. It looks like the sulphate of magnesia to the 
naked eye, but more talc- like. It is rather bulky, one ounce 
filling a two-fluid ounce bottle. From what I can judge, it is a 
very agreeable medicine, and would make an acceptable substi- 
tute for the smelling-salts of elderly ladies. There is nothing 
unclean about it. Its volatility renders it easy to administer in 
diseases of the air passages, even to infants and very feeble 
persons. 

Menthol is a bactericide, has the remarkable property when 
86 



1362 



DISEASE GERMS. 



administered, of sterilizing the blood to many disease-germs. 
The following are a few of the formulae in general use : 

For internal administration. — Menthol, one drachm ; three 
ounces each of fl. ext licorice, water, alcohol ; twenty drops each 
of oil of cajeput and carbolic acid. Mix. Four drops every two 
hours. 

For applying to the nostrils in hay fever. — Menthol, one 
drachm; ozone ointment, two ounces ; hydrochlorate of cocaine, 
one grain. Mix. 

For piles, eczema, pruritus of the genitals, fistulce, rectal excoria- 
tions. — Menthol, one drachm ; ozone ointment, two ounces : 
chaulmugra oil, half an ounce; cocaine hydrochlorate, two 
grains. Mix. 

As a gargle for sore mouth, scarlet fever, syphilitic and tubercular 
ulceration. — Take of each menthol and carbolic acid, twenty 
grains; two ounces each of fluid extract of licorice and glycer- 
ine ; peroxide of hydrogen, one drachm ; one pint of water. 
Mix. 

In pruritus. — Take one drachm menthol ; two ounces of alco- 
hol ; thirty grains carbolic acid ; the same of the benzoate of 
soda ; add the whole to six ounces of rose water. 



This drug is used by the natives as 

Mudar Bark. a remedy for epilepsy, paralysis, bites 

{Calotropis Gigantea) of poisonous animals, worms, etc. In 

cutaneous affections, especially lep- 
rosy, It is frequently employed. Its active principle, discovered 
by the late Dr. Duncan, of Edinburgh, called mudarine, pos- 
sesses the extraordinary property of congealing by heat and be- 
coming again fluid when cooled. Dr. G. Playfair found the 
milkly juice to be very efficacious in leprosy, lues venerea, 
herpes, dropsy, rheumatism, hectic and intermittent fevers ; and 
Dr. Duncan considered that it agreed in many respects with 
ipecacuanha, and that it might eventually supersede the latter. 
(See Major Heber Drury's "Useful Plants of India.") 



in the form of a tincture of the green plant, that 
Marigold is, flowers, leaves and stem, is a bactericide ot 
(^Calendula), the first order; hence it is of intrinsic value in 
all cuts, bruises, wounds, and contusions. It is 
altogether superior to arnica in ecchymosis. The mother tincture 
diluted one-half with water and applied to a wound or ulcer, pro- 
motes rapid cicatrization by destroying the bacteria. 



BACTERICIDES. 



363 



Asa germicide its range of action is large ; it sterilizes the 
oidium albicans of aphthae and sore nipples. 

It combines well with peroxide of hydrogen, and when four 
volumes of that invaluable agent are added, it is of the greatest 
possible utility in threatened gangrene, purulent ophthalmia, 
abscess, carbuncle, etc. 



Menyanthis Trifoliata. 

{Buck Bean.) 



A most intense- 
ly bitter tonic and 
germicide. In 
some sections of 
the country it is used quite extensively in the 
treatment of our indigenous fevers, rheuma- 
tism, jaundice and parasite cutaneous diseases. 
It is alterative and purgative. 

It is often administered in infusion — half an 
ounce of the pulverized plant to a pint of boil- 
ing water. Dose, a wineglassful repeated fre- 
quently. Also in the form of a fluid extract in 
doses of thirty to sixty drops. 




Buck Bean. 



Mexican Ointment. 

{For Rupture) 



This ointment is in very general use 

in Mexico as an ointment for hernia. 

Its true composition has as yet not 

been definitely settled. 

It is applied externally over the hernial aperture, and has the 

remarkable faculty of contracting the orifice, and at the same 

time, without the slightest irritation, causes thickening of the 

parts, and forever after prevents the rupture from taking place. 

It is a most excellent remedy to prevent the occurrence of 
rupture. 

It is spread on a piece of leather morning and night and ap- 
plied. 

It is a most excellent local bactericide when applied to the skin 
in any form, of either vegetable or animal parasitic disease, it al- 
most immediately kills it. 

Its action is perfectly painless. 



The whole plant is germicidal, and is a 
remarkable agent to render labor easy, 
it is also diuretic, tonic and astringent. 
It resembles the aleteris farinosa. 
The comp. syrup of partridge berry is the most important 
-agent ever presented to the profession in the treatment of dis- 



Mitchella Repens. 

{Partridge Berry) 



1364 



DISEASE GERMS. 



eases of the female reproductive organs. This syrup is emrriena- 
gogue, parturient, antispasmodic, diuretic and tonic, and is par- 
ticularly efficacious in the treatment of engorgement, inflamma- 
tion and induration of the uterus, dysmenorrhoea, menorrhagia, 
leucorrhoea, amenorrhoea, prolapsus uteri, hysteria, melancholia, 
pruritus vulvae, impaired vitality, vomiting of pregnancy, habitual 
abortion and uraemic eclampsia. It being a powerful uterine 
sedative, is the remedy par excellence in dysmenorrhoea or threat- 
ened abortion. 



Mulberry. 



Some of the most common affections, spring 
and fall, when the vicissitudes of temperature are 
great, are inflammatory affections of the glands 
of the mouth and larynx, 
chilliness, fever, pain in de- 
glutition, and as it progresses, 
swallowing becomes exceed- 
ingly difficult, if not imprac- 
tible. The tongue coated 
white or brown, mouth dry, 
and if the inflammation is 
not promptly checked by the 
use of antipyrine, small vesi- 
cles make their exit : in these 
the oidium albicans make 
their appearance. In such 
cases the glycerite of sul- 
phur, one teaspoonful every 
hour, and the throat packed 
from ear to ear, with a strong 
infusion of the inner bark of 
the white mulberry. As a gargle and mouth wash, the same 
infusion is unexcelled, as it destroys all germs in the mouth. It 
is also an infallible remedy in nursing sore mouth and ulceration 
of the nipple. 

The root has considerable reputation as a vermifuge. 




Common Mulberry (Morus nigra) \ fruit, leaf, and 
female flower. 



Arrowroot, is a variety of starch, extracted from 
Maranta, the roots of certain plants which grow only in 
tropical countries, and is much valued as a deli- 
cacy, a light, nutritious and easily digested food for children and 
invalids. The tuberous roots contain a large percentage of 
farina. That growing in the ozoniferous atmosphere of Bermuda 



BACTERICIDES. 



1365 



is a foot long when a year old, and when reduced to a pulp, by 
repeated raspings and washings, yields one of the finest antisep- 
tics in medicine. A small 
quantity of this extract in- 
troduced into albuminoid 
bodies preserves them for 
many months, without de- 
terioration or chemical 
change. The use of this 
antiseptic in all fevers, and 
in all diseases in which albu- 
minoid changes take place, 
is worthy of serious consid- 
eration. 

The amount of fecula or 
starch present in the root 
of the maranta varies ac- 
cording to age and soil, runs 
from eight to twenty-six per 
cent. The latter stage is 
reached when the plant is 
about a year old. 

A green tincture prepared 
from the fresh root is highly 
germicidal, and is an antidote to the stings and bites of venom 
ous insects and reptiles. 




Arrowroot ; 



tubers ; b, leaf and flowers ; c, stamen 
land style. 




Mistletoe. 

( Viscurn Album.) 



Mistletoe {l^iscum Album), 



This parasitical 
shrub, which de- 
rives its nourish- 
ment from the liv- 
ing tissue of the tree upon which it 
grows, and from which it seems to 
spring, has been held in high repute by 
both German and British Druids as a 
germicide in sterilizing the microbe of 
hooping-cough and the bacillus of hay- 
fever. It has a decided medicinal pro- 
perty in chorea, epilepsy, convulsions, 
and stands high as a pain-alleviating 
remedy. 

It is used most extensively in this 
country as a uterine tonic and vitalizer. 
The very best results are obtained by 
administering the elixir of the mistletoe 
during the last four months of preg- 



1366 



DISEASE GERMS. 



nancy, equal to the wine of the aieteris farinosa. Sure to 
reheve pregnancy and parturition of many compHcations, and 
insure ease and safety ; and still more, when its action in labor 
is aided by the uterine cones, we bring about the phenomenon in 
midwifery practice of " painless parturition." 



Mura Puama. — Fluid extract more powerful than damiana as 
an aphrodisiac. It forms the chief ingredients of the sexual 
invigorating fluid and pills. 



The fluid extract of mullein leaves is indicated 

Mullein, in pulmonary phthisis ; efficacious to relieve cough 
and ulcerated bowels ; obviates phthisical diarrhea. 
The smoke of the burnt leaves relieves irritation of the bronchial 
mucous membrane. 

Mullein oil, valuable in all cases of aural disease, as deafness 
otitis media, otorrhea, otalgia. 

This oil is prepared by polarised light and by peroxide of 
hydrogen. 

One to three drops in the ear. 

Dr. Mather, the celebrated English physician says : Mullein 
oil was worth a trial in bad cases of deafness, especially when 
labyrinthine mischief was suspected. I commenced its use in a 
large number of cases, with most satisfactory results. 

In nearly all cases complaining of pains and presenting signs 
of hyperaemia of the middle ear, the instillation every two or 
three hours of two or three drops of this oil rapidly arrested the 
pain, and prevented suppuration and perforation of the membrana 
tympani. 

In every case of otorrhea or otitis media, after the ear was 
washed out with tepid water and castile soap, it was dropped ; 
following its use there was no more odor, no muco-purulent dis- 
charge, not a vestige of the 'streptococcus pyogenes could be 
seen. 

In cases of labyrinthine deafness the result was extremely satis- 
factory. In some instance the cure was gradual ; in others at 
once. 

The mullein oil treatment of aural diseases excels all others, 
especially of an otalgic or suppurative character. 



BACTERICIDES. 



1367 



This is a substance 
Myrrh, which exudes from the 
bark of the balsamoden- 
dron myrrha, a tree peculiar to the 
tropics, in oily yellow tears, which 
gradually thickens, and finally be- 
comes hard, and darker in color. It 
is an invaluable germicide, was ex- 
tensively used by the Egyptians for 
embalming, and by the moderns as a 
remedy to destroy micro-organisms 
in the mouth and alimentary canal ; 
hence useful in all forms of oral ulcer- 
ation, spongy gums, fetid breath ; it 
destroys the bacteria of ulcers, hence 
if sprinkled on them promotes heal- 
ing ; of value to sterilize the amoeba 
of catarrh and bronchitis. A tinc- 
ture is good form for general use. 




Myrrh {Bacsamodendron myrrha). 



Ten drops of 
Myrtle, ozone et chlorine 
were added to six- 
teen ounces of tepid water, and 
when used an ounce of myrtol 
was added. Used as a mouth 
wash and douche by the nose; 
Most excellent results followed, a 
general improvement took place, 
a complete change from worse to 
better, ?o much so that I dete- 
rmined to try the myrtol inter- 
nally. The preparation I used 
was an ozonized distillation of 
the leaves and flowers of the 
common myrtle ; being a liquid 
possessing all the perfume of the 
plant. It is of less density than 
water, and evaporates at ordinary 
temperature. It has a slightly 
Myrtle in acrid, astHngcnt taste, followed 
by a sensation of freshness. It 
is a powerful germicide, stimulates all the vital functions of life, 
inimical to microscopic life. It is a great appetizer, a sedative 




Myrtle. 



I, Myrtle Flower. 
Flower. 



1368 



DISEASE GERMS. 



to the nervous system, enters the blood, acts as a scavenger to 
that fluid, and after disinfecting the entire body is freely elimi- 
nated by the breath, skin, and kidneys. It has a decided affinity 
to disinfect the respiratory mucous membrane, completely anni- 
hilates the amoeba of catarrh, laryngitis, bronchitis, asthma; also 
of glanders ; changes the opaque, gangrenous, purulent secretion, 
at the same time inducing a healthy condition. It is an unsur- 
passed remedy in chronic fetid bronchitis, complicated with 
paroxysmal asthma and emphysema. 



(CioHg) is a derivative of benzol, and allied to 
Naphthaline phenol. It appears as thin white shining rhombic 
crystals, with a strong pungent odor and burning 
taste. It is insoluble in water, but readily dissolves in alcohol, 
ether and fatty and ethereal oils. Externally it has been found 
of value in the treatment of venereal ulcers, ol wounds and of 
scabies. 

This substance was recommended. for certain intestinal affec- 
tions by Dr. H. Warner, Springfield, Mass. 

The purest naphthaline alone should be used, and he found it 
invaluable incase of chronic intestinal catarrh and cholera morbus 
in children, as well as in typhoid fever. In intestinal tuberculosis 
he found that it caused some improvement, but no radical 
change, and for acute diarrhea it was no better than opium and 
suitable diet. Dr. Warner's success was not attained by others who 
used naphthaline according to his directions, and they reported 
that it produced hypogastric pain, strangury, tenesmus, and 
urinary appearances suggestive of carbolic acid poisoning. 
Moderate success was reported, however, by a few writers. The 
author, after extensive and careful use during a sufficiently lon'^ 
period of time to warrant conclusions, decided : 

1. That naphthaline is ineffective in the so-called dyspepsias 
which are characterized by frequent movements of the bowels, 
and usually by the vomiting of coagulated milk, and is inferior 
to other medicaments which are in general use for such con- 
ditions. 

2. In all other forms of intestinal catarrh in children naphtha- 
line should be preferred to all other known means of medication. 
In simple acute diarrhea the preparations of opium would be pre- 
ferable, but for the fact that naphthaline checks fermentation pro- 
cesses, and in this way prevents an acute intestinal catarrh from 
developing into a chronic one. 

Naphthaline is a powerful antiseptic, insoluble in water, alkalies, 



BACTERICIDES. 



1369 



-and acids ; may be administered in capsules two to eight-grain 
doses without any noteworthy absorption by the stomach and in- 
testines. Excellent results are obtained from the use of this 
germicide in acute and chronic intestinal diseases, tubercular 
affections, diarrhea, dysentery, infantile diarrhea and cholera. It 
kills the germs of disease in the alimentary tract ; besides it dis- 
infects the entire passages of the germ-laden, green stools, so 
common among children in crowded cities during the hot season 
of the year. In cholera infantum it has achieved most wonder- 
ful results. 

An excellent formula for all cases, to destroy the bacteria and 
disinfect the entire alimentary tract, is the following : 

Naphthaline, sacch. lac, of each, two ounces ; oil peppermint, one 
drop. Ft. twenty chart. One every hour, and less frequent, 
according to the evacuations. 

Externally in a pure form, or in an ointment, it is useful in 
scabies, herpes tonsurans, eczema. 

Prof. Fuchs^ M. D., New York City, N. Y., several years ago, 
called attention to the value of this agent in the treatment of cer- 
tain diseases of the skin, and particularly of scabies. He em- 
ploys naphthol in a ten-per-cent. alcoholic solution, or in the form 
of ointment, and says that one or two applications will cure the 
most inveterate cases of common itch. He has had equal suc- 
cess with naphthol in psoriasis, eczema and ichthyosis, and there 
is nothing better, he says, to allay tormenting itching of 
prurigo. 

Dr. Fuchs speak in high praise of naphthol as an external 
agent (alcoholic lotion or pomade) in the skin diseases mentioned 
above. Van Harlingen, moreover, has seen favorable results 
from naphthol in obstinate cutaneous affections. 

The experiments to which allusions has been made, have led 
Bouchard to regard naphthol as one of the best and safest of 
antiseptics. According to these a three-per-cent. solution 
markedly retards the development of the typhoid bacillus, as 
well as that of the bacillus tuberculosis. The same solution is 
fatal to the microbes of several of the parasitic diseases of ani- 
mals, and prevents fermentations. Bouchard gives naphthol 
internally in typhoid fever, and believes that, if it does not abort 
this disease, it certainly renders its course milder. He regards a 
dose of forty-iive grains (2.50 grammes) a day as realizing the 
conditions of intestinal antisepsis, and affirms that in such doses 
there is no antiseptic agent which is more innocuous. This use 
of naphthol in typhoid fever has been followed to some extent in 
this country with apparently favorable results. 



370 



DISEASE GERMS. 



Indicated as a powerful stimulant to the 
Nitrite of Amyl. pneumogastric and vagus in angina pec- 
toris, asthma, epilepsy, syncope. Its action 
is instantaneous and certain, as it lowers vascular tension by 
dilating the arterioles ; stiffens up a weak heart, breaks or wards 
off the spasm. 

Dose: One, two, three, four, five, ten drops in pearls or glass 
shells. Crush a pearl in a handkerchief and inhale on the 
approach of a paroxysm. 



One of the most valuable stimulants in 

Nitro-Glycerine. the Materia Medica. Indicated in all 
conditions of prostration or collapse, in 
headache, asthma, angina pectoris, albuminuria, neuralgia, ner- 
vous anaemia. 

The best form for administration is a one-per-cent. solution. 
This is the handiest and least liable to change or become 
worthless. 

The average dose is one drop, but patients are not all alike in 
the amount required to produce an effect — some requiring 
less than one drop, others requiring three or four or more drops 
to produce the same effect. The effects usually last two to three 
hours. It is wisdom for the physician in all cases to call the 
remedy by a less terrorizing name — glonoin, or trinitrin. 

Physiological Effects. — Dropped on the tongue, the effect is the 
more rapid, as there is no dilution. By way of the stomach, 
unless greatly diluted, the effect is apparent in a few minutes, the 
pulse being increased from ten to twenty beats, and becoming 
ful and regular. In a few cases there is a slight headache, last- 
ing for a few minutes. In larger doses the face becomesflushed, 
a severe headache is experienced, accompanied with a feeling of 
fulness, singing in the ears, flashes before the eyes, and all the 
symptoms of an increased supply of blood to the brain. (3n 
account of this effect on the cerebral circulation, care should be 
taken in administering the remedy to the aged, as the sudden 
expansion of the cerebral vessels might cause a rupture of their 
weakened calcareous walls. Its action on the heart is through 
the sympathetic nervous system. The vagus nerve and the 
vaso-contractor nerves of the vaso-motor nervous system are 
depressed, partially paralyzed. This allows the extensive system 
of arterioles to dilate, and thus give room within their walls for 
a greater amount of blood to flow. Thus this enlarged reservoir 
of tubes relieves the heart of the work of forcing the current 
through narrow contracted tubes. This and the vagus nerve 



BACTERICIDES. I 37 I 

being depressed permits the heart to beat freer, fuller and more 
rapidly. 

Of great value in asphyxia.. Best administered by adding the 
prescribed dose to a little water, or in the form of pill. 

The antidotes to an overdose are either ergot, strychnine or 
belladonna. 

Two of our oldest physicians speak of it thus : 

J. H. Moon, M. D., Montpelier, Idaho, a physician of the high- 
est scientific attainments, gives his experience on nitro-glycerine 
in tinjiitus auriu7n, as follows : 

" After the usual experience in ear-work, and a gradual accu- 
mulation of unimproving cases of tinnitus aurium, I began to 
study the general effects of nitro-glycerine, and to use it in these 
cases. In some cases there was an improvement ; in others 
there was none. 

In the patients where improvement had occurred, there was 
found to be present a similarity of conditions, and I soon satis- 
fied myself that there was a class of patients in which the nitro- 
glycerine treatment was valuable. I found it most serviceable 
in patients having the tinnitus aurium, without much impairment 
of hearing, and where but little change had occurred in the naso- 
pharynx and where it was found on examination that some 
abnormal condition of the heart existed, either functional or 
organic. 

The tinnitus was generally constant, or nearly so. It was 
not, as a rule, more marked when the patient was in a recumbent 
position ; occasionally there was some remission in that position. 
The thermometric and barometric conditions of the atmosphere 
influenced the tinnitus ; damp weather, with low barometer, 
usually increased it. Dull, heavy headache, more or less per- 
sistent, and most frequently located in the parietal regions, 
though sometimes located in the frontal region, was of frequent 
occurrence." 

Wm. McAIillen, M. D,^ Sugar Branch, Ind., one of the most 
eminent physicians in the United States, and a close clinical ob- 
server, points out the value of this drug in various affections 
— angina pectoris, migraine, and neuralgia, (which he describes 
as angioneuroses), as also in sea-sickness, some forms of anaemia, 
faintness, palpitation, and other diseases ; depends upon the ex- 
istence of an irregular distribution of blood, which condition 
may be inferred from a certain degree of pallor of the skin, es- 
pecially of the face, often co-existent with a weak pulse and a 
small rigid radial artery, which frequently «is situated at some 
depth. When, on the other hand, headache and neuralgia occur 
in patients with chronic congestion of the subcutaneous veins of 



1372 



DISEASE GERMS. 



the face, nitro-glycerine is to be avoided ; and similarly it is of 
no use in asthma, when the face is reddened in consequence of 
emphysema. If, however, a pale face exists with angina pectoris, 
migraine, giddiness, shock, toothace, or sea-sickness, the best re- 
sults may be looked for by giving nitro-glycerine. The regulat- 
ing effect of the drug exercises an influence over the congestion 
of internal organs similar to that brought about by blood-letting; 
and in these congestions, whether of lung, brain, or kidney* 
when they are of a temporary character, the pulse is generally 
found to be slow and of low tension ; a fact which, as the author 
remarks, is sufficiently well known in reference to the fever-free 
periods of acute hyperaemia of the lung and kidney. He lays 
down as a rule, that the condition of the pulse is the best indica- 
tion for the employment of nitro- glycerine, and the most trust- 
worthy guide as to the dose with which to commence the treat- 
ment. The smaller the radial artery is, the more rapidly it 
dilates under the action of the drug, and the less the secondary 
effects proceed ; on the other hand, the fuller the pulse with a 
distended radial artery, the less it is affected ; and finally, the 
softer the artery, with a weak pulse, the greater the secondary, 
and the less the general effects. Single-drop doses of the one- 
per-cent solution are sufficient in cases of small pulse, but with 
a full pulse, it will be found that the full effects cannot be pro- 
duced with less than two-drop doses. When there is a soft 
artery with a weak pulse, subnormal doses only should be given ; 
a quarter to half a drop. After the trial dose is given, the 
patient's sensations of pulsation and pain in the head, as well as 
the distension of the radial artery under the finger of the physi- 
cian, will be the guides for increasing the dose. 




Nutmeg {Myristica moschata). A branch 
showing fruit, and section of ''fruit, with 
nutmeg enclosed. 



An aromatic ger- 
Nutmeg. micide of some 
power, and in large 
doses produces alarming senso- 
rial disturbance and stupefaction. 
Il is chiefly used as a spice, for its 
carminative and stimulant proper- 
ties. Its action is identical with 
mace, and in both, their virtues 
depend upon the presence of a 
volatile oil, which has a remark- 
able affinity for oxygen. When 
the oil myristicai is distilled at 
a temperature 347° F., there are 
marked traces of comp. oxygen, 



BACTERICIDES. 



1373 



and the pure colorless hydrocarbon, which remains after distil- 
lation, is identical in composition with the pure oil of turpentine. 

The extract which is thus prepared, is available for internal 
use. 

Mix two drachms of the oil with one ounce of pulverized 
mace ; macerate for a few days in one quart of deodorized alco- 
hol, then filter. Dose from five to ten drops, thrice daily. 



The tincture prepared from the seeds of the 
Nux Vomica, strychnos nux vomica, when administered in 
small doses, is an excitant or stimulant to 
the vaso-motor and motor-centres 
of the spinal, and thereby in- 
creases the activity of the circu- 
lation and general tone of the 
system. It is one of the most 
valuable of all tonics, and inimi- 
cal to microscopic life. 

In anaemia of the brain and 
spinal cord, in all forms of paraly- 
sis due to that pathological con- 
dition, this drug is invaluable, 
stimulating the cord and rousing 
up the inertia of the muscular 
system. It increases the activity 
of striated as well as non-striated 
muscular fibres — valuable in in- 
ertia, in a relaxed state of the stomach and bowels, which give 
rise to loathing of food, nausea, vomiting, colic, atony of the 
stomach and liver. Its general action as a stimulant to the ner- 
vous and vascular systems renders it a valuable tonic to aid 
digestion, to overcome a sluggish liver, habitual constipation. 

The dose is variable from a few drops up to fifteen of the com- 
mon tincture, added to water, thrice daily, before meals. 




Nux Vomica. Branchlet, leaves and 
flowers. 



The root of the white pond lily has 
Nymphae Odorata. been in use for several hundred years, 
pulverized and incorporated into poul- 
tices, and ointments for an antiseptic in gangrenous and phage- 
denic sores; an infusion has been very generally used as a wash 
in leuchorrhoea. 

The root has been recently subjected to a rigid chemical ana- 
lysis, and a very peculiar astringent, different from tannic and 



1374 



DISEASE GERMS. 




gallic acid isolated, which contracts connective, muscular and 
mucous tissue. Its action is most energetic on sphincteric fibres. 

If the urine is kept neutral 
or alkaline in incontinence, 
and this remedy administer- 
ed, it causes the sphincter 
to contract ; locally it con- 
tracts the walls of the vagina 
or rectum, if relaxed, and 
restores them to their pris- 
tine condition. 

To those suffering from 
prolapsus of the rectum, it 
is invaluable ; to ladies suffer- 
ing from falling of the womb, 
or lost contractility of the 
vaginal walls ; whose gener- 
ative system has lost its tone 
and vigor, and has become 
callous, inoperative to sexual 
White Pond Lily. enjoymeut, it is the remedy 

par excellence ; to all who suffer from catarrh and leucorrhoea it 
is of great utility. Take it all in all, it is a great vaginal con- 
tractor and rejuvenator. 

For the convenience of the profession it is put up in the form 
of pastiles. 

One to be used every night at bedtime. 

The glucoside isolated from this old and reliable remedy is 
attracting well-merited attention. This glucoside has an ex- 
tremely bitter astringent taste, is very hygroscopic -and not 
well adapted for internal use, but as a local remedy in all relaxed, 
devitilized states of the vagina it has no equal. Added to the 
butter of coca, it forms a most elegant pastile, tonic and astrin- 
gent to the vagina and uterus. One of these inserted every other 
night produces a complete revolution in the tissue, and causes 
contraction and vital tonicity. They are specially indicated in 
prolapsus uteri, leucorrhoea, sexual lethargy, sterility, and when- 
ever the reproductive organs are worn out by frequent parturi- 
tion or exhausted by sexual excesses. 



Water hemlock, water drop-wort, or 

CEnanthe Crocata. cowbane, a European aquatic plant, 

grows in ditches and margins of ponds. 

In Scotland it grows to a considerable height with a very large, 

fleshy white root. 



BACTERICIDES. 1 375 

* 

The entire plant is a virulent, narcotic, acrid poison to man 
and the inferior animals, and produces in them when inadver- 
tenth' eaten, giddiness, convulsions, 
coma, and profound cerebral disturb- 
ance analogous to a violent epilep- 
tic fit. 

The believers in the law of siinilia 
similibiis curantur, with their apostate 
brethren the specific medicationist, 
therefore deem this plant a specific in 
all epileptic seizures. 

By repercolation, an alcoholic extract 
of great power and efficacy has been 
prepared from a recent importation. 

The dose is small, a few drops in 
water, repeated at intervals of every 
three hours and increased with great 
care, so as to ward off the fits, stem 
the current of cerebral explosions. 

It is worthy of a fair trial. ,,, ^ ^. , 

■^ Wa'.er JJrop { (Ii,nanihe oocata). 




These '' cones " are prepared from the 

Obstetric Cones, finest butter of coca ; boroglyceride, hydro- 
chlorate of cocaine and hydrogen per- 
oxide. 

Their use is indicated in every case of parturition. 

vSimultaneously with the first pain, one should be inserted as 
far up the vagina as the finger can push it, and at the same time 
one up the rectum. These speedily melt, thoroughly lubricate 
the parts and produce anaesthesia of the uterine plexus of nerves, 
rendering the parts soft, moist, easily dilated. 

In a short time two more should be inserted, and thus repeated 
'every half hour, in accordance with the judgment of the ac- 
coucheur. 'At the same time the abdomen over the uterus and 
lumbar portion of the back should be rubbed with a mixture of 
concentrated ozone and chloroform. By these procedures the 
pangs of paturition are either totally obliterated or reduced to a 
cipher, the vagina rendered aseptic. 

The use of these cones in all cases of parturition at full time or 
miscarriage, is far-reaching. When thus used there is no tedious 
labor; no inertia of the uterus; no hour-glass contraction; no 
retained placenta ; no post uterine hemorrhage ; no metria ; no 
puerperal convulsions ; a speedy convalescence. 



1376 



DISEASE GERMS. 



These cones have numerous other valuable properties : they 
cure the three forms of dysmenorrhea, specific inflammations, in- 
duration of the neck, leucorrhoea, pruritis, piles, irritable and 
ulcerated rectum, ascarides. 



Compound oxygen, or oxygenized water, 

Oxygen Comp. is a germicide of immense power, destruc- 
tive to all micro-organisms, completely 
annihilating the bacilli of tubercle, syphilis, cancer, fungus of 
diabetes, germs of scarlatina, etc. Vitalizes the blood, promotes 
the activity of the pink marrow and entire lymphatic system. 
Very efficacious in general nervous debility, nerve tire, and in 
debility of the respiratory organs, as in asthma, bronchitis, con- 
sumption, pneumonia, hooping cough. An invaluable remedy 
for impure, impoverished, germ-laden blood, or where the blood 
is literally swarming with myriads of disease germs from over- 
crowding, sewer gas; in embolism, bacteria-laden blood from 
imperfect action of the heart, lungs, liver, spleen or skin. 

Dose : Internally. One teaspoonful three or four times daily, 
in a glass of cold water, is sufficient to supply the blood with 
oxygen — at least with all that it will imbibe, or in any form of 
blood disease, as chlorosis, anaemia, etc. 

As a Gargle. — In scarlet fever, syphiHtic, tubercular, malignant 
sore throat, one teaspoonful in half a tumbler of tepid water, 
every three hours. 

For inhalation use in full strength in a hot or steam atomizer. 

Prof. McFall, M. D., in his report to the Board of Health, 
Nashville, Tenn., says : 

" When pure atmospheric oxygen is exposed to the action of 
electricity, it is transformed into ozone, which is an allotropic 
modification. Ozone, at ordinary temperature, is being con- 
stantly generated in the atmosphere by the natural electric forces. 
The health of all animated nature is influenced by its presence ; 
all diseases, in which disease germs are the factor, are greatly 
aggravated by its absence, A locality er home in which ozone 
is freely evolved, is one in which contagious diseases cannot 
exist, while if only a small percentage exists morbid action is 
rampant. 

Oxygen gas is inadmissible as a remedy, as it oxidizes the 
tissues too rapidly and hastens metamorphosis. This is true, 
whether the pure gas is used or its combination with nitrous 
oxide gas. As a medicament, compound oxygen, ozone water, 
peroxide of hydrogen, are remedies of intrinsic value ; they are 
germicides ; their use keeps the blood pure and stimulates all the 



BACTERICIDES. 



1377 



vital functions of the body ; they restore lost vitality, stimulate 
the hepatic and renal organs ; a cardiac respiratory tonic. The 
remedy in one or other of its three forms, if added to a little 
water, and swallowed, enters the blood, first acts as a scavenger, 
then as a vitalizing tonic. 

Oxygen is respirable to a limited extent, but when greatly in 
excess, hastens destructive metamorphosis. It is essential to 
the support of animal and vegetable life, and is the most widely 
distributed of all the elements. It constitutes more than a fifth 
of the bulk and more than a fifth of the weight of the atmo- 
sphere. In combination with hydrogen it forms eight-ninths of 
all the water on the globe, and enters largely into combination 
with all the solid constituents of the globe, and is found largely 
in the tissue and fluids of all forms of plants and animals, none 
of which could maintain existence without this element. 

Although a great vitalizer and a potent remedy to increase 
the red corpuscles of the blood, by promoting the activity of the 
lymphatics, and destructive to all micro-organisms in the blood, 
it is totally inadmissible for inhaling or breathing, as it hastens 
destructive metamorphosis in the lungs and other vital organs. 
It is very different when introduced into the alimentary canal ;: 
there nature will absorb just what it requires to vivify and renew. 

Ozone water, which is simply negative oxygen, is one of our 
best vehicles for the administration of oxygen, as that gas libe- 
rates itself when taken into the stomach, is speedily absorbed, 
and does its work in cleansing the blood and tissues of all disease 
germs and increasing vital power. 

Comp. oxygen, or oxygenized water, is also a germicide of 
immense power, destroys all micro-organisms, an antidote to 
narcotic poisons. It destroys the bacilli of tubercle, syphilis, 
cancer, hooping-cough, but is not powerful enough to kill the 
oidium albicans of diphtheria, although it completely annihilates 
the fungus of diabetes with great promptness ; of great utility in 
in all our fevers. 

Its action upon the stomach in small doses is that of a tonic 
and appetizer, will destroy cancer on that viscus ; it cleanses the 
blood, imparts oxygen to the tissues, and has a radical effect 
upon the lymph canals and pink marrow." 



This compound is prepared from 

Ozonized Uric Acid the active principles of hydrangea ; 

Solvent. cleavers ; triticum repens ; iris versi- 

[Antilithic) color; fringe tree; liverwort ; juniper 

berries ; pichi ; salts of lithia ; acetate 

of soda ; nitrate of potassa, with peroxide of hydrogen. 

87 



12^8 DISEASE GERMS. 

This compound is valuable in sterilizing and destroying the 
bacillus amylobacta of rheumatism ; neutralizing the urate of 
soda of gout; disintegrading uric acid crystals. 

Dose : from a half to one teaspoonful, added to water every 
two or three hours. Most efficacious in dissolving uric acid 
concretions or formations, in both liver and kidneys. No remedy 
so effectually relieves a crippled kidney as this, it dissolves and 
washes the debris away, and renders the kidneys able to act as 
depurators of the blood. It relieves renal inadequacy by its sol- 
vent action, flushes the tubules and obviates the state of intersti- 
tial obstruction. 



The great catarrh annihilator. One 

Ozone et Chlorine, thorough application not to be repeated 
sooner than three or four weeks. Pre- 
cautions while using the remedy by the douche : No sneezing 
or blowing of the nose, because the moment the amoeba comes 
in contact with the ozone, it paralyzes them and they aggregate 
together into masses or colonies, leaving their abode in the head 
in a thick, ropy mass. 

Indicated in chronic nasal catarrh, ozaena, eustachian deafness, 
chronic laryngitis, asthma, bronchitis, and in incipient consump- 
tion. 

Before using the remedy paint with a camel's hair brush dipped 
in the fluid in its original strength, the tonsils, uvula, fauces. 
Then use the douche in the following manner : From one to 
two and a half ounces of the compound should be added to six- 
teen ounces of tepid water, and for the purpose of giving a bril- 
liant microscopical exhibition of the contents of the nasal cavity 
in catarrh, with its millions of disease germs, five to ten grains of 
permanganate of potassa should be added to each sixteen ounces, 
simply to color. If no microscopical examination is to be made, 
it can be omitted. The douche or cup for the fluid should be 
made of maple wood, and placed on a stand eight or nine feet 
high. The cup is better to hold twenty ounces. The bottom of 
this receptacle should be perforated large enough to admit a piece 
of pine wood, which should protrude outwards. This, also, 
should be perforated, to which a fine rubber hose is attached, 
long enough to stretch to the ground, to the end of which a 
nose piece of pine wood, large enough to completely fill the nos- 
tril, of an oblong shape, and this is to be perforated by burning 
a hole through it with an ordinary knitting needle. 

In applying this douche, first put in the water, then the ozone 
et chlorine mixture, and add the permanganate. Patient is to be 



BACTERICIDES. I^^g 

seated in a chair, with a newspaper pinned under his chin, secur- 
ing the end, and a square slop basin between his knees, head 
slightly stooping, then run about two ounces or so through one 
nostril, which, if there is no obstruction, will find its way down 
the other; then change the nose-piece to the other nostril, and 
run through about the same quantity, changing from nostril to 
nostril, till it all passes through. While the fluid is running up 
and then down, patient must hold breath well, so as to keep it 
from passing down the larynx. Continue in this manner till it 
all passes. If there is any difficulty with the ear, and it is desir- 
able to run the fluid up the eustachian tube to the inner ear, for 
the relief of deafness, then the patient must hold breath very 
firm, then suddenly, while the fluid is running through the nose, 
close the open nostril with the finger and thumb. This will 
draw up the fluid in the sinuses of the head ; breath held well, 
none can go down the throat, and the superincumbent pressure 
in the douche will force it up the eustachian tube to the ears. In 
this manipulation, the nose-piece must fit accurately, so as- to 
permit none of it running down its sides. The presence of the 
fluid in the ear is readily recognized by the pain in that 
organ. 

The eustachian tube maybe closed by disease-germs, by lymph, 
or it may not be pervious from collapse of its walls, and on the 
first effort it may not be successful ; if this should be the case, 
rest a few minutes, and try again, raising the douche higher and 
telling patient to hold breath still more firmly. If not successful 
at all, give it up for about a week and make another more deter- 
mined effort, and still another, before pronouncing it a hopeless 
case of deafness. The permeation of the tube by the fluid indi- 
cates recovery of hearing. It may have to be repeated every 
month for a few times. If the fluid reaches the inner ear, and 
the pain or distress is intolerable, an effort at emesis should be 
made by tickling the throat with a feather, the gagging efforts 
will cause the fluid to descend. If there is chronic laryngitis, 
with ulceration of the fauces, the back portion of the throat 
should be painted, or brushed over, or smeared with the catarrh 
fluid, in its original strength, or slightly diluted, before it is ap- 
plied by the douche. During the interval of changing nostrils, 
and after it is completed, for several hours patient should breathe 
by the mouth exclusively, and sit in a stooping posture, head 
bent forward so as to permit a free gravitation for the discharge 
with its millions of amoeba from the sinuses of the head. Dose : 
One application of from one to two and a half to sixteen ounces 
of tepid water sufficient to cure the worst case of nasal catarrh. 



38o 



DISEASE GERMS. 



Indicated wherever there are 
Ozonized Syrup of Tar. bacilli or microbes or micrococci 

irritating the periphery of nerves 
imbedded in the highly sensitive and exquisitely organized 
mucous membrane of the larynx ; thus it promptly relieves the 
cough of phthisis, by either sterilizing or destroying the bacilli 
of tubercle. Dose : From a half to one teaspoonful every three 
hours or more frequently, so as to relieve cough. 



Ozone Tablet. — Indicated in all diseases of the skin, and is a 
beautifier of the complexion, an aid to nutrition, a tonic to the 
whole intestinal tract. Triturated, added to a little water. After 
meals. 



The only remedy so far discovered that 
Ozonized Clay, will absorb internal fibroid tumors in either 
chest or abdomen or external infiltration ; 
it causes absorption of effused lymph in true and false anchylosis ; 
it has most marvellous power of absorption, it penetrates to 
internal parts by endosmosis, and softens and disintegrates. It 
is efficacious in all simple or malignant grovv^ths, tumors or swell- 
ings, of great utility in infiltrated breasts, goitre, consolidation of 
lungs, thickening of the walls of the stomach, ovarian and uterine 
tumors, enlarged liver ; very large tumors disappear under its in- 
fluence with remarkable celerity, no matter where located. 

Dose: Take sufficient quantity of the clay, add to it cold 
water, and while pouring on the water, keep constantly stirring 
until a paste suitable for a poultice is formed, then spread on fine 
muslin the size of the tumor or growth. Apply for a few hours 
every day, not long enough to cause erythema of the cutaneous 
surface. It should be bandaged or strapped over the part. 



It is invaluable in destroying all micro- 
Ozone Water, organisms or disease-producing germs in the 
human blood, annihilates the germs of 
typhoid fever, of erysipelas, of diphtheria, scarlet fever, small- 
pox and other contagiunt vivum. It is of great value in all 
nervous diseases, cleansing, purifying, vivifying, vitalizing and 
increasing renewed molecular growth of the entire nervous sys- 
tem. It IS true brain or nerve food, vitalizing and feeding, by 
promoting good blood for healthy brain. It is of great utility in 
all derangements of the stomach ; it annihilates the sarcinae of 



BACTERICIDES. 



381 



gastric catarrh, corrects faulty nutrition, the outcome of indiges- 
tion and mal-assimilation of food, promotes gestation and lacta- 
tion and is a true physical restorer in all cases of sexual debility. 
See peroxide of hydrogen, with which it is identical in chemical 
composition. 

Dose : From half to one teaspoonful in half a tumbler of 
water every three or four hours. 



Map out the cancer. Cover sound parts 

Ozone Paste, with several layers of adhesive plaster, cut a 
piece of table oil cloth somewhat larger than 
the size of the cancer, spread it over with ozone paste one-fourth 
inch thick, then apply. It may remain twenty-four, forty-eight, 
or even seventy-two hours, but best to renew every morning till 
it is completely killed, or drops out, then poultice and dress as 
an ordinary ulcer. 

Paste can be charged with ozone to any degree of strength, 
prepared to suit all and any special case. 

This paste is the most powerful germicide ever prepared, being 
simply ozone gas condensed by immense pressure into an inert 
powder, forming a paste of marvellous oxidizing power, which 
has a special and peculiar affinity to unite with and chemically 
annihilate all disease germs or microbes or micro-organisms 
without pain or loss of blood. 

Although it has a special affinity for the cancer germ, and will 
effectually destroy it by a process of oxidation, and convert the 
germ or tumor into an ozonoid or an inert body, nevertheless it 
is destructive to healthy tissue. What is claimed for this paste 
is, that it is the most powerful and least painful of all remedies 
ever discovered for the cure of cancer. 

For external use only. 



Indicated in all breaches of continuity 
Ozone Ointment, as a dressing to protect, heal and kill 
disease germs. The best application for 
wounds, cuts, bruises, burns, piles, ulcers and cutaneous erup- 
tions. Its action is unexcelled in the bites of insects, ivy and 
sumach poisoning, boils and erysipelas. It annihilates. the germs 
of variola on the face, nose, mouth and throat ; sterilizes diph- 
theric and aphthous patches in the mouth or on the nipple. 

When the tubercular bacilli have invaded lung structures, it 
can be spread on chamois or linen and applied over the germ 
colony, aiding the internal remedies in promoting the dissolution 



1382 



DISEASE GERMS. 



of the germs. The range of action of this ointment is immense, 
from the most malignant cancerous phagedenic or syphiHs ulcer, 
to the simple form of abrasion. 

Ozone ointment is a most efficient remedy in tinea capitis. A 
species of epidemic of this parasite recently occurred in one of 
our reformatories, which resisted ordinary remedies, when this 
was successfully applied. The disease was accompanied with 
severe itching and irritation, which at times became so intoler- 
able as to make the patients lose all control, and in five minutes 
undo the effect of a fortnight's treatment. All the usual reme- 
dies, including internal sedative treatment, were tried without 
avail for over two months. Ozone ointment was then resorted 
to, and the result was most satisfactory. The disease soon passed 
out of the acute stage, the itching was relieved, the red papules 
speedily disappeared, and the discharge ceased. In a very short 
time the patients became convalescent. 

Dose : The most efficacious ointment ever introduced. To be 
spread on linen and applied twice or three times daily. 



This tree grows in all tropical and sub- 
Papoid. tropical countries to a height of from fifteen 

{Carica Papaya.) to twenty feet, with leaves only at the top, 
where also the fruit grows close to the stem. 
The leaves are from twenty to thirty inches long. The fruit is 
of a green color, very similar in appearance, flavor, and odor to 
a small melon. By the natives it is eaten 
raw or boiled. The seeds are round and 
black, and when chewed they have the odor 
of cresses, bitterish to the taste. The pow- 
dered seeds and juices of the unripe fruit are 
most powerful anthelmintics. The juice of 
the fruit and the sap of the tree have power- 
ful germicidal properties : even the exhala- 
tions of the tree will preserve beef, mutton, 
poultry, game, keep them fresh for an in- 
definite time if hung up near to it, or on 
it; besides, it renders the toughest meat 
tender in a short time. It is a tree of rapid 
growth, exceedingly prolific, bearing fruit 
all the year round. 

The juice of the fruit contains a principle 
called papoid, a peculiar soluble digestive ferment, which is des- 
tined to supersede pepsin, as it will dissolve fibrine in the pre- 
sence of acids and alkalies, and in neutral solutions. 




Papaw Tree ( Carica 
Papaya) . 



BACTERICIDES. 



1383 



The juice of this remarkable fruit has a tendency to undergo 
butyric fermentation, which is prevented by adding glycerine 
to it. 

The active principle is worthy of universal use, as a drug to 
displace pepsin, very valuable in chronic gastric catarrh ; all 
forms of dyspepsia. 

Papoid digests better in the presence of a small quantity of 
fluid than when much diluted, thus possessing a greater advan- 
tage over pepsin and pancreatin, which in order that they digest 
well, require a large amount of fluid. 

It is a remarkable solvent to the false membrane of croup and 
diphtheria, more recently it has been used as a solvent for fib- 
rous growths in the bladder, stricture of the rectum, cutaneous 
cancer, epithelioma of the lip. Still more recently, it has, by 
continuous administration, opened an oesophagus closed by car- 
cinoma, by its powerful dissolving action. 

Intestinal indigestion may be greatly relieved, and in many 
cases practically cured, by the judicious exhibition of papoid. 
It is useful in all forms, but its value is more especially notice- 
able in those cases where constipation is a prominent factor, ac- 
companied by distension within a couple of hours after taking 
food. The method I have adopted, consists in the administra- 
tion of two grains of papoid powder in capsule before meals, the 
dose to be repeated two hours later, if flatus occurs. One par- 
ticularly valuable application which should not be overlooked, is 
its use in the treatment of attacks of a dull, disagreeable head- 
ache, depending upon indigestion ; a common affection amongst 
literary persons. Two grains of papoid powder, dry in capsule, 
will disperse it generally in from three to five days. 

It converts five times as much albumen into peptone as the 
best animal pepsin. It increases the flow of gastric juice by 
stimulating the peptic glands, acts as well with an acid as an 
alkali. With ozonized boroglyceride gives excellent results in 
gastric catarrh, as it kills the sarcinae. It is the greatest galacta- 
gogue known in medicine, also an abortifacient. Dissolves the 
germ colony or false membrane of diphtheria. 



This is comparatively a new hypnotic, and 
Paraldehyde, one that promises to be of much interest and 
^ value in the treatment of the various causes of 

wakefulness. It stands in the same rank as chloral, but is much 
safer, acts quicker and gives a more natural sleep. Several have 
written in high terms of its utility and safety. Like all new 
remedies, it is somewhat expensive. This dose is from one to 



'384 



DISEASE GERMS. 



two drachms. The name indicates its oily nature, and this is a 
difficulty which has to be met in prescribing. It is usually made 
into a draught by suspending in tragacanth powder, sweetened 
with syrup. I generally give it with whiskey or brandy in the 
proportion of one to three. The oiliness disappears when mixed 
with the stimulant, which is, I am convinced, a most useful ad- 
junct to every hypnotic. In its action it is gradual, and should it 
fail to produce sleep, it does not excite. Its use is not followed 
by headache or gastric disturbance, but it continues to be excreted 
by the. lungs for many hours afterwards. This is by some con- 
sidered a great objection. Now it may be, and no doubt is, an 
objection, but as one writer very truly says : ** Should we not 
rather look upon the disagreeable breath as a safeguard against 
the clandestine use of the drug, and not in the light of an objec- 
tion?" There is no accumulative principle in paraldehyde, and 
I have not met with a case of intolerance. It, however, is a much 
more valuable hynotic than sulfonal. 

Probably the best American authority on this subject is Prof. 
IV. H. H. Crandall, M. D., of Des Moines City, Iowa, who says : 

" Aldehydes have a strongly irritant action upon mucous mem- 
branes, and this is a great objection to their use as hypnotics. 
But they have a power of uniting with themselves, or polymeris- 
ing, as it is termed, and these polymeric forms are less irritant. 
Ethylic aldehyde unites with itself, and when three molecules of 
it combine it forms a paraldehyde. When several molecules, the 
number of which is unknown, combine, it forms metaldehyde. 
Paraldehyde is a useful hypnotic, which does not depress the 
action of the heart like chloral, and does not give rise to discom- 
fort next day. The chief objection to it is the unpleasant smell, 
which it imparts to the breath and which hangs about the patient 
for many hours." 



This medicament is excellent to 
Passiflora Incarnata. relieve the nervousness and insomnia 

in convalescence from fevers. We 
have been employing it in some cases of spinal meningitis after 
the acute symptoms had subsided, when the patients were unable 
to sleep either day or night, could not endure the bed, and were 
unable to maintain the sitting posture, with highly satisfactory 
results. It is administered in small doses. Add ten drops of 
the mother tincture to half a tumbler of water, teaspoonful every 
two hours. 



BACTERICIDES. 



1385 



They are of the greatest efficacy in all uterine 
Pastiles. diseases, and are an invaluable boon to both 

(Ozonizcd}j single and married ladies, if they are suffering 
from any disease of the womb. They positively 
-cure whites, falling and ulceration of the womb, induration, 
granular erosions and catarrh of its neck, all forms of painful 
menstruation, neuralgia, dragging in the back, and every morbid 
condition incidental to that potent organ, the motive power of 
the universe. They also overcome the condition of sterility 
and impotency, impart great tone, strength and vigor, to the 
sexual organs. 

They should be inserted when in the recumbent posture. It 
should be inserted up the vagina as far as possible with the finger 
and allowed to remain ; shortly after its introduction it will dis- 
solve and come in contact with the diseased parts. The v^agina 
should the following morning be washed out. 

Discontinue the use of the pastiles during the menstrual period ; 
when they disappear resume their use again, until the affection is 
•cured for which they were originally used. 



Peppermint. 

{Mentha Piperita}^ 



Extensively cultivated for its fragrant, 
bactericide oil, which is obtained by dis- 
tillation. 

The oil of mentha piperita 
the most valuable germicides. The pure oil painted 
on the diphtheric membrane instantly kills the strep- 
tococcus, causes it to shrivel up, completely annihi- 
lating the micrococci and spores ; the membrane 
peeling off eventually, leaving a health}-, healing 
surface behind. 

All varieties possess the same invaluable pro- 
perties. 

It has a wide range of action, being a stimulant 
and carminative. 




Water Mint. 



A fluid extract of the common pellitory is a 
Pellitory. bactericide of considerable power. In doses of 
from ten to twenty drops it is very efficient in 
clearing the alimentary canal of all forms of microbial life. 

Two species of streptococcus have been found in the pulp of 
decayed teeth, both agents of lactic acid fermentation. They 
are in the form of cocci, diplococci and chains, and are the cause 
of toothache. The old germicide remedies, creosote, cloves and 



1386 



DISEASE GERMS. 



arsenic are entirely superseded by a 
saturated or mother tincture of the 
common pellitory. 

This is a germicide of great power, 
in all cases it destroys the micro- 
organism in the cavity of the tooth. 
Besides the internal use of the drug, 
it is of great value as a diuretic, re- 
frigerant and lithontriptic. 



Pennyroyal. 




Pellitory. 



This is a grate- 
ful aromatic, car- 
minative and dia- 
phoretic — stimulating the stomach, 
bowels and kidneys, and an elegant 
efficient diaphoretic. The greatest 
care should be exercised in prepar- 
ing the infusion so as to retain its 
volatile oil, which escapes altogether 

if permitted to boil. The essential oil is 
inimical to microscopic life. So the remedy 
may be used in mucilage of gum arabic as 
a powerful germicide. The oil possesses 
all the antiseptic properties of the pepper- 
mint and eucalyptus, and hence will destroy 
fungous growths. 

It is an antidote to the stings of the 
mosquito and other insects. 




Pennyroyal. 



A digestive solvent, of great 
Pepsin, value in all forms of dyspep- 
sia, as it supplies a direct de- 
ficency in the animal economy. 
A most eligible form is the wine of pepsin, made by cutting up 
a cleaned call's stomach and covering with good sherry wine, 
macerating for two weeks, then percolating, and to every pint of 
it add half a pint of brandy to preserve. 
A teaspoonful after meals. 

The ozonized pepsin prepared by peroxide of hydrogen is the 
best for general use. 

The field for the use of pepsin seems constantly extending 



BACTERICIDES. 



1387 



with the improvements made in the quality of this agent, and it 
may now be employed with greater certainty as to residts than 
ever before. The application of pepsin to digest away the mem- 
brane in diphtheria and membranous croup is not new, and is 
more or less commended and resorted to by physicians in the 
treatment of these diseases. 

Naturally, however, its utility depends entirely upon its diges- 
tive activity, and on account of the many preparations of pepsin 
of feeble or no digestive power heretofore at the disposal of 
physicians the results obtained have been in some cases dis- 
couraging. 

As to the value of pepsin, however, in these affections when of 
proper purity and strength there can be no question. 

It is to be hoped, and it is certainly highly probable, that the 
further study of digestive ferments will lead to a pepsin still more 
active. 

If the false membrane could be easily digested, and there 
seems no reason why it might not be with a pepsin of high diges- 
tive power, we could expect to have fewer grave cases of interfer- 
ence with respiration and blood poisoning from absorption of 
septic material, now alas so frequent. 

The three agents which have been most extensively used as 
local solvents for the false membrane of croup and diphtheria are 
papayotin, trypsin and pepsin. 

Papayotin is a vegetable agent recently introduced, claiming 
to have the same digestive properties as pepsin. Dr. Cannon 
treated forty cases of diphtheria with papayotin and gives the 
following conclusion : First. It exercises a feeble solvent action 
when the membrane begins to decompose. Second. The deli- 
cate new membrane is not affected by it. Third. It exerts no 
effect on the mortality of the disease. Its present high price is 
also somewhat against it. 

In the use of trypsin it is necessary to maintain an alkaline 
condition of the throat, as trypsin acts only in alkaline solutions. 
The secretions of the mouth and throat in these diseases is 
strongly acid, and tend to neutralize and destroy the power of 
the alkaline solution of trypsin. 



Permanganate Potass. — Emmenagogue, kills microbe of 
snake bites and the fungus of diabetes. The best preparation ot 
manganese. ' 



Dose : One-half to one grain in water. 



1388 DISEASE GERMS. 

The fluid extract of pichi is indicated in all affec- 
Pichi. tions of the urinary organs ; especially useful in all 
catarrhal states of the bladder and prostate. It is the 
primary agent in the uric acid solvent. In that formula it allays 
irritation, causes the disintegration and expulsion of calculi in 
the uric acid diathesis. Dose : From a half to one teaspoonful 
everv^ three hours. 



The great value of this very ex- 
Peroxide of Hydrogen, cellent remedy is being seriously 

injured by its indiscriminate manu- 
facture by irresponsible parties who have been supplying the 
drug trade with a highly impure article. To such an extent has 
this been done as to render its employment in medical and sur- 
gical practice extremely dangerous. 

A remedy like this, which is indicated in all microbial dis- 
eases, should invariably be of the highest possible standard of 
purity. 

There is no morbid state, acute or chronic, in which this 
remedy is not indicated ; in all fevers its use is indispensable ; in 
mumps, hooping-cough, cholera, dysentery, by killing the mi- 
crobe, diseased action ceases ; in burns, boils, cuts, wounds, and 
gangrene, it destroys every vestige of germs. 

Physicians would do well to keep it in every family who are 
under their professional care, its employment is safe, its applica- 
tion never can injure, and it can always be depended on to kill 
the microbe of membranous croup, and thus save human life. 
Mothers can readily be intrusted in its use. 

AphthcB, follicular sore throat, oedema of the glottis, a gargle 
of from two to four volumes rapidly effects a cure by the de- 
struction of the germs. 

In nasal catarrh, after the mass of germs have either been an- 
nihilated or caused to migrate by a douche of the ozone et chlo- 
rine, following in a few days with a douche of one ounce of a fif- 
teen-volume strength of the peroxide of hydrogen to seven 
ounces of tepid water, and repeating this occasionally, a most 
excellent cure is the result. 

In epistaxiSy an eight-volume solution immediately arrests 
hemorrhage by coagulating the blood, and causing contraction 
of the blood vessels. 

The eruptive fevers are deprived of all their malignancy and 
danger by their treatment with germicides. What a saving of 
human life is effected in diphtheria and scarlet fever by the use 
of the glycerite of sulphur internally ; what a destruction of 



BACTERICIDES. 



1389 



germs, what a speedy recovery if the child is daily bathed with 
peroxide of hydrogen. It destroys the germs on the skin, pre- 
vents the peeling, which is the most infectious media. 

A ten or fifteen-volume solution applied to any venereal sore 
or chancre, instantly kills the microbe syphilitica. For inhalation 
it excels all known bactericides, sterilizes speedily all the tissues 
with which it comes in contact, stimulates the reproduction of 
healthy epithelium. 

The peroxide in an atomizer by the bedside of the patient, 
yields good results in all cases of diphtheria and malignant sore 
throat. 

In addition to other forms of microbic disease, the result of 
sewer gas poisoning, numerous cases of diarrhea and albumi- 
nuria are clearly traceable to that cause, sewage poisoning, intes- 
tinal irritation, nephritic congestion. 

An epidemic of typhoid, or diphtheria, or metria, or erysipelas, 
naturally excites attention to the drainage, but no attention is 
paid to that terrible feeling of goneness experienced by eighty 
per cent, of the population of our large cities, who are suffering 
from exposure to its morbific agency. Diarrhea and albuminuria 
having such an origin, are the result of a physiological effort by 
the bowels and kidneys to eject the germs and their noxious pro- 
ducts from the system. 

Such states are promptly relieved by the internal exhibition of 
the dioxide of hydrogen, which acts as a scavenger to diseased 
blood. 

The injecting of boils, abscesses, with a few drops of the per- 
oxide, instantly kills the streptococcus pyogenes ; healing the 
abscess by one application. 

Dose: half a drachm of the solution mixed with an ounce of 
distilled water, every four hours. 

There is a brilliant future for peroxide of hydrogen. In addi- 
tion to its great bactericide properties, it has a most remarkable 
property of aiding the absorption of fibroid tumors by a chemico- 
electric process — by simply keeping the electrode over the tumor 
constantly moist with C. P. medicinally pure peroxide of hydro- 
gen ; by endosmosis it enters the tumor, excites an absorptive ac- 
tion, by a withdrawal of its water and oxygen, at the same time 
liberating positive ozone, a bacterial destroyer. Electricity is 
thus a medicament of ponderous value. After each treatment 
there is a feeling of great comfort and freedom from pain, and 
eventually complete recovery. The method was first brought to 
the attention of the profession by Prof John J. Siggins, M. D., of 
Philadelphia, aad more elaborately carried out by his pupils, A. 
Parks, M. D., 517 W. Twenty-third street, New York, and F. A. 
Tuttle, M. D., 233 Main street, Springfield, Mass. 



I ^Qo DISEASE GERMS. 

is the acetyl of phenetine, i. e., of the ethyl- 
Phenacetine ether of the paramidophenal. Its crystals have 
a great resemblance to those of antipyrine ; 
they are white, odorless and tasteless. This absolute tasteless- 
ness renders the administration of the drug very easy. Similar 
to antifebrine it is very slightly soluble only in water, more so in 
hot water, but on cooling it is precipitated again. It is more 
readily soluble in glycerine, most readily in alcohol. The physi- 
ological action of the drug is that of a powerful cerebral stimu- 
lant ; as such it acts as a reliable antipyretic in all fevers and in- 
flammation ; as such it soothes the pain of neuralgia, as head- 
ache, angina pectoris, sciatica, ovarian irritation ; as such it is of 
great value in vasomotor neuroses, in the lancinating pains of 
locomotor ataxia ; it is a strong analgesic, does not produce 
cyanosis, like antifebrine ; acts very rapidly in spite of its insolu- 
bility in the gastric juice, and its administration is free from all 
untoward or depressing influence whatever. As it has a direct 
action upon the central nervous system, it exercises a powerful 
effect upon the circulatory system, its use being followed by a 
copious sweat. 

a glucoside, prepared from the root of the apple 
Phlorizin, tree, is a peculiar germicide, sterilizing the blood 

for quite a number of microbes. It should be 
administered in small doses, in a high state of trituration. It is 
most efficacious wherever ordinary bacteria are present in mal- 
assimilation. It, in a most remarkable manner, increases the 
transformation of sugar in the liver, and will produce glycosuria. 
It does this by lessening the normal process of oxidation, by 
which it should be converted into carbonic acid. 



Phytolacca. — Next to saxifraga the best vegetable alterative 
in the Materia Medica ; when ozonized it destroys the microbes 
of syphilis, cancer and tubercle. Dose : One teaspuonful every 
three hours. 

Platinum Chloride. — Useful in syphilis. Dose : One-thir- 
tieth of a grain triturated in sugar of milk, thrice daily. 



A germicide, warm, aromatic stimulant, used as 
Pimento, an adjuvant to tonic and purgative medicine, the 
taste of which it serves to disguise, while it in- 
creases their warm, their antiseptic properties, and renders them 
more acceptable to the stomach. 



BACTERICIDES. 



391 



It is specially indicated in dys- 
pepsia with flatulence. 

It is an excellent remedy in feeble 
heart, gives it tone, strengthens its 
contractions ; valuable in all cases 
of heart failure with passive hepatic 
engorgements. 

The tincture of pimento is of 
great efficacy in chilblains. 

The resinoid is a most useful 
auxiliary to sulphate of quine in the 
treatment of rebellious paludal fev- 
ers, and even in paludal dyscrasia. 
Useful also combined with solid ex- 
tract of black willow in leucorrhea, 
gonorrhea, and in constipation due to torpidity of the liver. 




Pimento. 



This is really the only genuine prepara- 
Phosphated tion of oats, differing from all others in 

Tincture of Oats, containing the entire amount of the glu- 
{Avena Sativa) coside " avena " in a given portion of the 
grain; it is prepared from the genuine 
Scotch oats, and before being tinctured and ozonized, is made to 
undergo acetous fermentation, so as to evolve its entire phos- 
phatic elements ; this mode of preparation gives it a strong acid 
reaction, and holds in it unimpaired, and in a concentrated form, 
the avena or phosphates. 

This preparation retains the full amount of nitrogen of the 
grain, which is the best criterion of its quality. 

In this form, it is the most nutritious of all agents prepared 
from the cereals, being strength-giving and sustaining, as well as 
flesh-forming, besides being the great brain and bone fertilizer. 

From among all cereals, oats give us the most perfect 
and highest stratum of brain growth and development. The 
amount of brain matter in this preparation excels all known com- 
pounds of the phosphates or hydrophosphites, and in a most 
assimilable form. 

This, the true essence of the grain, is a brain fertilizer, supplying 
that organ with its own constituents ; besides it has a most mar- 
vellous action in blood formation, stimulates the lymph canals, 
rebuilds, recruits tissues and forces lost in the destructive meta- 
morphosis of the body. 

Our entire nation is neurasthenic. This poverty of the nerve 
force, this tissue-starved nervous system is chiefly due to 



I^Q2 DISEASE GERMS. 

mental work, to sexual excesses, to the destruction of the 
phosphates in our food, etc. 

Retarded and difficult dentition, nearly all the cerebral diseases 
of childhood, are due to those causes and are promptly relieved 
by the administration of avena. 

That mysterious languor, that depressing lassitude, undefin- 
able headache and neuralgia, wandering pains, that feeling of 
goneness and dyspepsia, are traceable to defective phrenal nutri- 
tion, and are speedily relieved and cured by the administration of 
avena. 

The immense area of nervous diseases — the brain wearing out 
sooner than of old, civilization being unfavorable for healthy 
brain growth, and the like — is untrue, for it is to the vices, the 
excesses of our present state, to the improved methods of adul- 
terating food, destroying its phosphates, which is aiding in the 
production of cerebral starvation, and pushing upon us an off- 
spring with dwarfed brains and paucity of intellect ; all this can. 
be rectified by the use of " avena!' 

The decided increase of all nervous diseases is plainly trace- 
able in the large proportion of cases to defective cerebral nutri- 
tion, such as epilepsy, chorea, insomnia, brain softening. Wheii 
no organic lesion exists, the use of avena is curative, because it 
is reconstructive. 

The phosphated tincture of oats is a direct stimulant, perma- 
nent tonic to the sexual appetite at the base of the brain, increases 
virile power, and more too, its use promptly replaces the drained- 
off nervo-vital fluid upon which the brain rests (which is 
frequently exhausted by great mental effort or sexual excesses),, 
it is the antidote to that terrible base of the brain pain, peculiar 
to libertines. 

A tissue-starved brain gives rise in all cases to nervous bank- 
ruptcy, to depravity eccentricities, suicidal mania, crime, mastur- 
bation, the creation of habits. It is doubtful whether or not all 
vice, immorality, or crookedness of life, may not be due to a 
condition of tissue-starved brains ; all our nation needs the use 
of avena sativa. 

This preparation, being a reliable brain food, may be presented 
in paralysis, epilepsy, chorea, nerve exhaustion, insomnia, 
cephalalgia, in the alcohol, chloral and morphia habits, with the 
best results. 

The tincture, or fluid extract, prepared from the freshly crushed 
oats, is not nearly so active a brain fertilizer as that prepared by 
permitting the grain to undergo acetous fermentation. 

All who have been disappointed in the use of the remedy 
should try the phosphated tincture. 



BACTERICIDE^ 



1393 



All varieties are ger- 

Plantain. micidal. This property 
resides in all parts of the 
plant. The fresh leaves applied to 
wounds, ulcers, buboes, germinal swell- 
ings, by their anti-bacterial, antiseptic 
properties, discuss or heal them. 

A saturated tincture destroys the 
ordinary microbe in the mouth, and 
thus relieves toothache. 

It is prescribed internally in incipient 
phthisis, bronchitis, leucorrhcea and 
hemorrhages, but its action is too feeble 
to be of much efficacy. 

The seeds of the plantago ispaglniia, 
two drachmiS to the dose, taken in an 
uncomminuted form, in a little jelly, 
passing through the intestinal tract, de- 
stroy the bacteria and sarcin^ of intes- 
tinal catarrh, and heal ulcerations. 




Greater Plantain {Plantago major) 



Pomegranate. 

bark of the root. 



One of the best and most powerful of the 
vegetable germicides and parasiticides, much 
cultivated in warm climates for its fruit and 
In its wild state it is a thorny bush ; when 
cultivated it is a low tree with twigg},^ 
branches. The fruit is as large as an 
orange, with a thick leathery rind of a 
golden yellow color, with a rosy tinge 
on one side. The fruit consists of in- 
numerable berries densely packed to- 
gether in the orange-sized globe, the 
juice of which is highly germicidal, 
pressed with hot water forms a cooling 
antiseptic, a decoction of which is of 
the greatest efficac}' when the oidium 
albicans is evolved or deposited on the 
fauces or tonsils, or the bacterial mala- 
rial germ of dysentery. 

The bark of the root is used as an anthelmintic in tape worm. 

A decoction four ounces of the pulverized bark to one pint of 

boiling w^ater. reduced to one-half pint. Very efficacious taken 

ir^ two doses, half an hour apart ; some add calomel, ten to t\\ent\' 

grains, to stimulate the biliary secretion. 

88 




Section of the fruit of the 
Pomegranate. 



IOQ4 DISEASE GERMS. 

Sulphate and Tannate Pelleterin. — The alkaloid pelleterin, sul- 
phate and tannate (the latter is usually preferred, as being most 
active) is administered in doses of five grains, more or less, accord- 
ing to the constitution of the patient, observing the precaution of. 
a sweet-milk diet the day before, with no food the day of adminis- 
tration. Thirty minutes after administering the pelleterin a brisk 
cathartic should be given, as an ounce of the comp. tincture of 
jalap, and the same quantity in another half hour. The worm 
usually follows. Valdivine is a glucoside from the same root, 
equally efficacious. 

Another popular formula is: pulverized pomegranate red bark, 
half an ounce ; crushed fresh pumpkin seeds, one ounce ; ethereal 
extract male fern, one drachm ; powdered ergot, half a drachm ; 
powdered gum arable, two drachms ; croton oil, two drops ; add 
to the whole one pint of boiling water. Simmer down to half a 
pint, which is to be taken in two divided doses, one hour 
apart. 

Valdivine, a glucoside from pomegranate root bark, pump- 
kin seed, male fern, koussa, kanula and other taenicides. This 
preparation is identical with the dSk.2\o\di'' pelleturin ;^' put in 
extract of gentian and capsules, ready for administration. 

The patient should take very little food for two days, and that 
little should be of a fluid nature. On the evening of the second 
day, he should take a purgative (castor oil is best) of sufficient 
strength to cause an evacuation of the bowels ; in the morning, 
after the castor oil given the previous evening has operated, and 
while still fasting, the patient should take seven or eight capsules 
along with a full dose of castor oil, or other purgative ; follow 
that with another eight capsules to another dose of castor oil. 
The worm generally comes away within two hours after taking 
the second dose of capsules. 



The ozoniferous properties of the buds and bark 
Poplar, of this tree are too well known to require a descrip- 
tion. The leaf-buds are covered with a resinous 
exudation, which has a peculiar ozoniferous balsamic odor, with 
a bitter pungent taste. This exudation is highly antiseptic, is 
present in all species of the poplar and is most abundant in the 
buds. Poplar buds are as ozoniferous as turpentine, and make a 
most valuable tincture, liniment and ointment. The formula for 
the poplar ointment which is so popular is by simmering the 
leaves and buds for twenty-four hours in lard ; then removing 



BACTERICIDES. 



1395 



the crisped leaves and buds and adding more, and so on till the 
lard becomes saturated. This is to be done over a gentle fire. 

To this same ointment some add 
poppy heads, belladonna and hen- 
bane leaves, and digest them for 
twenty-four hours. It makes an 
excellent anodyne ointment for 
irritable or painful ulcers. 

The poplar bark makes a very 
superior tonic, very valuable in 
indigestion and all debihtated 
states of the system. It has a 
special tonic action on the liver 
and kidneys and corrects their 
deficient action. It is one of the 
most serviceable remedies in the 
Materia Medica. 

The bark yields largely of sali- 
cin, benzoic and other antiseptics. 




Poplar Buds 



This remedy is indicated in all states of nervous 
Protagon, bankruptcy. It is both in liquid and crystalline 
form, containing nitrogen and phosphorus. It 
does not differ chemically from kephaline. It is called protagon, 
as it was the first definitely ascertained specific constituent of 
brain. Dose : ten to thirty drops of the liquid, one to three 
grains of the crystals, after meals, every three hours. 



An invaluable non-alcoholic compound, contain- 

Prunia. ing all the tonic, vitalizing properties of the wild 
cherry bark, with its innate hydrocyanic acid unim- 
paired, and four volumes of the dioxide of hydrogen. 

The preparation is of great efficiency in some cases of pulmo- 
nary tuberculosis, being a bactericide of average power and 
operating most activel)'- upon the bronchi, pneumogastric and 
vagus. 

It has been found of utility in pneumonia, pulmonary tubercu- 
losis, bronchitis and other forms of microbial affections. 

The average dose is a teaspoonful every three hours. 

One of the leading physicians of Iowa, R. Small, M. D., of 
Decorah, in speaking of prunia, says : " The compound known 
as prunia is the most perfect sedative and lung tonic ever intro- 
duced to the profession; mitigates the intensity of all pulmonary 
affections, and aids the action of other bactericides. 



1396 



DISEASE GERMS. 



This plant, in the form of a mother tincture, or 
Pulsatilla, an alcoholic extract by percolation, yields a most 
efficient germicide, alterative and cerebral seda- 
tive of considerable power. Alone or combined or alternated 
with the tincture of kalmia, it is most efficient in destroying the 

syphilitic germ in the blood, and is 
a remedy of great value in chronic 
cutaneous affections. It was first 
brought to the notice of the profession 
as a therapeutic agent to calm the re- 
flex centres, in uterine and genital irri- 
tation transmitted, which gives rise 
to morbid states termed hysteria, mel- 
ancholia. Take it all in all, it fills a 
gap to which the bromides do not 
reach. 

In order to illustrate the remarkable 
action of this drug on the genito- 
urinary system, a trial of two-drop 
doses every three hours is suggested in spermatorrhoea, metritis, 
epididymitis. 

It exerts a special influence upon the reproductive organs of 
both sexes, restores normal menstruation, relieves the wander- 
ing pains incidental to gestation, and even exceedingly useful in 
neuralgia of the testes. 




Pulsatilla. 



is a colorless liquid, of a peculiar odor, readily 
Pyriden soluble in water and of a strong alkaline reaction 
when in solution. It is a product of the dry distil- 
lation of organic substances containing nitrogen and carbon, such 
as coal, bones. It absorbs water rapidly on exposure to the air. 
This is an invaluable remedy for inhalation in asthma and 
dyspepsia associated with disease of the heart. A few drops 
poured upon a plate, the patient with down-turned face inhales it 
for a few minutes. This can be repeated three or four times 
daily ; it affords prompt relief, and continued persistently, for a 
few weeks effects a cure. 



is an antipyretic drug, the active ingredient of 

Pyrodin, which , is acetyl-phenyl-hydrazin. It is in the form 

t . . :j , . , pf a powder, sparingly soluble in cold water ; having 

.neither an unpleasant taste nor smell, causing no irritation of the 

stomach. When administered it acts promptly and powerfully 



BACTERICIDES. 



397 



in reducing temperature by destroying the germ, the factor of 
fever ; hence it is of great utility in all fevers in which a disease 
germ or microbe is present. It acts well in all cases, but it must 
be carefully watched. It neither causes nausea nor vomiting, 
acts quickly and more powerfully than antipyrine, antifebrine, 
phenacetin. 



*5i£- 



The leaves of this plant 
Raspberry, yield their medicinal pro- 
perties freely to water. 
They contain a large amount of tannin and 
gallic acid ; a decoction, used tepid, pos- 
sesses in a most remarkable degree, one 
of the finest astringents in the Materia 
Medica. 

It is an excellent vehicle for the admin- 
istration of bactericides, thus : add some 
boroglyceride to it, it is an infallible eye 
lotion in all forms of ophthalmia ; add a 
small quantity of the eucalyptus distilla- 
tion to it, most efficacious in gonorrhea 
and leucorrhea. 




Raspberry. 



One of the derivatives of benzol, a germicide of 

Resorcin. the highest rank : a one-per-cent. solution will re- 
tard, and a two-per-cent, solution will arrest fer- 
mentation and coagulate albumen. 

These strengths do not irritate the skin, but stronger solutions 
might. Internally, five-grain doses may be readily taken three 
times a day in any simple vehicle ; but in larger doses, say from 
ten to thirty, it produces a striking resemblance to the effect of 
alcohol and other stimulants, quickening the pulse, causing flush- 
ing, giddiness, tinnitus, sweating, increasing the secretion of tears 
and saliva. It is an invaluable germicide, being specially inimi- 
cal to all microbes on the mucous membrane of the mouth, stom- 
ach, intestines, and bladder. If administered in aphthae, or sar- 
cinae ventriculi, or cholera infantum; or typhoid fever, or injected 
into a tubercular rectum or bladder loaded with fungus growths, 
it annihilates colony after colony of the germs, with a brilliant 
precision. By killing microbes it reduces heat. 

You can watch the physiological effects more plainly than of 
other drugs of this class. 

When the temperature is down, )'ou can keep it there by re- 
duced doses, one or two hours apart. 



1398 



DISEASE GERMS. 



Being a valuable antiseptic, it would seem to be especially in- 
dicated in fevers of septic origin. 

It will be particularly valuable if proved clearly, as circum- 
stances now tend to show, that it deranges the organs of digestion 
less than the other antipyretics. 

Its great solubility renders it of intrinsic value in otorrhoea 
and purulent ophthalmia, nearly as active a microbe killer as the 
ozonized boroglyceride. 

In various skin affections, put up in ozone ointment, or oil of 
boroglyceride, it gives great satisfaction, being more energetic 
than the best mercurial preparations. Gelatinized bougies of 
resorcin and boroglyceride will kill the gonococcus of gonorrhea, 
and one of them introduced into the uterus in a chronic case of 
intra-uterine catarrh, will effect in a few minutes what years of 
treatment could not effect. 

Most gratifying results can be relied on in cholera infantum 
and typhoid fever, and in ophthalmic and aural cases ; but its 
great anti-microbe properties fail before the giant germ of 
syphilis. 

The doses of resorcin may vary from ten to fifteen grains a 
day in light attacks, up to seventy-five grains as a maximum. 
It should be dissolved in about twenty parts of water or any 
other excipient, for which orange syrups, glycerine, brandy, etc., 
are suitable. It will also form good emulsions with almond, 
etc., or may be given in wafers. Used as a cleansing agent, it 
produces neither rust, nor does it affect the edges of knives. 
The odor of iodoform is almost entirely destroyed by it. 

Resorcin is used with much success in the treatment of epithe- 
lioma, and other cancerous diseases. Mix resorcin and ozone 
ointment in equal parts, and use locally to the diseased part, 
after a day or two, apply a milder ointment of two parts of re- 
sorcin and three parts ozone ointment. After the eschar is 
formed, then clean and dust over with iodoform ; boric acid, 
equal parts. Dress the wound with an ointment, one part resor- 
cin to ten parts ozone ointment. 

Resorcin rubbed up in ozone ointment, by its reducing or 
withdrawing oxygen power, applied in eczema, coagulates the 
serum and produces a firm germicidal covering, under which a 
rapid healing takes place. 

Thio-Resorcin is a combination of sulphur with resorcin, in the 
form of a powder, without smell and entirely non-poisonous. 
It is used as a substitute for iodoform, and usually applied as a 
dusting powder and often made into an ointment with ung. petro- 
leum of the strength of from ten to twenty per cent., for eczema, 
psoriasis, scabies, and other vegetable or parasitical skin diseases. 



BACTERICIDES I ^qq 

For barber s itch, etc. — Resorsin, -one drachm ; glycerine, water, 
of each one ounce; lac sulphur, one and a half ounces ; cologne, 
a half ounce; alcohol, four ounces. Mix. Apply to the af- 
fected parts several times a day, using a soft sponge. Bath the 
parts every morning in hot water. Ether, half ounce, to dis- 
solve the sulphur before adding the latter, makes the prescription 
more pleasant to use. 

Reduced by the most careful trituration and sifting to an im- 
palpable powder, it is highly recommended by the most eminent 
dermatologists as superior to any other germicide in eczema or 
irritation of the skin. 

It is insoluble in water and very sparingly soluble in ether or 
alcohol. 



Rhigolene. — This is the impure hydride of amyl, and is the 
lightest fluid of the petroleum series, and is well adapted for pro- 
ducing local anesthesia, and its bactericide properties render it 
very useful as a local application wherever a germicide is indi- 
cated. 



in incontinence of urine has passed into 
Rhus Aromatica household words. In Europe the medi- 
cament is becoming a well-known agent in 
the treatment of this affection, and its greatest success is in 
children. A great deal of trashy stuff is put on the market and 
sold under this name. When made of the recent article the 
medicament is well-nigh specific in enuresis and diabetes insipi- 
dus. It is also a grand heart tonic and valuable in chronic 
cystitis of old men who suffer from enlarged prostate and chronic 
catarrh of the bladder. 

Rhus tox. in incontinence of urine is said by Dr. J. H. Moon, 
M. D., of Montpelier, Idaho, to be a reliable medicine. He gives 
several cases of this disease cured with the remedy. In a simple 
uncomplicated case the following was prescribed : Rhus tox. 
three drachms ; glycerine, two ounces ; water, q. s. ad four 
ounces. Mix. Teaspoonful four times a day. Iron was given 
for the anaemia. The rhus and iron treatment was continued 
three months, a complete cure was effected. 

Rhus tox. is also a very valuable medicament in cases when 
patients (mostly women) complain of the urine scalding the 
urethra and meatus. It is often a really curative medicament in 
the severe back ache some women are so much tormented with. 



1400 



DISKASi: GliKMS. 



one of the oldest germicides, was 
Rue, held in high fav^or as a great 
ozone liberator, and preventive to 
contagion. It is also a tonic, diuretic, laxa- 
tive and vermifuge, but its real intrinsic 
value in fluid extract, decoction, essential 
oil, or emulsion is as a bactericide ; it kills 
the oidium albicans, neutralizes, or checks 
the chemical action of the ptomaines in 
cholera infantum. 

A decoction, sweetened for children, 
cleanses the entire intestinal tract of mi- 
crobes, thus wards off convulsions or fits, 
epilepsy due to reflex irritation. 

Although but a simple herb it is a valu- 
able stimulant and antispasmodic. Still it 
must not be administered in large doses, as it produces gastro- 
intestinal irritation, cerebral derangement, and acts energetically 
on the uterus. 




Rue Graveolus , 



A sweetening substance two 
Saccharin, hundred and eighty times 

{Sulphinide of Be?trjoic Acid) greater than cane sugar. A 

white crystalline powder solu- 
ble in two hundred and thirty parts of water, but very soluble in 
alcohol or ether. It has a faint odor of bitter almonds, which is 
more perceptible on heating. Chemically and physiologically 
totally different from cane sugar, being a powerful bactericide 
and unfermentable. It is indigestible, inert, non-toxical ; passes 
out by the urine unchanged. Its chemical reaction is that of a 
weak acid. 

In diabetes, where cane sugar, starch and other products feed 
the glucose fungus, it may afford the patient sweet nutriment, 
but in all other respects, that is as a dietary and medicinal agent, 
it is worthless. 

The eminent T. H, Goodman, M. D., of East Saginaw, Michigan, 
says on this subject : 

" Saccharin is not a food in any sense ; but it is recognized that 
there are many circumstances under which it is necessary to have 
a sweetening agent to take the place of sugar. As to the non- 
toxic nature of saccharin the experi nenters have no doubt, since 
their experiments confirm those of reliable investigators on the 
Continent. Saccharin has decided antiseptic properties, and in 
sufficient quantities is capable of sto})ping the action of organ- 



BACTERICIDES 



I4OI 



ized ferments. As regards its extra-corporeal action on the solu- 
ble ferments, as regards the peptic digestion of fibrin o.i per 
cent, of saccharin has no retarding influence, while 0.25 per cent, 
slows the process decidedly, and i per cent, greatly retards it ; 
0.1 per cent, of saccharin is equivalent to 30 per cent, of sugar, 
which may be said to be a dietetic impossibility. The diastastic 
solution of starch is not hindered by two per cent, of saccharin. 
The addition of saccharin to urine hinders ammoniacal fermenta- 
tion, as does ingestion of saccharin." 

As regards the intra-corporeal action of saccharin, it was found 
that a gramme of the substance, equal to more than eight ounces 
of sugar, did not interfere in the least with the gastric digestion 
of the dog. The article used in the experiments was " soluble 
saccharin," equal to about nine-tenths its weight of pure sac- 
charin. In is as soluble in water as table salt, and when properly 
diluted is scarcely to be distinguished from cane sugar. Dr. 
Goodman concludes that (i) saccharin is quite innocuous when 
taken in ordinary dietary ; (2) it does not interfere with nor im- 
pede the digestive processes when taken in any practicable 
quantity ; (3) it may be taken during an extended period without 
interfering with the digestive and other bodily functions. There 
is, then, no reason to think that its continual use may be in any 
way harmful. 

Dose : Thirty to seventy-five grains in water every three hours. 
The syrup is thus made : Dissolve ten parts saccharin, twelve 
bicarbonate soda in one thousand parts of water, at a tempera- 
ture of 80° Fahr. Useful in diabetes. 



The compound, as is well known, consists of 40 per 
Salol. cent, carbolic and 60 per cent, salicylic acid, and is 
decomposed into its componetjts by the action of the 
pancreatic ferment. 

This is a germicide of immense potency. It is a white crys- 
talline coarse powder, rather like damp table salt. The odor is 
very mark^, and is identical with that of glycerite of winter- 
green, which is chiefly salicylate of methyl. When taken into 
the mouth a fainter impression of the smell is received on the 
palate, and the taste of carbolic acid is just suggested. 

The internal administration of salol is certainly devoid of many 
of the objections that may justly be urged against the salicylic 
acid. It is well borne by the stomach, is tasteless and devoid ot 
odor, readily administered in water, and but seldom gives rise to 
the troublesome tinnitus that constitutes one of the drawbacks 
to salicylic acid. 



[402 



DISEASE GERMS. 



It is eliminated from the body very largely by the kidneys, 
the urine assuming, however, the characteristic appearance and 
reaction of carbolic acid urines, being dark green or almost black 
in color. Its reaction remains acid, it is free from albumen, and 
it deposits no sediment. The characteristic alteration in the 
color of the urine is manifest after a single dose of ten grains, 
.and persists for a long time, so that when salol has been given 
for some time, the color of the urine remains black five days or 
more after the remedy has been discontinued, showing that it 
accumulates in the system and is eliminated very slowly. The 
salicylic acid of its composition appears first as salicylic acid^ 
the carbolic acid being responsible for the changed color of this 
fluid. 

The advantages which are claimed for salol over salicylate of 
soda, for which it is prepared as a substitute, are dependent first 
of all on its insolubility in water and the juices of the stomach, 
and secondly on the ease and completeness with which it is de- 
composed after passing the pylorus. Being insoluble in water, 
it is free from the repellant and nauseating effects of salicylate of 
soda, which some patients find so objectionable that even syncope 
has sometimes supervened on ingestion. Passing through the 
stomach unaltered, it undergoes decomposition in the duodenum, 
where it comes into contact with the pancreatic juice and is 
broken up into salicylic acid and phenol. 

Salol can be used with good effects in all rheumatic affections, 
in chronic urticaria, in sub-orbital neuralgia, as an antipyretic,, 
in diabetes, in intestinal catarrh, in typhoid fever, in cholera, 
against intestinal parasites, in catarrh of the bladder, in ozaena, 
in otorrhea, as a local application in gonorrhea, and as a mouth 
wash. 

It is insoluble in the gastric juices, and consequently better 
borne by weak or irritg.ble stomachs ; its solubility is obtained 
by the action of the pancreatic secretion, and hence its more 
pronounced local effects upon the intestinal tract, chiefly upon 
the duodenum. The buzzing and ringing of the ears, produced 
by salicylic acid and salicylate of soda, are hardly noticeable 
with the use of salol. 

In articular rheumatism it allays both fever and pains better 
than the respective amount of salicylic acid that it contains. In 
neuralgia it succeeds fully as well as salicylic acid. 

Salol will kill the cholera bacillus, and thus prev^ent the for- 
mation of a poisonous ptomaine. 

The ordinary dose is five grains every hour, and decrease in 
frequency as an improvement takes place. 



BACTERICIDES. I403 

in uric acid diathesis is to be considered, 

Salicylate of Soda and often is prompt in bringing about a 
cure. Many cases of persistent pruritus, 
resisting all other approved treatment, yield to ten grain doses of 
salicylate of soda, and repeated every two to four hours. These 
are cases in which uric acid abounds in the urine, and often there 
are manifested other nervous symptoms. The excellence of this 
medicament in sick headache is now well known. The fact of 
most of these cases being complicated with uric acid in excess, 
or rather the former, may be taken as resulting from the latter. 
It will be found a valuable remedy, administered in decoction of 
black cohosh in many cases of chronic rheumatism, uric acid in 
marked excess in the urine in many of these cases. Recently a 
case of dry pleurisy came under my care, the urine contained 
much uric acid. Salicylate of soda, ten grains, dissolved in 
ammonia acetate, one and one-half drachms, and repeated every 
two hours. The pain • was relieved completely in six hours. 
Before the second dose was taken, marked relief of pain was 
obtained. 

In acute tonsillitis, ten-grain doses of salicylate, repeated every 
hour, are almost sure to give rapid relief to all the acute symp- 
toms in a few hours, and a cure promptly brought about. 

Added to the liquor ammonia acetatis it is a most effective 
remedy to sterilize and destroy the bacillus amylobacta, the 
microbe of rheumatism, and protect the heart from the ravages 
of the micro-organism. 

Valuable in diphtheria to sterilize the germs in the throat. 



is a crystalline substance, neutral in reaction, 
Santonin obtainable from the unexpanded flower-heads of 
certain species of artemisia. The flower-heads, 
which can, at first sight, hardly be distinguished from seeds, 
have a strong odor and bitter taste. To obtain santonin, these 
are bruised and boiled for a time with water and lime. To this 
fluid hydrochloric acid is added till the whole becomes curd, 
when it is set aside for the santonin to subside. The precipitate 
is well washed and otherwise purified till it is brilliantly white 
and crystalline. It must be kept away from the light. The 
crystals have but little taste and no smell, insoluble in cold 
water, but soluble and subliming with a moderate heat. These 
brilliantly white crystals become yellow by exposure to light. 
Nitric acid converts it into succinic acid. 

Santonin, if given in any quantity, colors the field of vision 
yellow, so that the patient sees everything of that color. Some- 
times green takes its place. 



I404 .DISEASE GERMS. 

Being tasteless, energetic in the destruction of the round 
worm, it is easily and readily taken by children. 

The crystals in trituration with sugar and milk. Lozenges 
and a glycerite are most eligible forms. Dose : one to two 
grains. 



is the product of a tree growing in India and 

Sandal Wood Ceylon, and also in the South Sea Islands. 
It occurs in billets of a dark brown color 
externally ; internally the rings are well marked. The powder 
is blood red, and has a slightly astringent taste. It is mainly 
used for the coloring matter, which may be extracted by alcohol 
or ether, and by alkaline solutions. It is sandal wood which 
gives the red color to the compound tincture of lavender and to 
Fowler's solution of arsenic. An oil of sandal wood has recently 
come into use as a remedy for gonorrhea. Fifteen or twenty 
drops are usually given for a dose : but k good many people it 
does not suit ; many cases are not benefited by it. In all 
instances it gives rise to a good deal of pain. Often it is very 
effectual. 

The mistura santal comp., highly ozonized, a combination of 
pure sandal oil, oil of cubebs, copaiba, kava kava, terebene, with 
tincture of hyoscyamus, with peroxide of hydrogen. 

A useful, reliable preparation for the destruction of the 
gonococcus. 

It forms, when diluted, an elegant and pleasant mixture, which 
does not interfere with the digestive organs, and may be given 
without producing the offensive eructations which follow the 
administration of copaiba. 

Its use is especially indicated in the advanced stages of gonor- 
rhea, and in protracted or chronic gleet, though it may be given 
with equally good effect in the earlier symptoms, unless contra- 
indicated by an inflammatory condition. 

If given as soon as possible after the appearance of the dis- 
charge, the effect is usually most gratifying both to patient and 
doctor. The discharge disappears, the scalding ceases, and by 
continuing the medicine, with attention to collateral treatment, 
a cure may generally be effected in from two to five days. 



This remedy has been in use 
Saponaria Officinalis, throughout Europe and America as 
{Soap- Wort) a bactericide, chiefly for killing the 

venereal bacillus, and parasite affec- 
tions of the skin. It is nearly as powerful a remedy as comp. 
saxifraga and phytolacca. 



BACTERICIDES. j.qc 

For its alterative and germicidal properties, best given as a 
decoction, or in the form of a fluid extract. 

It does kill the gonococcus by slow degrees, in about two 
weeks. 

Saponin, a proximate principle obtained from the root in large 
quantities, is" extremely poisonous; although a glucoside, it unites 
with acids and forms crystals. 



A germicide and parasiticide, belonging to the 

Savin, cypress section of the fir family, has an extended 

sphere of action, both externally and internally. A 

cerate prepared in the usual manner is 

most efficacious in tinea capitis ; applied 

to indolent gangrenous ulcers, destroys 

the microbes present, and they heal 

promptly, the savin cerate being equally 

germicidal to ichthyol. It is all efficient 

as a lotion, fomentation or powder. 

The fluid extract internally adminis- 
tered in small doses, frequently repeated, 

annihilates the microbe of rheumatism ; 

rouses up the dormant functions of the 

torpid liver. 

In cases of tape-worm, the oil, with a 

little chloroform added, rubbed over the 

abdomen for a few minutes, by endos- ' Sabma. 

mosis so paralyzes the parasite that it is expelled. Its action on 

the uterus is that of a drastic stimulant. 




The berries contain diuretic, sedative, 
Saw Palmetto. nutritive, and gland-stimulant properties ; 
{Sabal Serrulata) and in the form of a fluid extract are in- 
valuable, and have a special and decided 
action upon the glands of the reproductive organs, as the 
mammae, ovaries, prostate, testes, etc. Its action is that of a 
great vitalizer, tending to increase their activity, to promote 
their secreting faculty, and add greatly to their size. 

It is specially indicated in all cases of wasting of the testes, 
such as follows varicocele, or is induced by masturbation, or 
which is often present in sexual impotency. 

In atrophy of the prostate, so very common in cases of sexual 
perversion, this drug operates in a most remarkable manner, in 
overcoming the withered, blighted state of the gland ; so in 



l4o6 



DISEASE GERMS. 



uterine atropy dependent upon ovarian blight, its action is unex- 
celled. In gynecological practice it is much used to promote 
the growth of the mammae. 

But it is on the prostate gland that this remedy exercises its 
best effects. Great medical authority states, that when " the hair 
becomes gray and scanty .... the prostate gland be- 
comes increased in size," and this, irrespective of age. Nine men 
out of every ten have enlarged prostate, and one atrophy, ages 
varying from thirty-five to seventy-five, respectively, the result 
either of early indiscretion, as masturbation, or excess, or perver- 
sion of the sexual act, or sedentary habits, or from improperly 
cured gonorrhea. 

The prostate is composed of two lobes and a median portion. 
Sometimes one portion or all may be enlarged ; the part affected 
influences the function of micturition, whether it be wasted or 
enlarged. A patient may have enlargement as great as a small 
cocoanut, and no obstruction to micturition, provided the 
median portion is only but slightly enlarged. 

A man with prostatic trouble has always impaired sexual 
power, verging on partial or complete impotency, with wasting 
testes ; with urinary trouble, either a frequency, or a dribbling, a 
lack of power of propulsion. The dribbling, or lack of power of 
retention is altogether different from stricture, for in the latter 
the power is good, strong; although it maybe as fine as a 
thread, or split, or twisted like a cork-screw. 

Prostatic disease, acting reflexly on the brain, gives rise to in- 
numerable cerebral affections. 



Indicated in syphilis, cancer and tuberculosis ; 

Saxifraga. one of the most powerful vegetable alteratives 
known to medical science ; stands in the front 
rank of therapeutics as a great vegetable germicide. It would 
be impossible to successfully combat syphilis, cancer and tuber- 
culosis without this remedy. 

Saxifraga, Comp. Oz. — This preparation is purely vegetable, 
composed of the active principles of saxifraga, blue flag, tag 
alder, dulcamara, kalmia, corydalis, phytolacca and yellow parilla, 
prepared by a process of distillation and highly ozonized, after 
which five grains of iodide of potass and five grains of chlorate 
of carbon are added to each drachm. The preparation is en- 
dorsed by the entire medical profession, as the best of all altera- 
tives. 

It is not only the best of alteratives, but a potent germicide 
when it enters the human blood. It annihilates all disease germs, 



BACTERIClDEb. 



1407 



Sterilizes their micrococci and thus cleanses germ-laden blood, 
while it has the faculty of stimulating the springs of life, the vital 
elements of nutrition in aiding in the formation of pure and more 
vitalized blood. It is a true blood scavenger and tonic, strength- 
ening the system in a remarkable degree. 

It has a special faculty when it enters the blood, lymph canals 
and pink marrow of destroying the microbes of cancer and syph- 
ilis and the bacilli of tubercle. 

It completely supplants the use of mercury, antimony, arsenic, 
the iodides and other deleterious mineral agents in the removal 
of morbid action, destruction of myriads of germs which are 
always present in chronic maladies. 

As a great blood purifier and germicide, (the most efficacious 
in the whole range of therapeutics), it acts as a stimulant to the 
skin, liver, kidneys and every gland in the body. 

Dose : One teaspoonful every three hours. 



As a remedy to sterilize all disease germs or 
Skullcap, microbes, this one is too much neglected by the 
profession, especially in the treatment of all ner- 
vous diseases. It is a remedy of rare 
value, being a tonic, diuretic, anti- 
spasmodic. It has been used chiefly 
in convulsions, chorea, epilepsy, dys- 
menorrhoea and debility. It allays 
all irritation of the nerve centres, im- 
parts tone and quiets cerebral ex- 
citement. It is esteemed as our best 
remedy in hydrophobia. In this 
disease, to be effectual, it must be 
given in large doses until it produces 
a sort of paralysis or suspension, and 
if this is effected the germ dies or is 
sterilized. 

The remedy has also the same effect 
on the vibrios of nervous disease. 

It yields its properties freely to 
water, and in the form of an infusion 
it should be drunk freely, until there 
is a feeling of pins and needles ex- 
perienced over the entire body. 




SkuUcap. 



1408 



DISEASE GERMS. 



Senega Root 



is a famous germicide, possesses important 
medicinal properties, being a stimulant, 
diuretic, diaphoretic, and in large doses emetic 
and purgative. Its administration 
in catarrh, bronchitis, rheumatism, 
has a most sterilizing effect upon 
the germs of those respective ma- 
ladies. 

Even the mycelia of hooping-- 
cough are thoroughly paralyzed in 
its presence. The following for- 
mula is effective : Syrup senega, 
syrup of tolu, of each one ounce ; 
resorcin, half an ounce. Mix. Dose, 
from a half to one teaspoonful 
every two hours. 

A most wonderful remedy in 
the cure of diabetes, Bright's dis- 
ease, cystitis, sciatica, gout, rheu- 
matism, dropsy, neuralgia and 
carditis is the ozonized uric acid 
solvent. 

The addition of pichi and di- 
oxide of hydrogen to the com- 
pound has given it a world-wide 
reputation in all renal diseases aris- 
ing from defective assimilation and 
an excess of uric acid. Physicians 
using it should see that they have 




Polygala Vulgaris. 



the genuine ozonized. 



Serpentaria. 



snake 
stimu- 



actmg 



Virginia 
root is a 
lant tonic, 
also as a diaphoretic and diuretic. 
On account of its peculiar stimulat- 
ing action on the skin, its use is 
extremely beneficial in all forms of 
eruptive fevers ; it has the peculiar 
faculty of driving all the micro- 
organisms of those fevers to the 
surface, thus relieving cerebral and 
visceral congestion. Of great e|ifi- 
cacy when the kidneys are blocked 
up by solid bodies, as the urates 




Virginia Snake Root. 

or triple phosphates. It 



BACTERICIDES. 



409 



promptly relieves that sensation of weight and dragging in the 
loins, fulness in the chest, difficult respiration incidental to 
nephritic congestion. 

It augments vital force, increases the power of vital resistance. 

The comp. tincture and fluid extract are the most eligible 
forms for administration. 



Undoubtedly the most powerful 

Siegesbeckia Orientalis. and valuable of all vegetable germi- 
cides. Administered internally or 
applied locally, it either completely annihilates or sterilizes all 
micro-organisms. For internal administration, a syrup is pre- 
pared by pounding the green plant, adding sugar and straining, 
or by adding one drachm of the tincture to two ounces of simple 
syrup. This is the best form for prescribing in syphilis and 
cancer, and in cases where any 
microbes inhabit the human 
blood. It acts most efficiently 
upon the syphilitic germ, even 
exceeding in its germicidal ac- 
tion bichloride of mercury, 
iodide potass., saxifraga, kalmiia, 
etc. 

As a spinal stimulant it ex- 
cels nux vomica, ignatia, rhus; 
hence its value in aphasia, stam- 
mering, and in incontinence of 
urine or irritable bladder. 

As a local remedy to ulcers 
or sores, syphilitic, gangrenous, it promptly destroys the germs 
present, then stimulates rapid cicatrization. 

A very small quantity of the tincture added to a jelly, pre- 
pared from glycerine of starch, destroys the oidium aphthae and 
sore nipples. 

The tincture is a valuable cure, locally, for all forms of tinea, 
and can be prescribed with invariable success. 

Apply it in ring-worm, tinea circinata, tinea sycosis (tinea ton- 
surans), tinea versicolor, typical, well-marked cases, even of the 
most aggravated form in broken-down subjects; the result is 
marvellous in the extreme. The drug acts as a stimulant and a 
parasiticide, and the mode of cure, after it is applied, is that the 
diseased patch becomes broken up into a series of small patches^ 
with sound skin intervening. Then the re-application of the 
drug causes it to break, up into still smaller pieces, when it dis- 

89 




Siegesbeckia.— The great vegetable 
Bactericide. 



I4IO DISEASE GERMS 

appears altogether, and In their place a small red blush. This 
only remains for a day or two, and the most stubborn case is 
thus cured. 

The prescription in all forms, even the most aggravated and 
stubborn, is : equal parts of the tincture of siegesbeckia and 
glycerine, well rubbed into the affected area morning and night. 

At present it is a high-priced drug, but the dose is small, and 
its use, if indicated, brings colossal results. 

The Learned leading physicians of Canada are adopting the 
germ theory of disease with great avidity. 

Dr. Cannon, of Sharbot Lake, is pushing bactericides with 
great energy in his extensive practice. In one of his recent 
essays, he says : 

" The siegesbeckia orientalis in typhoid has not received the 
attention it merits. The time has arrived to lay before the pro- 
fession the results of an experience in its use extending over two 
years, comprising a series of seventy-nine cases. 

The general management of all those cases was : the patient 
was confined to bed in the recumbent posture, in a well venti- 
lated room, rigid hygiene, and every effort made to maintain 
the nutrition of the patient by fresh milk alternated with beef 
tea, etc. 

In the entire number of cases, no matter what time I was 
called, I ordered; one-drop dose of a saturated tincture of sieges- 
beckia orientalis in a tablespoonful of water in which a teaspoon- 
ful of the syrup of orange peel had been dissolved. The good 
effect of the remedy was immediate ; the pulse slowed, tempera- 
ture fell, tongue cleaned, diarrhea ceased, and the general condi- 
tion of all the patients improved so much that, as a rule, all 
anxiety as to the future of the cases was at an end, as they all 
proceeded to speedy recovery. 

What induced me to try this drug in typhoid fever was that, 
in my experiments in the cultivation of the typhoid bacilli and 
the effect produced upon the micro-organisms when the sieges- 
beckia tincture was introduced into the cultivating media, perfect 
annihilation of microbe growth took place. 

So internally in typhoid. 

Another reason was, I had applied this tincture in gangrenous 
ulcers (oidium albicans) with most marvellous results, and had 
demonstrated most clearly the destruction of the germs and the 
establishment of healthy, healing action, so I obtained similar 
results upon the germ-eaten bowels, so much so that I noted 
over half the cases were aborted on the second week. My 
seventy-five cases were treated all alike, the prevailing idea being 
to destroy the germ, and heal the ulcers on the bowels; just as 



, BACTERICIDES. 



I4II 



this great vegetable germicide was administered, so febrile dis- 
turbance ceased. 

This remedy owes its antipyretic action directly to its germi- 
cidal power, to its power over the germ before destroying it — 
that the germ being destroyed, no ulcers form on the intestines ; 
recovery from the fever is certain provided no accidental or 
adventitious cause arises." 



This is a strong bactericide, non-poison- 
Silico- Fluoride ous, unirritating to the tissues, inodorous, 
of Soda. non-volatile, non-corrosive, and not de- 

stroyed by oxidation. 
This remedy is very useful for washing out the peritoneal 
cavity after laparotomy, here using ten grains to the pint ; in 
cases of strangulated hernia ; in the radical cure for hernia ; in 
excision of joints ; in amputation of the arm, leg, and thigh ; in 
washing out the pleural cavity ; in the removal of tumors ; 
in excision of veins ; in ligature of blood vessels ; in compound 
fractures ; in osteotomies ; in washing out the bladder ; in wash- 
ing out the uterus after curetting the interior, and after the re- 
moval of septic retained membranes ; as a vaginal douche before 
and after Apostoli's operation for fibroid ; in the irrigation of ex- 
tensive ulceration in the rectum, where a poisonous antiseptic 
could not have been employed ; in washing out the stomach ; as 
an injection in gonorrhea (ten grains to the pint) ; as an injec- 
tion in otorrhcea ; in syringing out large pelvic abscesses ; as a 
gargle in hospital and in diphtheritic sore throat; as a nasal 
douche after removing polypi ; for syringing out empyema of 
antrum ; and in many other cases. 



an invaluable ozonized compound, composed 
Simabicidia, of cedron seed, coto bark, Jamaica dogwood, 
manaca, tonga and black cohosh, a specific for 
neuralgia. These remedies are a special combination of peculiar 
efficacy and highly germicidal. The preparation was first intro- 
duced by us, and on submitting it to the profession, it was found 
to possess extraordinary power in relieving neuralgic pain. Neu- 
ralgia is caused by the presence of living microbes in the blood, 
impoverishing the nerves. The theory of pain, caused by mi- 
crobes, or their poisons, was anaemia. 

Cedron seeds have obtained quite a reputation in the treat- 
ment of snake bites and other venomous reptiles. They are of 
undoubted utility in headaches and neuralgias due to the pres- 



I4I2 



DISEASE GERMS. 



ence of sewer gas, foul emanations, or microbe-laden atmo- 
spheres. 

A tincture or fluid extract of the coarsely ground seeds may 
be used, but for general use the simabicidia answers the purpose 
best. 

There is still another explanation which on many grounds has 
recommended itself, as accounting more satisfactorily for the 
phenomena observed, both to chemists and biologists. It is that 
the injurious effects produced by microbes on special nerves are 
due, not to what they take or to what they excrete, but to what 
they leave, and this is closely associated with the imperious de- 
mand they make for oxygen. Being in many instances anacrotic 

— that is, living and multiplying without 
direct exposure to air — they must obtain 
the oxygen they require for the process 
of life from the tissues by which they 
are surrounded ; but when oxygen is 
withdrawn from such complex chemical 
compounds as those of which our bodies 
are constructed, the elements enter into 
new combinations, and then, under the 
name of ptomaines, are believed to be 
the really poisonous agents. Attempts 
have been made to isolate these com- 
pounds ; and it has been shown that 
they are of the nature of alkaloids, and 
resemble, both in their constitution and 
in their effects, those deadly poisons that may be extracted from 
digitalis, conium, tobacco, delphinum, and other noxious plants, 
and that it is its action upon those poisons, in neutralizing or 
antidoting them, that is effectual and invaluable in all nerve pain. 
Dose : From half to one teaspoonful in water, three times a 
day. Relief generally follows the third or fourth dose. No ill 
effects from larger doses. 




Seeds of Simaba Cedron. Quarter 
natural size. 



This drug has been highly extolled as a remedy 
Simulo. to sterilize the microbe of neurasthenia and epilepsy. 
In the estimation of one of our best and most suc- 
cessful physicians in the treatment and cure of nervous diseases, 
Thomas L. Barnes, M. D., of Jamestown, N. Y., simulo is entirely 
worthless. The learned Doctor has tried this much-lauded 
remedy, and in no single instance does it control any, nay, even 
the mildest epileptic seizures. 



BACTERICIDES. 



413 



A germicide, aromatic, stimu- 
Solidago. lant. An infusion of the herb, 

{Szveet-Scented Golden Root) administered warm, is an excel- 
lent diaphoretic and carminative ; 
a fluid extract is valuable to cover the taste of 
nauseous drugs. 

Its medicinal properties depend entirely upon 
the presence of a volatile oil which contains all the 
bactericide properties. 

It is of great utility to sterilize or destroy all 
micro-organisms in the alimentary canal ; by doing 
this it relieves pain in the stomach and bowels, 
flatulence. It is also of great value for inhaling 
in all microbial diseases of the respiratory 
organs. 

Dose : From two to five drops, triturated with sugar, or cut 
with alcohol, every three minutes, until relief is experienced. 




A bitter, astringent tonic, sudorific, diuretic. 
Speedwell, expectorant, nerve stimulant. Employed jn some 
( Vej^onica.) countries as a substitute for tea, makes a pleasant 
beverage, restores the functions of the digestive 
organs, strengthens the mental and physical powers. Adminis- 
tered with great benefit in all cases of depression or over fatigue 
^, or exertion, it entirely 

wipes out that feeling 
of exhaustion and is 
unquestionably one" 
of the most powerful 
tonics to the muscu- 
lar system that we 
possess. The remedy 
can be specially re- 
commended to medi- 
cal men and nurses, 
and all who require 
to keep awake and 
be on the alert, and 
Speedwell (K^r^mVa). enabling them to do 

a vast amount of work with ease. Although of great efficacy in 
combating fatigue and drowsiness, no antidotal properties are 
claimed for it in any of the habits. 




I4I4 



DISEASE GERMS. 



Solanin. A glucoside derived from the leaves and berries of 
the solanum nigrum and other plants. It has an 
acrid, nauseous taste ; is insoluble in water, but freely soluble in 
ether or alcohol. It has a powerful germi- 
cidal action upon all the fluids and solids 
of the body, has an anesthetic action upon 
the base of the brain, influencing chiefly 
the pulmonary plexus, and diminishing the 
sensibility of the bronchial mucous mem- 
brane. Its peculiar action upon the respira- 
tory centre of the brain causes it to slow 
the pulse, diminish respirations and lower 
temperature. 

In large doses it is an irritant and paraly- 
zer; in small doses it is of the greatest 
efficacy in destroying the micro-organisms 
of hooping-cough, bronchitis, carditis, 
asthma, emphysema, rheumatism, gout, 
sciatica and cystitis. By its peculiar seda- 
tive action on the pneumogastric, it relieves 
Administered in doses of a quarter to one 
For subcutaneous injection the hydrochlo- 




Common or Black Nightshade 
{Solanum nigrum.') 



gastralgia, vertigo, 
grain thrice daily, 
rate of solanin is used in an aqueous solution. 



is closely allied 

Spikenard to the valerian 

family, but has a 

much stronger odor and is more 

powerfully germicide. 

Simmering the sliced roots in 
oil or vaseline makes an embro- 
cation of the greatest utility in 
the successful cure of old fetid 
ulcers, k is an old remedy, 
but one of great value, and 
likely to regain its place in 
modern therapeutics. 

A tincture is the most eligible 
form for exhibition ; being a good 
nerve stimulant, it affords almost 
instant relief in innumerable 
painful affections. 




Spikenard, 



BACTERICIDES. 



I415 



consists of the bulb of the sea onion {Urginea scilla 
Squill or Scilla maratima) sliced and dried. It grows along 
the shores of the Mediterranean, partly in the water. 
The bulb is pear-shaped, and often of considerable size. It is 
covered with brown scales overlapping like those of the lily. 
The outer ones are membranous, the inner 
white and fleshy, these being cut across. 
Squill is commonly seen in small white 
pieces, consisting of transverse sections of 
those scales. Squill has a bitter taste and 
not easily powdered until well dried ; in 
that state they may easily be converted 
into powder, but if allowed, the powder 
speedily absorbs moisture from the atmo- 
sphere, so that the powder becomes a solid 
adherent mass. Squill seems to owe its 
efficacy to a resinous substance, which is 
not, however, separated for use. Its pre- 
parations are, vinegar of squill, oxymel 
of squill, made by mixing squill vinegar 
with honey, a syrup and a tincture. 

It is a bactericide of no mean order, and 
as it yields its properties to acetic acid 
dilute, we have the advantage of two 
germicides in one. 

It is also an excellent remedy to facili- 
tate expectoration, and for rousing up the 
action of the kidneys, and to promote the 
absorption of fluids; hence its value in dropsy. As an expec- 
torant, use it alone, or combined with syrup of tolu, senega, wild 
cherry, ipecac. It is one of our best remedies in stubborn 
dropsical cases in alternation with strophanthus. 




Squills. 



Common broom, which grows so 
Sulphate of Sparteine, abundantly in the temperate lati- 
tudes of Europe, yields by decoction 
and alcoholic extract an invaluable cardiac tonic and vitalizer. 
This property resides in the w^hole plant, leaves, stem and flowers, 
but specially in the young tops and seeds. Besides its decided 
action on the muscular structure of the heart, it is an efficient 
diuretic and laxative. 

These are the ordinary properties of the scoparius, but the 
alkaloid is sulphate of sparteine, which is obtained freely from 



I4i6 



DISEASE GERMS. 



the tops, takes its place in the front rank as a most extraordinary 
heart tonic. 

The constant physiological and therapeutic effect of this drug 
is to strengthen the heart's action, improve its pulsations, increase 



its growth. 



The sulphate of sparteine is most effective administered hypo- 
dermically in the morphia and other habits ; the injection should 
be given when the craving comes on. Invaluable in asthma. 





Lakespur or Stavesacre. 
{Delphinhcnt stapJiisagria.) 



Common Broom; a, flowering branch- 
let; ^, end of branchlet, not flower 
ing, showing leaves with three leaf- 
lets; f, a pod ; </, the tube of stamens 
cut open 



Stavesacre seeds 
Staphisagria. are emetic, cathar- 
tic and parasiti- 
cide ; owing to their violent action 
they are seldom given internally; 
chiefly used locally. 
The fluid extract, in small doses, exerts a favorable action 
upon the reproductive organs of both sexes. It quiets irritation 
of the testes, strengthens their secreting faculty, lessens irritation 
of the piostate-urethra, arrests leakages; often of utility in 
catarrh of the bladder. 

An ointment, made by digesting over a vapor bath for twenty- 
four hours, three parts of stavesacre seeds, in powder, with five 
parts of vaseline, and then straining, may be used for the destruc- 
tion of all cutaneous parasites. It is most effectual when 
applied in destroying the entire crop of parasites present, what- 
ever they may be. 



BACTERICIDES. I^ipr 

The alkaloid principle, delphinine, is extremely acrid ; but 
administered in small doses it is often effectual in overcoming 
paralysis caused by the action of the lactic acid of rheumatism 
or general nervous prostration. 



A microbicide of some power. Its 

Stillingia Sylvatica. bactericide properties are present only 

{^Queen's Root.) in the oil, which is very volatile, hence 

there is none in our fluid extracts if 

made by heat or compression. Alcohol extracts this oil. 

All comp. syrups of stillingia are entirely worthless when 
made with fluid extracts. Alcoholic syrups made by re-percola- 
tion contain the oil in great abundance. 

The use of this syrup kills the bacillus of tubercle, cancer, 
syphilis ; besides it is a general alterative, tonic, diuretic. 
The stillingia is worthless if the oil is extracted. 
The compound syrup, which consists of stillingia, corydalis, 
Phytolacca, iris versicolor, prickly-ash, chimaphila, umbellata, 
and cardamom seed, made by maceration, is a powerful and effi- 
'cient alterative. 

The oil of stillingia, dissolved in alcohol, is invaluable as a 
liniment in or over joints loaded with the bacillus amylobacta. 



This invaluable remedy has a wide 

Virginia Stone Crop, range of action, and can be used 

with marvellous efficacy in a large 
number of diseases, but specially in nervous affections, morbid 
states of the alimentary canal, and in genito- urinary affections. 

It stands pre-eminent and alone as a great rectal tonic and 
vitalizer ; operates exceedingly well in all feeble or relaxed condi- 
tions, as catarrh, prolapsus, spasmodic and refractory states of 
the sphincter ani, and in neuralgia ; of great utility in ulceration 
of the rectum and piles. Ascarides are effectually destroyed 
with it in the form of an injection. 

No remedy can excel this in all diseases of the genito-urinary 
organs of both sexes ; it operates like a charm in relieving irri- 
table bladder and prostate ; has a most beneficial action in pros- 
tatorrhea, checks all leakages, or any oozing, even the exudation 
of chronic gonorrhea or gleet ; in the female, its use cures leu- 
corrhea, dysmenorrhea, and that neurosis, termed vaginismus, 
spasm of the sphincter muscle of the vagina, and uterine neu- 
ralgia. 

It exercises a most ex':raordinary sedative action on the kid- 



141 8 DISEASE GERMS. 

neys and bladder ; of great efficacy in the expulsion of calculi ; 
in acute and chronic cystitis ; in vesical tenesmus, and in incon- 
tinence of urine of all ages. 

It is of great value in dyspepsia, gastric and gastro-intestinal 
catarrh, gastralgia, and flatulent, biliary and infantile colic. It 
restores the tone of the alimentary canal by its peculiar tonic ac- 
tion ; increases the appetite, promotes digestion ; gently stimu- 
lating the organs of excretion. 

it vitalizes the respiratory organs ; good in colds, hoarseness, 
or in elongation of the uvula, chronic laryngitis and pharyngitis, 
aphonia, and the lack of tonicity of the vocal chords. 

It is of great efficacy in all nervous disease, as chorea, epilepsy, 
lumbago, nervous cough, hooping-cough ; its use overcomes all 
habits, as the desire for liquor, morphia, etc., and it may be 
given with decided benefit in anaemia, chlorosis, incipient con- 
sumption, convalescence from fevers. 

As a local remedy in contusions, ecchymosis, incised wounds, 
indolent ulcers, it has no superior. 

Dose : Internally from twenty to sixty drops added to water, 
three times a day ; for local use, one ounce to four ounces of 
water ; as an ointment, one ounce of the extract to three ounces 
of vaseline. 

J. J. Crider, M. D., Ottumwa, Iowa, in an elaborate disserta- 
tion on our indigenous remedies, says of stone crop : 

" The most highly vitalizing of all tonics for the gastro-intes- 
tinal mucous membrane, operates efficiently from the tip of the 
tongue to the verge of the anus. The most effective remedy we 
possess in an ulcerated, germ-eaten rectum. 

Stone crop is an effective remedy in relaxation of the uvula, 
chronic pharyngitis and hoarseness, dependent upon a lack of 
tonicity of the vocal chords. The fluid extract may be given in 
these affections in half-drachm doses, four times daily, and em- 
ployed also as a gargle when diluted with four times its volume 
of water. It is also of value in gastro-intestinal catarrh, and the 
catarrhal gastritis of beer and alcohol drinkers. It lessens the 
desire for liquor, restrains the secretion of mucus, and restores 
the normal tone of the alimentary canal, and re-invigorates the 
depressed nervous system. 

Constipation, hemorrhoids, rectal neuralgia, vague pelvic 
pain, are cured by inserting a suppository made of the glucoside 
prepared from the stone crop. 

Add half an ounce of resorcin to four ounces of fluid extract 
stone crop, and we have an invaluable remedy for chronic gon- 
orrhea, leucorrhea, prostatorrhea, infantile and biliary colic. 

As a general tonic, increasing the appetite, promoting diges- 



tJACTERICIDE; 



I4I9 



tion, and gently stimulating the fountain of life, it is useful in 
very many diseases." 

When taken either in small or large doses, 
Stramonium, produces symptoms, analogous to those pro- 
duced by the use of belladonna. 
It is used with some suc- 
cess in puerperal mania ; be- 
neficial in neuralgia. It has 
acquired quite a reputation 
in spasmodic asthma. It is 
only employed during the 
paroxysm, which it either 
alleviates or subverts. It may 
be used either in a pipe or 
cigarette. 

Externally, stramonium is 
used advantageously as an 
ointment or cataplasm in irrit- 
able ulcers, inflamed tumors, 
swelling of the mammae, and 
painful hemorrhoidal affec- 
tions. 

The green leaves simmered ^°"^"^°° Thom-apple {Datura stramonium). 

in lard, until saturation, form an ointment of rare value in para- 
sitic affections of the skin. It, like belladonna, sterilizes all 
disease germs. 




or styrax, is a kind of liquid balsam obtained from 

Storax, the bark of a tree, liquidainbar orientale, growing in 

Asia Minor. This balsam is afterwards purified. It 

occurs in two forms ; a thick liquid of the consistence of honey, 

and brownish red, nearly solid masses, softening with- heat. 

Storax contains, as do all balsams, cinnamic acid, which, when 
pure, occurs in flat crystals ; also styracin and styrol. Styracin 
is a compound containing cinnamic acid and styrone. It is crys- 
talline when pure, and insoluble in water. Styrol is a colorless 
oil which by oxidation may be converted into benzoic acid. Its 
odor is aromatic. 

Storax if pure should be soluble in alcohol or ether, and is by 
chemical means capable of being broken up into a variety of pro- 
ducts. Storax is not nowadays much used in medic'ne, but 
belongs to a group which the bacteriologists highly esteem. The 
whole family of balsams are active germicides, killing the various 
forms of germs. 



1420 



DISEASE GERMS. 



Styrone, prepared from liquid storax and balsam of Peru, has 
intense germicidal properties. It possesses several excellent ad- 
vantages, it is efficient, non-poisonous, and its odor is agreeable. 
It may be used to an ulcerating surface in the form of a spray, 
styrone one drachm to one ounce of water, and one of glycerine, 
or applied to raw surfaces in the form of an emulsion, with olive 
oil, petrolina. From experiments made by us, the germicidal 
properties of styrone are considerable, completely annihilating 
the micro-organisms of putrefactive bacteria ; comma-bacilli ; 
streptococcus pyogenes, and staphylococcus pyogenes aureus. 

is a reliable hypnotic, possessing none of the pecu- 

Sulfonal liar effects of the narcotics on the nervous and cir- 
culatory systems; it has no injurious secondary 
effects, and may be taken in proper doses with impunity, to pro- 
duce the most quiet, uninterrupted, refreshing natural sleep for 
eight or ten hours. It possesses neither taste nor odor. 

It has a decided action upon the insomnia of the inebriate ; 
upon the delirium of the typhoid, and upon the raving mania of 
the insane. 

The drug can be administered in wafers or capsules, or if the 
patient refuses the remedy, it can be mixed with soup, wine, 
water, coffee, or strewn on bread, or any dish the patient may be 
eating. The dose is from thirty to forty-five grains. 

Paralysis from phrenal anaemia, cerebral softening, and other 
grave pathological brain lesions, are becoming amenable to reme- 
dies. By the use of sulfonal we can prolong sleep in the raving 
maniac to twelve or sixteen hours in the twenty-four ; by the 
use of the glycerite of kephaline we can supply the blood with 
adequate brain matter, from which even the bankrupt cerebrum 
of the insane can, during prolonged repose, recuperate. 

The two remedies are being tested in several of our insane 
asylums with brilliant results. 

Nervous affections are essentially infectious and contagious ; 
all lesions, whether inflammatory or not, are but a mass of mi- 
crobes. In sulfonal we have a drug which produces a quasi 
suspension^ during which germs either die or become sterilized ; 
in the glycerite of kephaline we have a true brain essence and 
germicide. The pulse, temperature, and digestion are unaffected 
by the remedy. 



Indicated in the prevention 
Sulpho-Carbolate Sodium, of ingress and destruction of 

the oidium albicans of diph- 
theria, the microbes of small-pox, the bacteria-vibrio of puerperal 



BACTERICIDES. 1^21 

fever, the bacteria of erysipelas and boils and all forms of rectal 
ulcer caused by eroding germs. It renders the blood aseptic, 
making that fluid a habitat into which no disease germ will enter 
while the patient is taking that drug. 

Dose : For children, one to two grains ; for adults, three to 
four grains, added to water or dry on the tongue or rectum, 
every four hours. 



The antiseptic and antifermentative 

Sulpho-Carbol, properties of this compound are re- 

the New Antiseptic, markable, and it has the advantage 

over carbolic acid of being soluble in 
water in all proportions, and of being neither poisonous nor 
caustic. It is a syrupy, rose-colored liquid, of a pungent odor, 
but no wise disagreeable in solution. It is volatilized in a water- 
bath, and may be used for fumigation. It may be given inter- 
nally also, in syrup and water, in doses of from one to five 
grammes daily. Indeed, being an inoffensive product, its doses 
may be increased ad libitum, which of course is not the case with 
carbolic or salicylic acids. 



Three varieties serviceable : First, to 
Soluble Gelatine kill the gonococcus ; second, to arrest 
Urethra! Bougies, seminal leakages ; third, to rouse up 
erections in profound impotency. To 
insert one after urinating and allowing it to dissolve direct, im- 
mediate cure of a recent gonorrhea ; of marvellous efficacy in 
checking all leakages or seminal losses ; as a remedy in impotency 
they have no equal ; imparts to the virile organ all the force and 
ardor of youth. 

Insert in urethra every night. 



This plant is very widely distributed over 
Strophanthus. equatorial Africa. It produces pods or fol- 
licles from nine to twelve inches in length, in 
which are contained from too to 200, or even 300, oval seeds^ 
characterized by bearing beautiful comose appendices, which 
give it an arrow-like appearance. The active or medicinal part 
of the plant is in the seeds, which are generally used in the form 
-of a tincture, which contains about 8^ per cent of a crystalliz- 
able principle, termed " strophanthin," which has an intensely 
bitter taste and an acid reaction, readilv soluble in water and 



1422 



DISEASE GERMS. 



alcohol, but insoluble in ether, benzol, etc. This substance is 
found also in smaller proportions in the leaves and bark. The 
action of this very remarkable drug in medicinal doses, when 
introduced into the human stomach, is to increase the contrac- 
tile power of the heart, and to render its contractions more com- 
plete and prolonged — a true cardiac tonic and strengthener. 
By the regulation of the dose, a most distinct physiological 
influence may be produced on the heart, while the other muscles 
remain unaffected. It is a most valuable cardiac tonic-invigora- 
tor of the heart muscle, accompanied by a rise in blood pressure, 
increased secretion of urine and reduction of temperature. In 
its action it bears a strong resemblance to digitalis, but it is a 

cult breathing, 
much relief is 



much more 
effective and 
safer drug for 
a much-weak- 
ened heart, 
whatever the 
cause of that 
weakness may 
be. 

As an arte- 
rial sedative, 
reducing the 
frequency of 
pulse, lowering temperat 
and diminishing respira- 
tions, it is of rare value; 
also in the stage of col- 
lapse of cholera, typhoid 
fever, and all cases of heart 
failure, it is of unexcelled 
efficiency. It is a true heart 
tonic in enfeebled heart ; in- 
creases both the first and 
second sounds of the heart, 
both in length and volume ; 
increases the radial pulse. 

In oedema of the legs, 
the result of cardiac ob- 
struction, great diminution 
of the swelling is obtained, 
-the water-logged extremi- 
ties are cleared; and in car- 
diac obstruction, with diffi- 




afiforded to the 
laboring heart. 
It is the Ex- 
celsior drug in 
heart failure 
due to the use 
of tobacco or 
exces sive 
study. It will 
not cure a fat- 
ty heart, but it 
steady its action, dimin- 
ish its irregularity. 

It is a true tonic of great 
utility in all states of dam- 
aged or weakened heart. It 
does its work well, relieves 
the difficult breathing, and 
the system never becomes 
habituated to its use. On 
the contrary, its action from 
first to last is uniform in 
increasing cardiac muscular 
impulse. It encourages the 
action of the kidneys. In 
anaemia, with weak heart, it 
is of great value. 

The best and safest prepa- 
ration for general use is a 
tincture prepared from the 



BACTERICIDES. 1^23 

seeds alone, and in doses varying- from two to ten drops, added 
to a little water. 

The method of preparing the tincture adopted by us is as 
follows : 

Strophanthus seeds, deprived of their comose appendices, 
reduced to powder, and dried, one ounce or one part. Ether, 
freed from spirit and from water, ten fluid ounces, or ten fluid 
parts. Alcohol, a sufficiency to obtain one pint, or twenty fluid 
parts. 

Remove entirely the stalks and comose appendices from the 
seeds, reduce the seeds to a moderately fine powder, dry the 
powder by exposing for twelve hours to a temperature of 100*^ 
or 120° F., and weigh. Pack in a percolator (the percolator 
being furnished with air valves, or being otherwise so constructed 
that the percolation may be arrested when desired), add ether 
until the whole of the powder is saturated, and a small quantity 
of the ether has dropped into the percolator ; arrest the perco- 
lation for twenty-four hours, and then continue percolating 
slowly until the whole of the ether has been used. If the last 
ether percolate should not be almost colorless, use more ether. 

Remove the powder from the percolator ; expose to the air, 
and break up any lumps after the ether has sufficiently evapo- 
rated ; and continue the exposure, heating the powder, if neces- 
sary, to 100° or 120° F., until all the ether has evaporated, when 
a uniform, nearly white, dry powder may easily be obtained. 

Repack the powder in the percolator, add enough alcohol to 
moisten it thoroughly ; arrest the further flow of the alcohol, and 
macerate for forty-eight hours, and pass alcohol slowly through 
until twenty fluid parts of tincture have been obtained. 

In this process, the preliminary extraction with ether is for the 
purpose of removing the large quantity of inert oil contained in 
the seeds, which, if present in the tincture, would cause it to 
become opalescent on the addition of water. 

The dose of this tincture is from five to ten minims. It may 
also be used in doses of half a minim to two minims, frequently 
repeated. 



is employed in medicine in two forms — sublimed 
Sulphur sulphur and precipitated sulphur, or milk of sul- 
phur. Subhmed sulphur is commonly used. It is 
prepared by fusing virgin sulphur, and conducting the vapor 
into a cool chamber, where it consolidates into bright yellow 
powder without taste or smell. It burns with a blue flame, and 
produces the unpleasant fumes of sulphurous acid. The precipi- 



1424 DISEASE GERMS. 

tated sulphur is pale yellow, and its powder is much finer. The 
preparations of sulphur are a confection and an ointment. The 
confection contains sulphur, cream of tartar, and syrup of orange- 
peel. It is a valuable laxative in piles, or where it is not desired 
to do more than gently open the bowels, as in fissure of the anus, 
or in stricture of the rectum. It is mainly, however, as an exter- 
nal application that sulphur is employed. Sulphur ointment 
still remains the great remedy for the itch, but it is useful in 
other forms of skin disease. Itch is due to a small acarus which 
burrows in the skin and gives rise to the intolerable itching. 
By rubbing the skin thoroughly with any unguent, these bur- 
rows may be broken down ; but something more is required — 
the acarus and its eggs must be destroyed ; this the sulphur or 
the ointment seems to do. It is important before using the sul- 
phur that these burrows should be exposed, and nothing does 
that so well as a good hot bath and an effectual rubbing with 
soft soap. After that a single application of sulphur ointment, if 
well rubbed in, may cure. With delicate skins this plan will not 
do, as a good deal of irritation may be produced. Frequently it 
is enough to use this treatment to certain parts of the body, 
especially the hands, arms and inside of the thighs, where usually 
the crop of eruption is richest. Simple cleanliness may suffice 
for other parts, but usually the ointment should be applred every 
night for a night or two, and only washed off in the morning. 
The clothing must subsequently be disinfected by heat, or the 
malady is prone to return. If there has been much inflamma- 
tion round the spots, a little carbolic acid lotion or ointment may 
be applied. 

Burning sulphur is our great disinfectant and bactericide. Its 
effects in hooping-cough are marvellous. 

It is also highly recommended in tuberculosis by Pro/.R. Khig, 
of Georgia. He recommends the following treatment in the case 
of tuberculous patients. "They should be brought into a room 
into which small quantities of sulphur (one or two drachms) are 
burnt every hour over a spirit lamp or on a stove. At first 
coughing of a more or less aggravated character takes place, and 
after eight or twelve days the bacteria gradually disappears and 
cease to irritate the lung tissue. To complete the cure, the 
patients should be brought into rooms which contain some aro- 
matic vapors." 

Sulphuric Acid is the most powerful of all the acids. It is 
made by burning sulphur, and afterwards oxidizing the sulphur- 
ous acid by the fumes of nitre. Sulphuric acid thus prepared 
is a heavy oily-looking fluid, commonly Icnown as oil of vitriol. 
It is intensely acid, and speedily chars any vegetable substance 



BACTERICIDES. j_l^25 

added to it. Commercial oil of vitriol often contains aiser.ic 
from the use of impure sulphur. The diluted acid is used in two 
forms — as aromatic sulphuric acid, which is flavored by cinna 
mon and ginger, and dilute sulphuric acid, in which water alone 
has been added. The strong sulphuric acid is rarely employed, 
even as a caustic ; it is unmanageable, and less powerful reagents 
are preferred. Internally the aromatic or dilute sulphuric acid is 
mainly used as an astringent. In this way it is of much service 
in the wasting sweats of consumption ; and it may be of service 
where there is a chronic mucous discharge from the bowels. It 
is also of importance as an astringent in diarrhea, especially if 
combined with opium. The ordinary dose of dilute or aromatic 
sulphuric acid is about ten or fifteen drops, well diluted with 
water, or some such vehicle. In diarrhea that quantity ought to 
be given with as much laudanum, if irritating substances have 
been expelled. 

StilphiLrous Acid is a remedy of some importance. It may be 
prepared in a variety of ways, but it is most commonly obtained 
by reducing sulphuric acids by means of charcoal. It is most 
easily prepared by burning sulphur in the open air. It has the 
well-known odor of burning sulphur. Sulphurous acid is a pow- 
erful deoxidizing reagent, and is powerfulh' destructive of vege- 
table life. Applied to the skin it causes some reddening ; and 
if any vegetable parasite is present, as is not unfrequently the 
case in skin disease, it is destroyed. Hence arises its value in 
such maladies. Internally, if there is any tendency to fermenta- 
tion, and if fungi are present in the stomach, it does great good. 
Used as spray in certain forms of sore throat, sulphurous acid is 
also of great use. It ma\' be freely applied, and- subsequently 
used somewhat diluted as a gargle. Sulphates and hydro-sul- 
phates, especially of soda, are frequently given internally in its 
stead. 

Glycei'itc of Sulphur ozonized. — This combination of sulphur 
with ozone possesses most remarkable, energetic germicidal pro- 
perties, so much so that when administered internally it is most 
destructive to all microbes in the blood and tissues. 

Its use is specially indicated in diphtheria, hooping-cough, 
cerebro-spinal meningitis, • small-pox, scarlet fever, erysipelas, 
rheumatism, etc., whenever disease germs are present in the 
vitiated secretions of the body. 

To the streptococcus of diphtheria it is a decided specific, kill- 
ing and sterilizing the germ and its micrococci. 

Dose: From one-half to one teaspoonful to be taken every 
hour or more frequent. The dose varies with the age of the 
patient and the intensity of germ development. As microbes are 
90 



I J, 26 DISEASi: GERMS. 

killed off or sterilized, which will be known b\' the amelioration 
of symptoms, the size and frequency of dose should be gradually 
less. 

Coffip. SulpJnir Loze7iges Ozonized. — (i.) The results obtained 
from large cHnical practice are derived from the administra- 
tion of very small doses of sulphur continued for a lengthened 
period of time, the dose being much smaller than those hitherto 
employed, often not exceeding five grains each day, and the time 
of exhibition much longer, namely : weeks, months, and in some 
cases, years. (2,) A lozenge named the Compound Sulphur 
Lozenge, containing five grains of sulphur, and one of cream of 
tartar, was usually prescribed, as being very convenient, and by 
no means unpleasant in taste, and it was found that patients 
could be readily induced to persevere in using them for an almost 
indefinite time. (3.) The physiological effects of these minute 
doses of sulphur are observed upon the alimentary canal and the 
organs connected with it, also on the pulmonary mucous mem- 
brane and the skin. (4.) Sulphur is not an element foreign to 
the system, as it is contained in the most important proximate 
principles of the blood and flesh, and likewise of the bile and 
saliva. Dose : one or two at bed-time. 

Sulphur water, has been recognized as a valuable 

germicide, disinfectant and parasiticide. As a local 

remedy in all skin affection it is unexcelled, being 

inimical to all microbe existence. It is essentially 

destructive to the micro-organisms present in 

malignant and sore throat, scarlet fever, laryngeal 

diphtheria, croup, influenza, tonsillitis, either in- 

The Bacillus of tcmally or locally applied ; while in typhoid and 

su p ur water. Qt;her fevers, by its use, we diminish both their 

seventy and duration. 

PI Recognizing its potent germicidal action upon nearly every 
form of microscopic life, it has a most extensive range of action, 
If administered in gastric catarrh (sarcinae ventriculi), it ef- 
fectually kills the fungus or microbe, provided fluids entering the 
stomach are limited. Concentration of fluids hinder, and dilu- 
tion favors the growth of the sarcinae. Because dilution favors 
movement of molecules, hence promotes the catalytic action of 
the germ. 

Concentration of fluids retard mobility ; all germs in a state of 
activity are endowed with motion ; whatever hinders motion re- 
tards germ evolution. 

The hybrid microbe of tuberculae in all forms of lupus is para- 
lyzed in the presence of sulphur water, nay, further, it is rendered 
incapable of existence. 




BACTERICIDES. 



1427 



In all cryptogamic affections of the skin, as the different forms 
of tenia ; as well as in those obstinate squamous forms lepra, 
psoriasis, it is of the greatest efficacy. 

Even in those giant forms of microbial disease, syphilis, can- 
cer, tubercle, its occasional use is of great service. 

Besides its innate germicidal properties, it has a powerful stimu- 
lating action upon the powers of life. 

In the preparation of sulphur water, before and after it is ozo- 
nized, there is a remarkable bacillus found in it and the more 
numerous they are, in it, the more energetic it is as a microbi- 
cide. 

The leading physician in Wilmington, Delaware, speaking of 
sulphur water in the treatment of epidemic typhoid fever which 
is so common in that city, says : '* Nearly all the physicians made 
use of sulphur water in alternation with an infusion of kaki. 
All were m.uch impressed with the success of the remedies. 
During their administration, heat, respirations and pulse were 
lowered and the onward progress of definite germ evolution cut 
short. 

AH were well marked, typical cases of typhoid. The sulphur 
water was administered in half teaspoonful doses every hour or 
two hours in water. It is assimilated rapidly, improvement is 
progressive, the growth, sprouting, or multiplication of the germ 
is checked by its germicide action. The drink, infusion of kaki, 
as well as the sulphur water, should 
be continued to convalescence." 

By the use of germicides in typhoid 
we stamp out its very existence, and 
its formidable sequelae, besides saving 
the patient and sterilizing his blood. 
No nurse, no washerwoman, no dear 
friend can suffer from the perform- 
ance of their duties, as the contagium 
vivnni is wiped out. 









Sumach. 



The mother tincture 

of the green leaves and 

ripe berries of this sim- 
ple herb are most powerful germi- 
cides, and also parasiticides. It has 
the potency of killing the crypto- 
gamic growths which embrace the 
entire family of tinea, and thus cures those obstinate skin affec- 
tions ; it is destructive to the bacteria of boils and erysipelas, 
and to the vibrios of nervous affections ; hence its utility in 
cases of paralysis, amaurosis, chronic rheumatism. 




1428 



DISEASE GERMS. 



The dried leaves and berries, ground, made into a decoction, 
sweetened, make an excellent drink in fevers ; lower heat, pulse, 
and diminish the respirations by annihilating the germ, the 
contagiiim vivtim ; useful also in all forrns of aphthae, as it 
destroys the oidium albicans on the tongue, gums, lips ; espe- 
cially useful if the germ is active, as will be seen by the diffused 
redness of the parts.' 

is the root of a plant growing somewhere in 

Sumbul, Central Asia. It reaches us mostly by way of 

{Musk Root) Russia, partly also by way of Bombay. Its 

odor resembles that .of musk, and at one time 

was supposed likely to become a valuable remedy. Subsequent 

experience has confirmed this view, and it is now regarded the 

standard remedy in epileptic attacks. 

The peculiar character of the ozonized fluid extract renders it 
a most invaluable preparation of immense utility in both chorea 
and epilepsy if they are in any way associated with disease 
germs. 

Dose : One teaspoonful every three hours or more frequent. 

Thomas L. Barnes, M. D., of Jamestown, N. Y., who is an 

authority on epilepsy, says : " Musk root, ozonized extract, is 

our best remedy in epilepsy ; its pro- 
longed use is curative ; at first dimin- 
ishes the force and frequency of the 
convulsive seizures, and latterly ob- 
literating the pathological condition. 
In order to cleanse the blood of all 
microbes ; while administering the 
musk root, it is invariably a good 
plan to alternate it with small doses 
of ozone water ; later on, avena or 
glycerite of kephaline." 




A tincture of the 
Sweet Flag. root of the acorus 
calamus is a car- 
minative, stimulant, diaphoretic, 
tonic, alterative and antiseptic. It 
forms a very valuable adjunct to all 
prescriptions, such as the following : 
Fluid extract saw palmetto, three 
ounces ; fluid extract damiana, one ounce ; fluid extract nux 
vomica, one drachm ; fluid extract calamus, one ounce. 

Mix. Dose : Half a tablespoonful every four hours, added to 
water. Excellent in genital debility. 



Calamus. 



B ACT EKIC IDES. 



1429 



Fluid extract bayberry, three ounces ; fluid extract calamus, 
one ounce. 

Mix. Dose : One teaspoonful ev^ery four hours, added to warm 
water. Of great efficacy in intestinal catarrh. 



This remedy has acquired quite a reputation 

Tag Alder, as an alterative. Next to the comp. saxifraga, 

it is excellent, prepared as follows: Tag alder, 

yellow dock, bittersweet, comfrey, dandelion — of each' two 

pounds. ; mandrake, blue flag, of each one pound. 

Let all the herbs be good and fresh, (i) Then grind fine and 
mix the articles together ; place the whole twelve pounds in a 
co.nvenient vessel, cover 
them with alcohol of 76 
per cent, and macerate for 
four wrecks. 

Then transfer the whole 
to a displacement appa- 
ratus, and gradually add 
alcohol, until five pints of 
the alcoholic tincture has 
been obtained, which retain 
and set aside. (2) Then 
continue the percolation 
with water as long as it ex- 
hibits a sensible amount of 
medicinal properties with 
an alcoholic taste. (3) Con-' 
tinue the displacement with water until it has no taste. Boil 
down these two solutions (all except the alcoholic tincture), so 
that it will make thirty-two pints. (4) To these two vsolutions 
combined, add thirty-two pounds of refined sugar and dissolve it 
b\\ heat, carefully removing any scum which arises as it comes 
to the point of boiling ; and if it exceeds thirty-six pints, evapo- 
rate to that quantity with constant stirring. Then remove from 
the fire, and when nearly cold add the four pints of reserved 
alcoholic tincture. To the above, when it cools, add two ounces 
of the chlorate of carbon. It is then read\' for use. 




AlJer Tree. 



A valuable diuretic, tonic, Stimulant and parasiti- 

Tansy. cide. The whole plant possesses strong antiseptic 

properties, the pulverized flowers being the part 

generally used. In suppression of urine, due to the presence of 



I430 



DISEASE GERMS. 




micro-organism and funguses in the 
bladder, it is of great utility. 

It is a drug extremely destructi\'e 
to worms, especially the lumbricoides ; 
but its use most be carefully guarded, 
as it is an irritant narcotic. 

The microbicide action of the oil of 
tansy in parasite affections of the skin 
is too much overlooked. Its addition 
to ozone ointment makes it an efficient 
remedy in all forms of tinea. 



Terebintha. 

( Turpentine.) 



Tansy. 

(^Tanacetum Z'ufgare.) 






The pine tree in all 
its different species, 
and in every country 
on the globe, is a 
great natural ozone generator. The 
tree itself, and its oils, extracts, resins, 
all liberate ozone in great abundance. 
The ozonized turpentine for peritonitis has no equal as a local 
ozone generator. 

Spirits of t'urptntine applied 
externally, or administered inter- 
nally, is a great ozone generator 
— germicide. 

There is no organic bodv that 
can absorb so much chemically 
pure ozone gas and retain it as 
turpentine. There is no physi- 
cian that should be without this 
agent. It should be incorpor- 
ated in all poultices where theic 
is no breach of continuity, to 
destroy disease germs, and as a 
local stimulant it is never-failing 
in its action. 

Ozonized turpentine excels in 
therapeutic power, tartar emetic 
ointment in peritonitis. 

Ozonized Tar Syrup. — This is 
one of those medicaments con- 
cerning \vh(jse curative powers 
all physicians, irrespective of 
school, are in full agreement. 
Its action upon all microbes is d'rcct am 




Pine. 



decided — either in 



BACTERICIDES. 1 43 1 

destroying or sterilizing them. All preparations of tar, such as 
antipyrine, antifebrine, kairine, thallin are stable, easily assimilable, 
do their work promptly, and are reliable, effective preparations — 
can be used with precision, and nothing can excel them in 
practical utility in a very large percentage of all diseases. 

Recent modern pathological discoveries have suggested its 
more extended use, on etiological grounds, based upon its action, 
a pure ozone-generating germicide with a clearly defined action 
peculiar to itself. 

The present era in the history of medicine will, as some one 
has aptly expressed it, be known as the antiseptic or germicid'^ 
epoch, and experimental therapeutists everywhere are employed 
in starting " cultures " and testing the anti-microbe power of the 
articles of our Materia Medica. Not satisfied with these, how- 
ever, investigators go still further, and attempt to discover not 
only the drugs which are active, but those whose effects are vir- 
tually negative. An example of this is well represented by a 
recent article from the pen of that brilliant author and scientist, 
Enoch Mather, M. D., of England, in which he calls attention to 
the effect of the oil of turpentine on germs of various kinds. 
His method consisted of taking fresh colonies of the micrococcus 
prodigiosus and staphylococcus aureus. The vessels used were 
carefully sterilized, and agar-agar and gelatine were used as cul- 
ture beds. After some hours, oil of turpentine was applied, and 
its -effects on the life and growth of the germs noted. Under 
these circumstances it was soon evident that the turpentine, 
unless applied in large amounts and for a considerable time, pro- 
duced no effect of sufficient force to enable one to use the drug 
in ordinary everyday life for the purposes of antisepsis. Its irri- 
tant properties, when concentrated, and its loss of the little retard- 
ing power which it possesses on micro-organisms, as regards 
their growth, on dilution, exclude it from use on the tissues of 
the patient, and confine its sphere of value to the instruments 
employed. Certainly, from our present knowledge of the drug, 
we may rest assured that it is only proper to use it as an anti- 
septic when nothing better can be obtained. 

Distillation of the needles of the pine tree, highly ozonized, is 
decidedly an efficient bactericide. The needles of the pine tree, 
teeming with natural ozone, has yielded up its properties to the 
resources of modern chemistry. Its powerful vitalizing and 
germicidal principle has been isolated from the highly ozonifer- 
ous buds, young shoots and needles, suitable for internal admin- 
istration. This elegant preparation has been distilled with the 
greatest care, so that its rich ozoniferous principle is preserve 1. 

An eminent practitioner, /, A. Hendricks, M. D., Sumni^r 



14^2 DISEASE GERMS. 

Hill, Pa., in speaking of this distillation, says: "It is a clear 
ethereal liquid, carefully distilled from the American pine, very 
fragrant, a powerful bactericide^ it is administered internally by 
dropping it on sugar ; used as an inhalant in pulmonary tubercu- 
losis ; for frictions and massage. It does not irritate; a valuable 
remedy in microbial diseases." 

Equal parts of white rosin, sulphur and cream of tartar. Mix. 
Dose: One tablespoonful. in some jelly is a great intestinal 
disinfectant. 

Terebenc. — Pure terebene is strongly recommended in "winter 
cough," chronic bronchitis, emphysema, phthisis, bronchorrh. 
etc. ; in those cases aggravated with a dyspeptic element it con- 
trols the complication at once. It checks the formation of flatus 
so quickly, and is so efficacious in expelling any that may remain 
in the stomach or intestines, that I constantly employ it in cases 
of dyspepsia when flatulence is a prominent symptom. Patients 
like it, and often continue taking it for months or years. It acts 
as an antiseptic, probably much in the same way as glycerine, 
oil of cajeput and oil of eucalyptus. I am surprised that it has 
not come more largely into use in the treatment of flatulence. 
Pure terebene is of such \'alue in winter cough that I rarely ex- 
perience the necessity of resorting to other remedies. It is a 
powerful expectorant, and if inhaled the first thing in the morn- 
ing, when the mucous membranes are covered with thick viscid 
secretion, will give very great relief. Pure terebene is a valuable 
remedy, and will in time come largely into use. 

Terebene is pleasant to take, and has the agreeable odor of 
fresh-sawn pine. The dose is ten drops on a piece of sugar 
three or four times a day. It is so effective that its remedial 
value is apparent in a day or two. 

Dose : Fifteen to thirty drops during the course of the day. 
As it does not mix with water, five or ten drops can be dropped 
on sugar at proper intervals. 

C. Collin, M. D., Middletown, New York, an eminent and 
leading bacteriologist, in his essay on the subject, says that he 
has used terebene for seven years, both internally and as an 
inhalant in phthisi-;, bronchiectasis, chronic bronchitis, and other 
pulmonary complaints characterized by profuse purulent expec- 
toration. " In cases where the trouble has not been of long 
standing, and the symptoms are slight cough, more especiall}^ at 
night ; expectoration moderate in quantity and easily voided ; no 
feting of rawness in the chest, and little or no disturbance of the 
general health, I consider that pure terebene is almost to be 
rnnked as a specific, so quickh' is a cure effected." 

Tcrpiji Hydrate. — Colorless, inodorous, rhombic cr\'stals. 



BACTERICIDES. 



433 



soluble in hot water, alcohol, chloroform and ether; of neutral 
reaction. 

A bactericide of great power, used with great success in all 
microbial disorders of the respiratory organs, kidneys and 
nervous system. 

Terpin hydrate covers all that class of cases in which turpen- 
tine used to be prescribed. Dose : Two grains e\ery three hours. 
Specific for bronchitis. 

Dr. Collin also speaks highly of terpin hydrate. He gi\^es the 
case of a lady suffering from obstinate bronchitis, and says : 
" After two doses (of three grains each) there was already an 
amelioration in my patient's condition ; the cough began to 
loosen ; expectoration became free and easy in consequence of 
elimination by the bronchial mucous membrane; the skin be- 
came soft, moist and natural on palpation ; and there was a 
marked diminution in the bronchial whistling and rales." In 
anoth'fer case — one of catarrhal congestion of the larger bronchi 
— treated as in the preceding case, " there was a notable decrease 
of the mucous rales ab ijiitio, and normal vesicular murmur 
could be distinctly heard in a very few clays after." Other cases, 
such as nasal and pharyngo-laryngeal catarrh from cold, have 
been treated with equal success. ^ In night cough from habit, 
two grains of hydrate of terpin exhibited at bedtime had a 
good, effect. 

Terpinol is prepared from terpin, used in diseases of the 
bladder, and by rectal injection in the same class of diseases 

A very highly ozonized cerate or ointment is prepared from 
the needles, which is one of the most healing agents in the 
Materia Medica. It is an ointment which, being prepared with 
very great care and skill, is pharmaceutically perfect. It pos- 
sesses the curative and antiseptic properties of the pine essence 
in a form suitable for toilet requisite, or as a soothing and heal- 
ing application to excoriated and irritated surfaces. Its efiBcacy 
in obstinate cases of eczema is testified to by hundreds of un- 
solicited testimonials from medical men. As an application to 
ulcers and raw or weeping surfaces general!}' it is probably 
without a rival. 

It is highly spoken of as an adjunct to the massage treatment, 
lubricating the skin and facilitating the necessary manipulation. 

Pine ointment is always well received b}' patients on account 
of its agreeable odor. 

All preparations of the pine tree may be utilized for inhala- 
tion; they are valuable microbicides in bronchitis, pulmonary 
tuberculosis, asthma, catarrh. Valuable remedies to sterilize the 
blood. 



434 



DISEASE GERMS. 



is an antipyretic and germicide of rare value. It is 

Thallin generally employed in the form of a sulphate or 

tartrate, both of which occur in the form of white 

crystalline powder, possessing an aromatic taste and odor, and 

readily soluble in wine or water. 

A very small dose causes a marked reduction in temperature, 
lasting several hours. It is adapted to all ages and degrees of 
strength, may be administered in syrup of prunus virg. The 
urine of all individuals taking thaUin assumes a green or brown 
yellow tint. 

Thallin, either in the form of an injection, or, better still, incor- 
porated into a gelatine bougie and inserted into the urethra laden 
with the gonococcus of gonorrhea, annihilates it at once. One 
application effects in a few minutes what requires weeks, often 
months, to cure. By means of these bougies the remedy is 
carried to the farthest part of the urethra ; the germicide mass 
adheres to the germ-laden urethra, slowly dissolves, and by unin- 
terrupted and immediate contact with the germs destroys them 
most effectually, 

Thallin, combined with papoid, has proved itself efficient in 
digesting cancers. 



An alkaloid analogous 
Theine. to caffeine, of weak basic 
properties, variable quan- 
tities, being found in dii%r€nt grades 
of tea, two to four per cent, in ordinary 
qualities ; very rarely does it exceed six 
per cent, in the best grades. 

The physiological action of theine is 
it diminishes waste or disintegration of 
all the tissues of the body ; under its 
administration metamorphosis is les- 
sened, vital force increased. 

The use of tea is prejudicial to every 
young or middle-aged American ; in 
some cases it is beneficial to the old or 
infirm, but never to people in ordinary 
health. The frequent use of strong tea 
in a highly oxygenized atmosphere like 
ours leads to utter destruction of bodily 
The Tea Plant; and mental vigor. The important alka- 

loid in tea is caffeine, which is the highly 
nitrogenized crystalline principle, occurring in colorless silky 
needles. Caffeine is a stimulant of the medulla and cardiac centres, 




BACTERICIDES. 



1435 



quickens the pulse and respiration, and raises the blood-pressure 
when given in moderate doses. The effects of caffeine "are identical 
with those of digitalis ; slowing of the heart pulsation; augmenta- 
tion of its force of contraction ; diuresis ; no nauseous effects ; no 
cumulative action. This drug, therefore, does not necessitate an 
incessant watchfulness. You can employ it in cardiac cases where 
the kidneys are affected." As to mode of administration. Pure 
caffeine is soluble in from eighty to one hundred parts of water; 
its solubility is increased by acids. I have generally employed 
the citrate, which is freely soluble. It has been objected that it 
is a doubtful salt, but this objection is of small importance if the 
proportions of caffeine and citric acid used in its manufacture are 
definite, the only important function of the acid being to render 
the salt easy of solution. I employ it in from three-grain to five- 
grain doses, dissolved in the ordinary saline mixture ; diluted liq. 
ammonia acttatis. The dose is generally administered three 
times in the day, but in some cases once only. Instead of the 
citrate, the pure caffeine may be employed dissolved in solutions 
of benzoate or salicylate of sodium : in these it dissolves freely, 
and thus a concentrated solution may be made for hypodermic 
injection. The following is a good formula for internal adminis- 
tration : Pure caffeine and benzoate of sodium, of each one 
drachm ; distilled water, six fluid ounces. Half an ounce con- 
tains five grains of pure caffeine. 



A camphoraceous, power- 
Thymol, ful bactericide, derived from 
the oil and resin of various 
plants of the thyme family. The thymus 
serpyllum of America and Europe and the 
ptychotis ajowan of India, yield this prin- 
ciple in greatest abundance. 

The germicidal properties of the oil and 
camphor of thyme are equal if not superior 
to carbolic acid, creosote, peppermint. 

As a bactericide, it has an extensive field 
of action ; its use in all fevers quietens the 
pulse, lowers temperature by killing the 
germ, the factor of the disease ; its use 
sterilizes the sarcinae of dyspepsia, the mi- 
crobe of diarrhea and dysentery; locally, 
in skin affections, it is equal to resorcin, ichthyol, creolin, 
naphthaline ; dissolved in alcohol and applied to rheumatic 
germ-laden joints, it instantly kills the amylobacta, and relief is 
immediate. 




Thymus Serpyllum. 



143^ 



DISEASE GERMS. 



Compound thymol jelly, an infallible bactericide as a dressing 
for wounds, ulcers, most valuable in scarlet fever, small-pox, and 
all other contagious diseases. 

As a disinfectant for the hands, this jelly excels 
in bactericide power, all known remedies. An 
elegant agent in obstetrical practice, and bound to 
come into very general use by all. 



Couch Grass. 



From among the class 
Triticum Repens. of remedies designated 
astringent diuretics, there 
is none that can compare with couch grass ; its 
action upon the kidneys and bladder is much more 
efficient than buchu, uva ursi, queen of the meadow, 
pipsissewa. 

In papilloma of the bladder, with frequent mic- 
turition, it rarely fails to afford immediate relief, 
and in alternation with the oil of thuja, is essen- 
tially curative. 

It is to this remedy, combined with the pichi, 
that the uric acid solvent owes its most valuable 
properties. 

This is the 
Tobacco, most power- 
ful antispas- 
modic, sedative, and germ 
sterilizer in the Materia Medica. Its good 
and* bad effects may be briefly enumer- 
ated : In either smoking or chewing, there 
is no doubt whatever, that its moderate 
daily use disgorges the salivary glands of 
the mouth of all disease germs which may 
have deposited themselves in that region, 
or sterilizes those factors of disease ; it has 
a most disastrous depressing action upon 
the heart muscles, causing cardiac failure ; 
its use paralyzes the base of the brain, im- 
pairing the cerebral faculty of speech, giv- 
ing rise to vertigo, amaurosis, color-blind- 
ness, faintness, prostration. In the drain- 
ing of and vitiating the saliva, it gives rise 
to indigestion ; it prevents salivary secre- 
tion, and the continual blunting of the 
gustatory nerves, which is the predisposing cause of cancer of 
the tongue. 




Virginian Tobacco. 
(Mcofiana tahacunt. 



BACTERICIDES. 



437 



destitute of oxygen, 
tobacco plant, in the 
in combination witii 



Tobacco smoke prevents the development of some micro- 
organisms, and retards or sterilizes others. 

Nicotine (C20H14N2) is one of the natural volatile oily bases 
and constitutes the active principle of the 
leaves, roots, and seeds of which it occurs 
malic and citric acids. It is likewise con- 
tained in the smoke of the burning leaves. It is a colorless, in- 
intensely poisonous liquid, of specific gravity 1.027 ^t 66°, which 
boils at 480°; evolves a very irritating odor of tobacco, especially 
on the application of heat, is very inflammable, and burns with a 
smoky flame. It is moderately soluble in water, and dissolves 
readily in alcohol and ether. If exposed to the air, it absorbs 
oxygen, and becomes brown, and ultimately solid. The quan- 
tity of nicotine in tobacco varies from two to eight per cent"; 
the coarser kinds containing the larger quantity, while '.the best 
Havannah cigars seldom contain more than two per cent , and 
often less. 



Thuja Occidentalis, 



or arbor vitae, 

a highly ozon- 

iferous tree, 
yields a peculiar balsamic resin, which has 
an agreeable smell and high germicidal 
properties. The fluid extract retains all 
those properties in a high degree, but the 
ozonized oil is extremely powerful. It has 
a specially destructive action upon the 
micrococci of warts of all kinds, and its 
use in those affections entirely obviates 
the practice of burning with chromic acid 
or any other caustic. It is quite imma- 
terial what the kind of wart may be, ven- 
ereal warts, single or double, or in masses, 
or those upon the hand, all wither and die 
the moment it is brushed over them— it 
kills the spores or germs in all cases. 
Large masses of venereal warts in the 

vagina disappear after half a dozen applications of this remedy. 
It is a good practice to administer it internally, as well as apply 
it locally. The dose is from twenty to thirty drops in water 
thrice daily. 

The arbor vitae, fluid extract, in six to ten drops, more or less, 
is destructive also to the microbe of variola. It should be admin- 
istered every two or three hours in water. Commence the 
moment the diagnosis is made. 




Arbor Vi 



1438 DISEASE GERMS. 

Thuj.i is one of our best remedies in chronic inflammation of 
the pharyngeal mucous membrane, especially if dark colored. 



The bark of this 
Tulip Tree, beautiful tree yields a 
bitter antiseptic aroma- 
tic, and a glucoside tulipine, which a few 
years ago was quite extensively used 
f )r Peruvian bark. 

More recently tulipine has been used 
in the uric acid diathesis and rheuma- 
tism instead of colchicum, and with 
marvellous success. This is accounted 
for by its action on the liver ; the latter 
organ being the chief one concerned in 
the formation of urea. The tissues in 
their oxidation or disintegration con- 
tribute but little. The chief source is the red blood cells, which 
are broken up in the liver ; the coloring matter goes to form bile 
and urea. 

The glucoside is definite and positive in its action. 




p Tree. 



The nitrate of uranium is of utility in diabetes. 
Uranium. Dose: One-sixth to one-half grain eviery three 
hours. 



Urethan. From fifteen to 
twenty grains sel- 
dom fail in producing the most 
profound refreshing sleep. 



Uva Ursi. 



diuretics, 
is upon 



Its 
the 



This is one 

of the best of 

the astringent 

specific action 

genito-urinary 



tract as a vitalizer, a bracing 

tonic. It is an antilithic, very 

serviceable in all forms of . 

gravel, dissolving and washing 

away from the kidneys and 

bladder small concretions. It UvaUrsi. 

is of great utility in chronic 

nephritis and diabetes ; of great efficacy in enlarged prostate with 

continence or incontinence of urine ; and of appreciable value in 




BACTERICIDES. 



M39 



gleet and leucorrhceal discharges. So energizing on the genital 
organs of the female is the remedy, that many physicians use it 
in labor to induce stronger, more active uterine contractions A 
cry-talline principle is extracted from the leaves, termed " arbu- 
tin," which has a bitter taste, and when placed under the influ- 
ence of dilute acids, separates into glucose and hydrochinon. 
It is soluble in warm water. 

Arbutin is considered a valuable astringent diuretic, and has 
all the properties of the uva ursi in an increased degree — positive, 
definite in action in restoring tone to the bladder and kidneys. 
The dose of the arbutin is from thirty to sixty grains. 



Valerian. 



The root imparts its pro- 
perties to water, alcohol 
and ammonia. It owes its 
medicinal properties to a volatile oil and 
valerianic acid. It is of great efficacy in 
all conditions of reflex irritation, in anae- 
mia of the brain or cord, as witnessed in 
the widespread state of melancholia, inci- 
dental to neurasthenia or nerve exhaus- 
tion. In this affection the triple valerian- 
ates operates like a charm, as in the fol- 
lowing : Valerianate of quinine, of zinc, 
of iron, of each twenty grains. Make 
twenty pills ; one every three hours. 

The American valerian is equal, if not 
superior to the European. It is free from 
the disagreeable odor of the latter ; very 
soothing, allays pain, promotes sleep. The* 
so-called cypripedin is an inert, worthless 
preparation. 

The recent importation of a so-called glucoside of valerian 
from a German house is also of no therapeutic value whatever. 




Valerian. 



American hellebore, in the form of a 
Veratrum Viride. tincture, administered in all fevers and 
inflammations, was the most powerful 
cardiac and cerebral sedative in the Materia Medica. It was of 
special utility in inflammation of the brain and lungs. Modern 
scientists have entirely superseded the use of veratrum viride in 
the practice of medicine by the discovery of such rare remedies 
as antipyrine, antifebrine, kairine, thallin — remedies definite in 



I440 



DISEASE GERMS. 




their action, positive in their 
effects, will lower heat, pulse, 
respiration, and hold the posi- 
tion gained for several hours in 
succession. Much more effi- 
cient in ameliorating suffering 
and curing disease than verat rum 
viride, each and all of them be- 
ing potent active germicides. 

The veratrum viride is a valu- 
able germicide, but as a local 
remedy in erysipelas is entirely 
superseded by the ozonized boro- 
glyceride, still it is a most valu- 
able local remedy to the throat 
in diphtheria. 



Veratrtim Viride. 



able as 
bladder 



A glucoside 
Veronica has been re- 

^_ Beccabunga. cently extract- 

(Brooklime.) ed from this 
plant, which 
has proved itself to be invalu- 
in all lung, kidney, and 



a .^bactericide 
affections. 

The fluid extract has the same properties. 
As the plant is extremely succulent, it yields 
by expression a large quantity of juice, which 
in its fre^sh state is a remarkable efficient alter- 
ative. When administered in this state it com- 
pletely annihilates the bacillus of syphilis and 
'eprosy! 




a most excellent bactericide, also '' 

Vervain, sudorific, tonic, expectorant, dia- Brookiime 

phoretic, and in large doses emetic. 
The juice of the green plant is as effective in expelling tape 
worm as the tannate pelleterin. It is an excellent drug in all the 
eruptive fevers. A few drops of the fluid extract added to warm 
water, make a most excellent, drink ; by its sterilizing action on 
the germs, it lowers heat, diminishes respiration and pulse. 

Vervain, an invaluable germicide, having a very wide range of 
action, being of great utility, both locally and internally — in the 
former to wounds, bruises, ulcers, up to even the aggravated 



BACTERICIDES. 



I44I 




forms of snake bites; in the latter to 
malarial fever, disorders of the stom- 
ach and bowels, and urinary organs. 

For Malarial Fevers. — FJuid ex- 
tract vervain and concentrated tinc- 
ture of kurchicine of each two ounces. 
Mix. One teaspoonful every three 
hours. 

Fluid extract vervain, two ounces ; 
fluid extract stone crop, three ounces ; 
fluid extract leptandra, one ounce. 
Mix. One teaspoonful every three 
hours in gastric debility and intes- 
tinal catarrh. 

Fluid extract vervain, one ounce ; 
uric acid solvent, three ounces. One 
teaspoonful every four hours ; good 
in all bladder and kidney trouble. 



Warburg's 
Tincture. 



Vervain. 



then 
half 

another half an ounce; no drink 
must be allowed, not a drop, as 
it is a pabulum for the germ. The 
formula for this tincture is : aloes 
soc. one pound ; rhubarb, ange- 
lica fruit, confection of democra- 
tis, of each four ounces; elecam- 
pane, saffron, fennel, prepared 
chalk, of each two ounces ; gen- 
tian, zedoary, cubebs, myrrh, 
camphor, agaric, of each one 
ounce. Digest the whole in five 
hundred ounces of alcohol for 
fourteen days, then percolate, 
after which ten ounces of quinine 
is added and dissolved. Dose : 
half an ounce undiluted, every 
three hours. 



three 
an ounce 



Indicated in mala- 
ria ; its administra- 
tion must be pre- 
ceded by a purge ; 
hours before the chill, 
prior to the chili 




Water Plantain. 



Water Plaintain. — The leaves in the green state are highly 
germicidal and, applied to engorged lymphatic glands, sterilize 



1442 



DISEASE GERMS. 



or^ kill the microbes, and thus relieve the engorgement. A 
tincture prepared from the green root is of utility in intestinal 
catarrh, it being destructive to both the gastrc and intestinal 



sarcmae. 



Witch Hazel 

[Hamamelis Virginica), 



an indigenous shrub, from five to fif- 
teen feet high, growing usually on 
hills and stony places, flowers late in 
September, bears a fruit, a nut-like 
capsule, like a hazel 
'.^ nut. The bark has 

a bitter, sweetish 
astringent taste. 
Marvellous results 
have been obtained 
from a distillation 
of the bark, leaves, 
and twigs ; ten 
parts of them to a 
mixtuie of ten of 
alcohol and ninety 
of water. All parts 
of this shrub pos- 
sess similar pro- 
perties. Of great 
efficacy in all hem- 
orrhages, from 
lungs, stomach and 
bowels ; a splendid 
remedy in all rectal 
affections prepared 
from equal parts of 
witch hazel, white 
oak bark and apple 
tree, in ointment 
form. An infusion 
is often valuable in 
incipient phthisis. 
This famous remedy, as an astringent and antiseptic, has ac- 
quired great and deserving repute in all diseases dependent upon 
a relaxed or devitalized condition of the mucous membrane of 
nose, vagina, uterus, bladder, and rectum. As a topical applica- 
tion it destroys germs and promotes healing ; it makes an excel- 
lent wash for sore mouth, ophthalmia, or rectal fissure, or ulcer; 




Witch Hazel. 



BACTERICIDES. 



443 



of rare value in the radical cure of all varicose veins, whether 
they be on the extremities or be varicocele, or piles, etc. The 
internal and local use of the remedy is indicated in all diseases of 
veins and mucous membrane, and in those it effects a cure in 
the most stubborn cases. 



The leaves are the part 
Wormwood, used; a tincture or fluid 
extract administered has 
a well marked influence upon the digestive 
organs, increasing the appetite, promoting 
assimilation. It is also of great value in 
hepatic torpor and in all states of debility- 
dependent upon imperfect digestion or de- 
bility of the stomach. 

It is an anthelmintic, being antagonistic 
to the lumbricoides' and ascarides. Fluid 
extract wormwood, fluid extract coUinsonia. 
of each two ounces ; fluid extract nux vom- 
ica, tincture capsicum, of each two drachms. 
Mix. From a half to one teaspoonful be- 
fore meals, Invaluable in indigestion and 
torpidity of the liver. 




Worm-seed. 



Fluid Extract of 
the Black Willow. 

{Salix Nigra), 



The properties of the black willow 
bark are tonic, carminative, stimulant, 
sedative, anaphrodisiac, astringent, germ- 
icide. Its special properties in both 
sexes are a powerful sexual 
sedative — of ver}' decided value 
in prostatorrhea and spermator- 
rhea — used with marked benefit 
in all cases of nocturnal emis- 
sions, or seminal losses. Its 
action is ver\^ similar to that of 
the bromides, without their de- 
pressing or debilitating proper- 
ties. 

By its peculiar sedative and 
astringent action, it arrests semi- 
nal emissions entirely, but it 
does not. in an}- way, diminish 
virile power or passion. 
Its action is direct upon the genito-urinary organs, upon which 
it.' exercises a benign influence, so much so that menstrual pain 




The Black Willow {Salix Nigra). 
The great sexual sedative. 



1444 DISEASE GERMS. 

and uterine irritability are entirely relieved with it; ovarian 
hyperaesthesia overcome. No case of failure when it is used ; it 
always brings about speedy and lasting relief 

It is indicated specially in spermatorrhea and prostatorriiea 
whenever the seminal or ejaculatory ducts have lost their tone in 
all leakages. 

Dose : From a half to one teaspoonful of salix nigra should 
be taken thrice daily. 

One of England's most celebrated physicians and a specialist 
in genito-urinary diseases, E. Mather, M. D.,oi Masbro, Rother- 
ham, says of the black willow: 

" A sexual sedative of the highest order, administered in from 
half to one drachm doses, three times a day, exceeds in thera- 
peutic power the action of the green root tincture of gelsemium 
and the bromides combined, without any deleterious effect what- 
ever. 

In nocturnal emissions of our drained-dut young men, the drug 
is used with the most marked benefit. The pollutions cease en- 
tirely, virile power and passion are not in the least diminished." 



The prickly ash is a low deciduous tree 
Xanthoxylum. common from Canada to Virginia. It is in 
high repute, both as a diffusible stimulant, as 
a diaphoretic, diuretic and antiseptic. Both 
bark and berries are used. It sterilizes the 
sarcinae, vitalizes the stomach ; has a most 
decided action on the gonococcus in the 
urethra, and if its use is persisted in the 
micro-organism will disappear. 

Of utility in flatulent colic; cholera mor- 
bus ; Asiatic cholera; tympanitis and 
chronic disease of the mucous membrane. 
Xanthoxylum frax. is a powerful vaso- 
motor stimulant. It slows the heart beats 
xanthbxyium Fraxineum. and Strengthens them in a remarkable 
manner. Its action is not confined to the 
vasomotor centre, but extends to the cardiac also. It seems to 
regulate the rhythm of a feeble heart as much through the pres- 
sor nerve. It acts well in adynamic fevers, etc., when the heart 
beats are fast, weak, and the rhythm irregular. Its value in 
some forms of dropsy, especially that originating in heart weak- 
ness and attended with passive hepatic engorgements, is often 
remarkable and when combined with collinsonia does excellent 
service. 




INDEX 



Abdomen, 17. 
Abortion, 18. 
Abscess, 20. 
Acarus foil., 21. 
Acholin, 21. 
Acne, 22. 
Actinomycosis, 22. 
Addison's disease, 25. 
Adenoma, 27. 
Adenitis, 28. 
Adipose tissue, 30. 
Albuminuria, 31. 
Alcoholism. 32. 
Alopecia, 34. 
Amaarosis, 34. 
Amoeba, 3^9. 
Amenorrhea, 37. 
Ammonremia, 39. 
Amyloid degeneration, 4] 
Anasarca, 45. 
Aaiamia, 45. 
Anchylosis, 48. 
Aiicinism, 49. 

cardiac, 51. 

thoracic, 51. 

abdominal, 52. 

nervous, 53. 
Angma pectoris, 53. 
Anthrax, 57, 1 129. 
Aphasia 60. 
Aphonia, 61, 
Aphth?e, 6c. 
Apoplexy, brain, 64. 

spinal, 67. 

pulmonary, 68. 
Ascaris, 69. 
Ascarides, 69. 
Ascites, 70. 
Asphyxia, 71, 521. 
Asthma, 77. 
Ataxia, 81. 
Ataiectasis, 83. 
Atheroma, 84 
Atrophy, 85. 

Bacierium poiri, 392. 
decalvans, 423. 



Bacillus amyloi)acta, 392. 

anthracis, 393. 

cancer, 394. 

indicus, 395. 

m*llei, 395. 

tetanus, 396. 

saprogenes, 396. 

dental caries, 397, 

tuberculosis, 397. 

typhoid fever, 398. 

subtilis, 399. 

syphilis, 4c o. 
Bacteria, 390. 
Balanitis, 89. 
Bites, 91. 
Boils, 92. 
Brass disease, 94. 
Burns, 95. 
Bronchitis, 96. 

chronic, 98, 

senile, 141. 

infant's, lol. 

plastic, 102. 

mechanical, 102. 

microbial, 103. 

hay, 103. 
Bronchocele, 104. 
Bursal swellings, 105. 
Bubo, 105. 
Bullae, 106. 

Calculus, 107. 

biliary, 107. 

prostatic, 109. 

renal, 1 1 r, 
Carcinoma, 114. 
Cancer of anthrax, 121. 

Iip,.i2i. 

breast, 123. 

liver, 129. 

rectum, 130. 

oesophagus. 133. 

palate, 13 . 

pancreas, 134. 

penis, 137/ 

stomach, 138. 

tongue, 139. 



(1445) 



1446 



INDEX. 



Cancer of uterus, 144. 

. vulva, 151, 
Caries, 151. 
Catalepsy, 152. 
Cataract, 154. 
Catarrh, bile duct, 153. 

bladder, 157. 

bronchial, 158. 

gas'.ric, 160. 

intestinal, 166. 

nasal, 167. 

prostate, 170. 

rectum, 172. % 

urethra], 1 180. 

uterine. 174. 

utrine cervix, ij^^- 

vagina. 177. 
Chancre, 1185. 
Chilblain, 178. 
Chlorosis, 178. 
Cholera, 179.' 

infantum, 180. 

morbus, 183. 

epidemic, 184. 
Chordee, 1181. 
Chorea, 188. 
Chyluria, 191. 
Climacteric descites, 191. 
Colic, 228. 
Collapse, 230. 
Coma, 231. 
Concretions, 234. 
Concussions, 235. 
Constipation, 236. 
Contusions, 239. 
Coryza, 239. 
Coup desoleil, 241. 
Cretinism, 242. 
Croup, 243. 
Cyanosis, 244. 
Cysts, 246. 

Deafness, 248. 
Dentition, 527. 
Diabetes, 249. 
Diarrhea, 254. 
Diathesis, 260. 
Diphtheria, 267. 
Dropsy, 279. 
Dysentery, 280. 
Dysmenorrhea, 283. 
Dyspepsia, 288, 

Ecthyma, 292. 
Eczema, 293. 
Elephantiasis, 295. 
Empyema, 296. 
Embolism, 297 
Emphysema, 299. 



Epilepsy, 300. 
Erysipelas, 307. 
Erythema, 308, 
Erythrasma, 309. 

Fatty degeneration, 310. 
heart, 310. 
liver, ^12. 



kidney, 314. 



>I4. 



329- 



;t)8. 



Fa;cal accumulation. 
Fever, 315. 

ephemeral, ^19. 

gastric, 320. 

bilious, 322. 

malarial, 322. 

remittent, 327. 

malignant biliou 

typhoid, 330. 

surgical, 338. 

typhus 339. 

relapsing, 341. 

dengue, 342. 

yellow, 343. 

puerperal, 346. 

hay, 350. 

cerebro-spinal, 35 4. 

eruptive, 355. 

measles, 356. 

scarlet, 359. 

small-pox, 363. 
Filaria sanguinis hominis. 
Fissure, 369. 
Fistula in ano, 371. 

recto-vaginal, 374. 

vesico- vaginal, 375. 
Frost bite, 178. 
Functional disorders, 37b. 
Fungus, aural, 755. 

diabetes, 417. 

yeast, 418. 

Germ diseases, 378. 
Glanders, 424. 
Glaucoma, 427. 
Gleet, 1 1 80. 
Gonorrhea, 1175. 
Gout, 428. 



Hair lip, 531. 
Habits, 434. 

tobacco, 434. 

opium, 435. 

caffeine, 435. 

chloral, 436. 

arsenic, 4 ]6. 
Hemorrhagic temperament, 438. 
Hemorrhage, 438. 

nose, 439- 

kidn.'VS, 441. 



INDKX. 



^447 



Hemorrhage, lungs, 442. 

rectum, 4)2. . 

skin, 443. 

stomach, 444. 

uterine, 445. 
Hemorrhoids, AAl- 
Headache, 454. 
Hemiplegia, 761. 
Hiccough, 457. 
Home-sickness, 458. 
Hooping-cough, 459. 
Hydatids, 462. 
Hydrocele, 466. 
Hydrocephalus, 467. 
Hydrocephaloid disease, 469. 
Hydrothorax, 469. 
Hydrophobia, 469. 
Uypertrophy, breast, 472. 

heart, 473, 

livtr, 474. 

muscles, 475. 

prostate, 475. 

testes, 489. 
Hydrops pericardium, 489. 

Ichorrhsemia, 489. 
Ichthyosis, 490. 
Icterus, 491. 
Impetigo, 492. 
Incontinence of urine, 492. 
Incubus, 746. 
Imperforate anus, 493. 

hymen, 494 
Impotency, 495. 
Infantile diseases, 510. 
Inflammation 538. 

bone, 544. 

periosteum, 545. 

brain, 545. 

membrane of brain, 553. 

bowels, 556. 

bladder, 558. 

breast, 560. 

cellular tissue, 562. 

cornea, 564. 

ear, 564. 

eye, 567. 

heart, 573. 

heart covering, 574. 

iris, 576. 

kidneys, 577. 

larynx, 592. 

liver, 595. 

lungs, 600. 

mouth, 611. 

nails, 612. 

nose, 613. 

rhinitis, 615. 

pericardium. 616. 



Inrianimatiou, o\ary, biS. 
parotid, 621. 
pleura, 621. 
peritonaeum, 624. 
I prostate gland, 628 

rectum 634. 
'] retina, 635. 

stomach, 636. 
spinal cord, 638. 
; testicles, 641. 

tonsils, 643. 
tongue, 645. 
\ uterus. 645. 

j veins, 651. 

I Influenza, 652. 
Injuries, 655. 
Insanity, 656. 
Insomnia, 669. 
Invagination of bowels, 671. 

Keloid, 674. 

: Labor, 840. 
I Leprosy, 675. 

Leucorrhcea. 677. 
j Leucocythema, 678. 
I Lichen, 679, 
j Lupus, 680. 

i Masturbation, 683. 

I Mellituria, 249 

j Menstruation, 689. 

I Mesenterica, 690. 

; Microbe actinomyces, 401. 

I dengue, 416. 

diarrhea, 401. 
j epidemic cholera, 403 

leprosy, 420. 

dysentery, 403. 

influenza, 404. 

boils, 404. 

malaria, 405. 

mumps, 418. 

neurasthenia, 406. 

rhinoscleroma, 421. 

bronchitis, 406. 

croup, 413. 
Micrococcus endocarditis, 407. 

gonorrhea, 407. 

haemophilia, 408. 

measles, 408. 

variola, 408. 

tetragonos, 409. 

typhus, 409. 

urea, 410, 

hooping-cough, 410. 
Moist tetter, 293. 
Molluscum, 692. 



1448 



indp:x. 



Nails, 693. 
Neuralgia, 694. 

breast, 696. 

ear, 697. 

coccyx, 698. 

face, 699. 

kidneys, 599. 

intercostal nerves, 700. 

muscles, 700. 

sciatic, 70 r. 

testes, 703. 
Neurasthenia, 708. 

brain, 710. 

sexual, 719. 
Neurosis, anus, 731. 

aorta, 733. 

bowels, 734. 

brain, 734. 

clitoris, 735. 

genitals, 735. 

heart, 736. 

larynx, 736. 

nose, 738. 

penis. 739. 

prostate, 740. 

sexual sense, 740. 

skin, 742. 

spinal cord, 742. 

vagina, 744. 

general, 745. 
Nightmare, 746. 

Obesity, 747. 
Oidium albicans, 411. 
Old age, 747. 
Olfaction, 751. 
Ophthalmia, 567. 

infantile, 568. 

common, 569. 

purulent, 569. 

gonorrheal, 571. 

tubercular, 571. 

rheumatic, 571. 
Otha-matoma, 753. 
Otomycosis, 755. 
Otorrhcea, 756. 
Oz;vna, 757. 

Papul;^, 759. 
Paralysis, 761. 

paraplegia, 762. 

amyloid, 766. 

mercuric, 766. 

lead, 767. 

agitans, 768. 

infantile, 768. 

wasting, 770. 

rheumatic, 770. 

diphtheric, 770. 



Paralysis, local, 772. 

bladder, 772. 
Paraphimosis, 773, 
Parasites, 774. 

mtestinal, 775. 

ascarides, 776. • 

lumbricoides, 776. 

taenia solum, 777. 

trichiniiie spiralis, 781. 

lice, 784. 

itch, 784 

ringworm, 786. 

liver spot, 789. 

baldness, 791. 

barbers' itch, 791. 
Pemphigus, 793. 
Perineal pressure, 795. 
Perversion of sexual sense, 797. 
Phimosis, 802, 
Phlegmasia, dolens, 803. 
Phospliorus disease, 803. 
Piarrhasmia, 804. 
Pityriasis, 805. 
Peptonuria, 805, 
Petechia, 806. 
Phrenal syphilis, 1190. 
Pneumococcus, 391. 
Pneumothorax, 806. 
Poison, 807, 824. 
Polypus, 808. 

aural, 809. 

nasal, 812. 

pharyngeal, 816. 

rectal, 817. 

umbilical, 820. 

uterus, 821. 

urethra, 824. 
Polyuria, 825. 
Porrigi decalvans, 826, 
Pregnancy, 828, 
Presentations in labor, 840. 
Priapism, 862. 
Prolapse of mesentery, 862. 

rectum, 864. 

uterus, 8c6. 

vagina, 869. 
Prostatorrhoea, 870. 
Pruritis, 872. 
Prurigo, 875. 
Psilosis, 875. 
Psoriasis, 875. 

lingua, 876. 
Pterygium, 878. 
Ptomaines, 879. 
Purpura, 883. 
Pyoemia, 884. 

Rabies, 886. 
Races, 888. 



INDEX. 



449 



Railway^ 896. 
Ranula', 897. 
Rectum, 897. 
Rectal medical, 898. 
Reflex irritation, 899. 
Respiration, S99- 
Rigor mortis, 904. 
Retching, 905. 
Rheumatism, 906. 
Rhinoscleroma, 917. 
Roseola, 918. 
Rupia, 919. 
Rupture of heart, 919. 

muscle, 919. 

hernia, 920. 

inguinal, 927. 

femoral, 928 

umbilical, 929. 

uterus, 929. 

Sanitarv' science, 930. 
Sarcina ventriculi, 418, 

intestinal, 419. 

uicrine, 419. 
Scurvy, 955. 
Scythianas, 795. 
Sea sickness, 956. 
Seminal vesicles, 959. 
Sight, 961. 
Sleep, 964. 
Sore throat, 965. 
Spasms, 966. 

bladder, 967. 

rectum, 968. 
Spermatorrhoea, 969. 
Spermatozoa, 977. 
Spinal, 979. 
Spirillum plicatile, 41 1. 

relapsing fever, 412. 
Sprains, 982. 
Stammering, 983. 
Staphyloma. 984. 
Sterility, 985. 
Stertorous breathing, 991. 
Strabismus, 992. 
Stryptococcus of diphtheria, 412. 

cerebro-spinal meningitis, 413. 

erysipelas, 413. 

foot disease, 414. 

pyogenes, 415. 

puerperal fever, 415. 

yellow, 416. 

periostitis, 416. 

rabies, 417. 
Stricture of oesophagus, 995. 

rectum, 995. 

urethra, 997. 
Styes, 1 001. 
Suicide, looi. 



Sweat, 1003. 
Syncope, 1004. 
Synovia, 1004. 
Syphilis, phrenal, 1 190. 
Temperaments, 1005. 
Tetanus, 1006. 
Thrombosis, loio. 
Tongue, loii. 
Tonsils, 1014. 
Toothache, 1 01 5. 
Tuberculosis, 10 16. 
Tubercle in lung, io2i. 

nose, 1039. 

larynx, 1039. 

bowels, 1041. 

peritoneum, 1044. 

mesentery, 1045. 

bladder, 1047. 

rectum, 1049. 

prostate, 1051. 

testes, 1052. 

eye and ear, 1052. 

skin, 1053. 

bone, 1055, 1057. 

spine, 1061. 

hip-joint, 1067. 

knee-joint, 1069. 

wrist-joint, 107 1. 
Tumors, 1093. 

fibroma, 1094. 

myxoma, 1097. 

chondroma, 1103. 

osteoma, 1103, 

lymphoma, 1104. 

sarcoma, 1105. 

myoma, 1108. 

neuroma, 1 109. 

angioma, mo, 

papilloma, 1113. 

adenoma, 1115. 

mixed, 11 17. 
Ulcers, 1 1 21. 

cutaneous, 1121. 

healthy, 11 23. 

irritable, 1123. 
j indolent, 1124. 

tubercular, 11 24, 

varicose, 1125. 

fistulous, 1 1 25. 

phagedenic, 1126. 

bed sores, 1127. 

gangrenous, 11 27. 

hospital gangrene, 11 27. 

syphilitic, 1 1 28. 

malignant, anthrax, 1129. 

gastric, 1 1 29. 
, of the larynx, 11 34. 

diphtheric, 1 1 35. 

on the rectum, 1136, 1141, 



45C 



INDEX, 



Ulcers on the neck of uterus, 1142. 

on the vulva, 1148. 
Ursereiia, i [49. 
Urine, 1150. 
Urticaria, 1165. 

Vaginal medication, I168. 
Varix, 1 1 69. 
Varicocele, 1171. 
Venereal disease, 11 74. 
bacillus, 1 1 83. 

in the eye, 1189. 

in the brain, 1190. 

in offspring, 1195. 

in the liver. 1 197. 



Venereal bacillus in the lungs, 1198. 

in the lymphatics, 1202. 

in urethra and vagina, 1 202. 

in nasal cavity, 1 204. 

in the skin, 1206. 

in the trachea, 1217. 

on the tongue, 1219. 
Vertigo, 1219. 

Vasico-urethral erethism, 1222. 
Vulva, shrinking, 1224 

Warts, 1225. 

Wasting disease, 1227, 

Xeroderma, 1227. 



BACTERICIDES. 



Abnis Precatorius, 1 229. 
Acacia, 1231. 
Acetic Acid, 1231. 
Achillea, 1232. 
Aconitine, 1232. 
Acta Racemosa, 1233. 
Adahatoda Vasica, 1 234. 
Adonidin, 1234. 
Agaric Acid, 1234. 
Agrimony, 1235. 
Aleteris Farinosa, 1236, 
Alkanet, 1237. 
Alnus Niger, 1237. 
Althaa, 1238, 
Aloe, 1238. 
Alum, 1238. 
Aluminum, 1239. 
Acetate of Aluminum, 1 239. 
Alvelos Milk, 1239 
Amaranthus, 1240. 
Ammonia, 1240. 
Amylene Hydrate, 1241. 
Anagallis Arvensis, 1241, 
Andromeda Polyfolia, 1242, 
Anemone Nemorosa. 1242. 
Angelica, 1242. 
Antefebrine, 1243. 
Antimicrobe Pov*rder. 1244. 
Antipyretics, 1245. 
Apocynum, 1247. 
Apiol, 1247. 
Arnica, 1247. 
Arnotto, 1248. 
Arsenic, 1248. 
Arum Triphyllum, 124(>„ 
Asclepias, 1249. 
Aseptol, 1249. 



Asparagus, 1250. 
Aspidospermine, 1250. 
American Ash, 1251. 

Balsam Copaiba, 1251. 
Balsam of Peru, 1252. 
Balm Melissa, 1252. 
Bay berry, 1253. 
Benzoin, 1253. 
Berberis Vulgaris, 1254 
Belladonna, 1255. 
Betin, 1255, 
Bismuth, 1256. 
Bistort, 1257. 
Bittersweet, 1257. 
Bladder- Wrack, 1258. 
Bloodroot, 1258. 
Blue Cohosh, 1259. 
Boldo, 1259. 
Boroglyceride, 1260. 
Bryonia, 1263. 
Burdock, 1264. 

Cadmium, 1264. 
Calabar Bean, 1264. 
Cajeput Oil, 1264, 
Calcium, 1265. 
Camphor, 1266. 
Campho-Phenique, 1267. 
Cannabis Sativa, 1267. 
Capsicum, 1268. 
Cardamom Seeds, 1269. 
Carbolic Acid, 1270. 
Caraway, 1270. 
Carbonic Acid Gas. 1271 
Caroba, 1271. 
Can-ageen, 1272. 



INDEX. 



145 I 



Cascara Sagrada, 1 272. 

Cassia Alata, 1273. 

Celona Glabra, 1274. 

Centaury. 1 274. 

Cerastinum Vulgatum, 1273. 

Cerebrin, 1275. 

Cerium, 1275. 

Cinchona, 1275. 

Cinnamon, 1276. 

Camomile, 1277. 

Chelidonium, 1278. 

Charcoal, 1278. 

Chaulmogra Oil, 1279. 

Chrysarobin, 1 280. 

Chian Turpentine, 1 281. 

Chinoline Salicylate Tartrate, 1281. 

Chionanthus Virginica, 1281, 

Chloral Hydrate, 1282. 

Croton Chloral Hydrate, 1282, 

Chloralamid, 1282. 

Chlorine Water, 1283. 

Chloride of Chromium, 1283. 

Clover, 1284. 

Coca Erythroxylon, 1 285. 

Cocculus Indicus, 1288. 

Cochlearia Officinalis, 1288. 

Coca Theobroma, 128Q, 

Coffee, 1289. 

Columbo, American, 1290. 

Colchicum, 1291. 

Collinsonia Canadensis, 1 292. 

Collodion, 1293. 

Colt's-Foot, 1294. 

Comfrey, 1294. 

Convolvulus Panduratus, 1 295, 

Concentrated Ozone, 1295. 

Cendurango Bark, 1295. 

Conium. 1296. 

Convallamarin, 1296. 

Croton, 1297. 

Corallorhiza Odontorhiza, 1297. 

Corn Smut, 1298. 

Cotton Root, 1298. 

Coumarin, 1299. 

Creatine, 1299. 

Creosote. 1300, 

Creolin, 1301. 

Cuphea Viscasissima, 126?!., 

Curare Sulphate, 1303. 

Cyclamen. 1304. 

1 
Damiana, 1304. 
Digitalis, 1305. 
Dogwood, 1305. 
Drosera, 1306. 

Eggs, 1306. 
Eiaterium, 1306. 
Elecampane, 1307. 



Elder, 1308. 

Elm Bark, 1308. 

Ephilobium Angustifolium, 1309 

Erigeron Canadensis, 1309. 

Ergot, 1 310. 

Erythronium Americanum, 1313 

Eryngium, 131 1. 

Eschohltzia Californica, 1312. 

Eucalyptus, 131 2. 

Euphorbia Pilulifera, 1314. 

Euphrasia, 1 3 14. 

Eupatoreum Purpureum, 1315. 

Exalgine, 131 5. 

Fennel, 1316. 
Fumarine, 131 7. 

Gaultheria, 131 7. 
Gelsemium, 131 8. 
Gentian, 1320. 
Geranium, 1320. 
Ginger, 1322. 
Gillenia Trifoliata, 1322. 
Glycerine, 1323, 
Glycerite of Ozone, 1326. • 
Guttapercha, 1327, 
Gold Chloride et Soda, 1328. 
Grindeha Robusta, 1329. 
Guiacum, 1329. 

Helianthus, 1330. 
Hepatica, 1330. 
Hindoo Bitters, 1349, 
Hoang Nan, 1330. 
Hound's Tongue, 1331. 
Hops, 1 33 1. 
Horse-Chestnut, 1332. 
Hyssop, 1333. 
Hydrastis Canadensis, 1333. 
Hydrocotyle Asiatica, 1334. 
Hydronapthol, 1335. 

Ichthyol, 1336. 
Ingluvin, 1337. 
Indigo, 1338. 
Ipecac, 1338. 
Iodine, 1339. 

Jaborandi, 1342. 
Jalap, 1343. 

Jamaica Dog^vood, 1345. 
Jambul, 1344. 
Juniper, 1345. 

Kaki, 1345. 
Kalmia, 1346. 
Kava-Kava, 1346. 
Kola Nut, 1347. 



1452 



INDEX 



Koussa, 1349. 
Kurchicine, 1349. 

Lactic Acid, 1350. 
Lochnantes Tinctoria, 1352. 
Lactose, 1352. 
Lactucarium, 1353. 
Lavender, 1353. 
Lemon, 1354. 
Leplandra, 1355. 
Licorice, 1355. 
Lic|uid Ozone, 1356. 
Lithia, 1357. 
Lobelia, 1357. 
Lycopodium, 1358. 
Lycopus, 1358. 

Male Fern, 1359. 
Manaca, 1359. 
Marjoram, 1 360. 
Marrubium, 1360, 
Menthol, 1361. 
Miidar Bark, 1362. 
Marigold, 1362. 
Menyanthis Trifoliala, 1363. 
Mexican Ointment, 1363, 
Mitchella Repens, 1363. 
Mulberry, 1364. 
Maranta, 1354. 
Mistletoe, 1365. 
Muira Puama, 1366, 
Mullein, 1366. 
Myrrh, 1367. 
Myrtle, 1367. 

Napththaline, 1368. 
Nitrite of Amyl, 1370. 
Nutmeg, 1372. 
Nux Vomica, 1373. 
Nymph ae Odorata, 1373. 

Ginanthe Crocata, 1374- 
Obstetric Cones, 1375. 
Oxygen, Compound, 1376. 
Ozonized Uric Acid Solvent, 1377. 
Ozone et Chlorine, 1378. 
Ozonized Syrup of Tar, 1380. 
Ozone Tablet, 1380. 
Ozonized Clay, 1380. 
Ozone Water, 1380. 
Ozone Paste, 1381. 
Ozone Ointment,* 1 381. 

Papoid, 1382. 
Paraldehyde, 1383. 
Passiflora lucarnata, 1 384. 
Pastiles, 1385. 
Peppermint, 1385, 
Pellitory, 1385. 



Pennyroyal, 1386. 

Pepsin, 1386. 

Permanganate Potassa, 1387. 

Pichi, 1388. 

Peroxide of Hydrogen, 1388. 

Phenacetine, 1390. 

Phlorizin, 1390. 

Phytolacca, 1390. 

Platinum Chloride, 1390. 

Pimento, 1390. 

Phospi ated Tincture of Oats, 1391. 

Plantain, 1393. 

Pomegranate, 1393. 

Pelleterin, 1394. 

Poplar, 1394. 

Protagon, 1395. 

Prunia, I395. 

Pulsatilla, 1396. 

Pyriden, 1396. 

Pyrodin, 1396. 

Raspberry, 1397. 
Resorcin, 1397. 
Rhigolene, 1399. 
Rhus Aromatica, 1399, 
Rue, 1400. 

Saccharin, 1400, 

Salol, 1401. 

Salicylate of Soda, 1403. 

Santonin, 1403. 

Sandal Wood, 1404. 

Saponaria Officinalis, 1404. 

Savin, 1405. 

Saw Palmetto, 1405. 

Saxifraga, 1406, 

Skullcap, 1407, . 

Senega Root, 1408. 

Serpentaria, 1408. 

SiegCbbeckie Orientalis, 1409. 

Silico- Fluoride of Soda, I411. 

Simibicidia, 141 1. 

Simulo, 1412. 

Soldago, 1413. 

Sozoidol, 1 34 1. 

Speedwell, 141 3. 

Solanin, 1414. 

Spikenard, 1414. 

Sulphate Sparteine, 141 5. 

Staph isagria, 141 6. 

Stillingia Sylvatica,»i4i7. 

Stramonium, 141 9. 

Storax, 14 1 9. 

Sulfonal, 1420. 

Sulpho-Carbolate of Sodium, 1420. 

Sulpho-Carbol, 1421. 

Soluble Gelatine Urethral Hougies, 

Strophanthus, 1 42 1. 

Sulphur, 1423. 



[421. 



INDEX. 



H53 



Sumach, 1427. 
Sumbul, 1428, 
Street Flag, 1428. 



Tag Alder, 1429. 
Tansy, 1429. 
Terebintha, 1430. 
Tcrpin Hydrate, 1432. 
Terpinol, 1433. 
Thallin, 1434, 
Tbeine. 1434. 
Thymol, 1435. 
Thio-Resorcin, 1398. 
Triticum Repens, 1436. 
Twbacco, 1436. 



Thuja Occidentalis, 1437. 

Tulip Tree, 1438. 

Uranium, 1438. 

Urethran, 1438. 

Uva Ursi, 1438. 

Valerian, 1439. 

Veratrum Viride, 1439. 

Veronica Beccabunga, 1440. 

Vervain, 1440. 

Virginia Stone Crop, 141 7. 

Warburg's Tincture, 1441. 

Water Plantain, 1 44 1. 

Witch Hazel, 1442. 

Wormwood, 1443. 

Willow, Black, Fluid Extract, 1443. 

Xanthoxylum, 1444. 



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